Shoulder Mobilizations
Anterior-Posterior GH Mobilization
(High Grade)
• Position pt. supine with humerus to be mobilized at the edge
of the table
• PT to stabilize the pt.’s distal extremity, while placing other
hand over the anterior proximal humerus
• PT then provides a force in an A-P direction, starting with
grade 1 and working up to grade 4 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob for 3
seconds
• Note: The pt.’s arm should be abducted to the barrier in
motion OR to the pt.’s first point of pain, but then backed off
until pain free (if taken to the point of pain, the force
generated by the PT should be less then if no pain present)
Anterior-Posterior GH Mobilization
A-P GH Mobilization (Low Grade)
• Position pt. supine with humerus to be mobilized at the
edge of the table, pt.’s forearm and hand resting on their
stomach
• PT will use both hands (fingertips on anterior humeral
head and thumbs on posterior humeral head)
• PT then provides a force in an A-P direction, starting with
grade 1 and working up to grade 3 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob
for 3 seconds
A-P GH mobilization (Low Grade)
AC A-P Mobilization
• Pt. lies supine with side to be mobilized towards the edge
of the table
• PT places one hand under the shoulder, over the scapula
to stabilize it – The pisiform of the other hand is placed
directly over the distal end of the clavicle at the AC jt.,
perpendicular to the table so the force is directed
straight down
• PT then provides a force in an A-P direction, starting with
grade 1 and working up to grade 4 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob
for 3 seconds
AC A-P Mobilization
AC Inferior Mobilization
• Pt. positioned supine with arms at the side
• PT sits at the head of the pt. with both thumbs
positioned over the superior surface of the distal
clavicle, adjacent to the AC Jt.
• PT then provides a force in an superior to inferior
direction, starting with grade 1 and working up to
grade 4 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each
mob for 3 seconds
AC Inferior Mobilization
Inferior GH Glide in Abduction
• Pt. lies supine with side to be mobilized towards the edge of the
table, arm abducted off the side of the table
• Pt.’s neck is laterally flexed toward the side receiving the mob (to
slacken the nerves)
• PT stands in lunge position superiorly to the pt.’s shoulder: one
hand grasps around pt.’s elbow (holding it in slight flexion), the web
space of the other hand is around the proximal humerus
• PT then provides a force to the proximal humerus in an inferior
direction, while simultaneously abducting further starting with
grade 1 and working up to grade 4 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob for 3
seconds
• Note: The pt.’s arm should be abducted to the barrier in motion OR
to the pt.’s first point of pain, but then backed off until pain free (if
taken to the point of pain, the force generated by the PT should
cause no more than minor discomfort)
Inferior GH Glide in Abduction
Inferior GH Glide in Flexion
• Pt. lies supine with side to be mobilized towards the edge of the
table
• PT stands in lunge position superiorly to the pt.’s shoulder: one
hand grasps around pt.’s distal humerus (holding the elbow in 90
degrees flexion), the web space of the other hand is around the
proximal humerus
• PT then provides a force to the proximal humerus in an inferior
direction, while simultaneously flexing further starting with grade 1
and working up to grade 4 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob for 3
seconds
• Note: The pt.’s arm should be flexed to the barrier in motion OR to
the pt.’s first point of pain, but then backed off until pain free (if
taken to the point of pain, the force generated by the PT should
cause no more than minor discomfort)
Inferior GH Glide in Flexion
Clavicle Rotation
• Pt. positioned supine with arms at the side
• Stand near the pt.’s shoulder, facing towards the
clavicle
• Gently grip the middle of the clavicle using your
thumbs on the inferior surface and fingertips on the
superior surface
• Apply a gentile mobilization force using a rocking or
“wiggling” motion through repetitive wrist flexion
and extension to impart rotation of the clavicle on its
long axis
• Parameters: 8-10 reps each grade (up to grade 3)
Clavicle Rotation
FABER P-A mobilization
• Pt. starts prone with arm to be mobilized flexed, abducted,
and ER (Forehead resting on the dorsum of the hand)
• PT stands by the head of the pt. on the side to be mobilized.
PT places the thumbs and web spaces of both hands on the
posterior proximal humerus, fingers are wrapped around the
anterior surface
• PT then provides a P-A force starting with grade 1 and
working up to grade 4 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob for 3
seconds
• Note: The pt.’s arm should be flexed/Abd to the barrier in
motion OR to the pt.’s first point of pain, but then backed off
until pain free (if taken to the point of pain, the force
generated by the PT should cause no more than minor
discomfort)
FABER P-A mobilization
GH External Rotation
• Pt. lies supine with side to be mobilized towards the edge of
the table, arm is abducted up to 90 degrees (as pt. can
tolerate) and elbow is flexed to 90 degrees
• PT stands facing the pt.’s head and stabilizes the pt.’s elbow
with one hand, while grasping the wrist with the other (grasp
bony prominences at the elbow and wrist)
• PT slowly externally rotates the pt.’s shoulder until pt.
discomfort or tissue resistance is met; hold for 3-5 seconds
and then back off.
• Repeat up to 30x, and try to move the shoulder a little further
each time as the tissues relax.
* Note: Encourage the pt. to completely relax as much as
possible!
GH External Rotation
GH Internal Rotation
• Pt. lies supine with side to be mobilized towards the edge of the
table, arm is abducted up to 90 degrees (as pt. can tolerate) and
elbow is flexed to 90 degrees
• PT stands facing the pt.’s feet and stabilizes the pt.’s elbow with
one hand, while grasping the wrist with the other (grasp bony
prominences at the elbow and wrist)
– Note: May have to stabilize the pt.’s shoulder girdle instead of holding
at elbow if compensation occurs
• PT slowly internally rotates the pt.’s shoulder until pt. discomfort
or tissue resistance is met; hold for 3-5 seconds and then back
off.
• Repeat up to 30x, and try to move the shoulder a little further
each time as the tissues relax.
* Note: Encourage the pt. to completely relax as much as
possible!
GH Internal Rotation
GH Horizontal Adduction
• Pt. lies supine on the table with the uninvolved side toward the edge of
the table; Pt.’s involved arm is place in 80-90 degrees of shoulder flexion
and 90 degrees of elbow flexion
• PT stands on pt.’s uninvolved side, facing the pt. PT grasps the pt.’s
involved side at the posterior/medial elbow, and uses the heel of the
other hand to stabilize the pt.’s scapula
• The technique involves first stabilizing the scapula and then horizontally
adduct the shoulder until the barrier is felt. Once the barrier is felt, PT
then provides a posterior force starting with grade 1 and working up to
grade 4 as pt. tolerates. As motion is gained, horizontally adduct the
shoulder further until a new barrier is felt
• Parameters: 8-10 reps (at each grade) – hold each mob for 3 seconds
* Note: Be careful not to flex the pt.’s shoulder past 90 degrees to avoid
creating an impingement at the shoulder
GH Horizontal Adduction
GH Longitudinal Distraction
• Pt. lies supine with the shoulder to receive treatment at
the edge of the treatment table
• PT stands on the side to receive treatment, facing
towards the pt.’s head. Stabilize the pt.’s forearm against
the PT’s side. PT’s medial arm cups the middle to
proximal humerus and lateral arm cups laterally around
the humeral head.
• The PT gently distracts the humerus by pulling toward
their body, imparting an oscillatory force (30-50x) once
distracted.
*Note: Make sure the PT moves his whole body to
provide the distraction force, do not just pull with
arms
GH Longitudinal Distraction
P-A GH Mobilization
• Pt. lies prone with arm to be mobilized toward the edge of
the table in 90 degrees of abduction (off the table), elbow
flexed with some glenohumeral internal rotation.
• PT grasps the pt.’s distal humerus, allowing forearm to
hang down toward the ground. Heel of proximal hand is
placed against the posterior humeral head with elbow
locked.
• PT then provides a P-A force by moving their body/trunk
down through their locked out elbow, starting with grade 1
and working up to grade 4 as pt. tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob for
3 seconds
P-A GH Mobilization
Scapular Elevation-Depression
• Pt. is sidelying (facing the PT) with shoulder and elbow
flexed and forearm resting on clinician’s forearm
• PT: Lower hand is placed around the inferior angle of
the scapula with the thumb and forefinger along lateral
and medial scapula borders. Upper hand grasps the
spine of the scapula, cupping the heel of the hand
anteriorly over the clavicle
• PT mobilizes scapula superior and inferior by using
trunk to provide the key force through the arms. PT
starts with grade 1 and works up to grade 4 as pt.
tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob
for 3 seconds
*Note: Pt. must completely relax scapula musculature.
Scapular Elevation-Depression
Scapular Protraction - Retraction
• Pt. is sidelying (facing the PT) with shoulder and elbow
flexed and forearm resting on clinician’s forearm
• PT: Lower hand is placed around the inferior angle of the
scapula with the thumb and forefinger along lateral and
medial scapula borders. Upper hand grasps the spine of
the scapula, cupping the heel of the hand anteriorly over
the clavicle
• PT mobilizes scapula medially and laterally by using
trunk to provide the key force through the arms. PT
starts with grade 1 and works up to grade 4 as pt.
tolerates
• Parameters: 8-10 reps (at each grade) – hold each mob
for 3 seconds
*Note: Pt. must completely relax scapula musculature.
Scapular Protraction - Retraction
Translational Glenohumeral
Mobilization
• Pt. lies supine with the arm to be mobilized toward the
edge of the table with the arm abducted to 90 degrees
• PT stands to the side that will be mobilized and
supports the pt.’s forearm against their side. Both
hands grasp the glenohumeral joint at the site of
articulation with the thumbs on the superior-anterior
surface, and the fingers wrapped around the posteriorinferior aspect of the joint.
• A short lever-arm translational glide is imparted to the
glenohumeral joint in anterior, posterior, superior, and
inferior directions.
*Note: You may add a distraction force to produce more
tension through the glenohumeral joint capsule
Translational Glenohumeral
Mobilization