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Self-administered Shoulder Mobilization (Lateral Distraction)
Self-administered Shoulder Mobilization (Lateral Distraction) is a technique used to improve mobility and range of motion in your shoulder joint. It involves placing a pillow or towel between your arm and your torso and then slowly increasing the distance between your arm and your torso while actively rotating and abducting your arm. This technique helps break up adhesions within the shoulder joint and improve range of motion. It can also be used to decrease pain and improve control of the shoulder joint.
Transcript
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This is Brent live from Rick Richie's
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independent training spot, the new home
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of the Brookbush Institute. I'm very excited to be here, very excited to be
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doing our next self-administered mobilization video. In this video we're
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going to look at the shoulder and how we can increase range of motion, increase
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arthrokinematics, that surface-to-surface motion between the
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humeral head and the glenoid fossa. Now with all the changes in muscle activity
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of length, in upper body dysfunction people have a propensity towards
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anterior and superior migration of the humeral head in the glenoid fossa. So
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what we're going to be looking for is how do we stretch out these inferior and
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posterior fibers of the capsule. I'm going to have my friend Aaron come in,
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he's going to help me show you guys some techniques I've been working on. Now
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these techniques are going to look a lot like our hip mobilization video, as you
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guys remember from what I was talking about in that video, I talked about
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anterior and superior glide on the femoral head and the acetabulum. So it's
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all very similar, instead of putting the band around his hip though I'm going to
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put the band around his shoulder, and then you'll see the logic flows very very
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similarly. So let's have you getting into quadruped, put that way up high around
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his humeral head. Now you see Aaron's starting here on his hands. we've been
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experimenting with this a little bit and I can tell you up on the hands doesn't
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work out quite as well, and my thinking is is that it activates your tricep
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which the long head of your tricep does cross the shoulder, and I think it
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activates the rotator cuff a little bit to be in this position, which makes
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mobilization of this joint a little less effective. So I'm going to have him get down
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on his elbows. Now his shoulders in a little bit more relaxed position, and
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even just a little bit of force I can feel that humeral head come away from
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the glenoid fossa, and so we're gonna put this up nice and high. Now what the
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position we have here, this would be a lateral distraction of the humeral head.
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Lateral distraction just like for the hip is a nice general mobilization that
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is going to get those inferior and posterior fibers that are
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tight. In this position this is a technique I use as an
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introductory shoulder mobilization. All I'm going to have him do is rock back and
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forth a little bit. The same thing we do with our manual techniques, maybe one to
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two oscillations per second; he can count to 15 or 20, or we could go even
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more oscillations than that and say, okay go ahead and keep doing that for 30
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seconds. How does that feel? (Really good). All right so this is kind of that mobility
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work, those grade 3 and 4 mobilizations we've been taught. Like I could even go
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more towards a grade four by going okay well what if we bring your elbow in, and
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I really challenged him at his end range here all right, and then rock and he can
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adjust his hips as he needs to. How does that feel? A little more intense right.
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We could then start thinking about a little bit towards mobilizations
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in different ranges of flexion and extension; so maybe I'd been I've been
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getting him closer and closer, more and more flexion, getting closer closer to
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optimal, instead I just had him maybe maybe this is as far as he can go, I'm going to
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have him bring out both arms so he's even. Good and now he can rock back and forth
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there at a hundred and thirty degrees of shoulder flexion. Okay we can take it
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even one step further we could do these mobilizations with motion, and now what I
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could have them do is go okay we're going to do this a little bit of lateral
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distraction but I want you to keep center okay. All right and this time I
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want you to rock back and forth between neutral and as much flexion as is
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comfortable for you. How does that feel? It's great all right so now we got that
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lateral distraction while working on flexion and extension, this one works
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wonderfully, it's a very comfortable position for the client or patient and
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you can go through the same kind of reps. We're way over mobilizing the shoulder
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right now guys, please don't go through all of these in one session you will end
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up with a little htyperrmobility and that could be painful. Alright so the
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next technique we're going to work on, actually let me take one step back. The
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one thing you could do going back towards our grade ones and twos that
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we've been taught, if somebody had a painful shoulder remember we could limit
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range, you can use any of these techniques but
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limit the range just to pain free range of motion. So let's say he has a little
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bit of pain at a hundred and ten degrees, he's got a little bit of that shoulder
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impingement issue, all I'm going to do then is he'll rock back and forth just
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touching where that pain is, until that pain goes away at that range, and then he
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can move a little further. Alright so hopefully you guys are putting this all
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together. We can we can just oscillate, we can oscillate at the end of range right
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either flexion or adduction, we can isolate with flexion and extension, or we
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can just go through pain free range and start working in smaller smaller ranges
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of motion until that pain goes away. Now another technique that is definitely a
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progression from this. This technique I'm about to show you is a lot more
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aggressive, it's very effective for a stiff shoulder though. I'm going to have
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Aaron flip around so bring your backside this way, and what we're going to do is a
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superior to inferior mobilization. This is a big one, what he's going to do
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though is he's going to get his arms up on a foam roll, and what most people
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would want to do is just go forward, I'm sorry staey keep your arms over there,
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most people just want to go forward with our body. The problem with that though is
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as the band's pulling him back his arms going back, so we're really not getting a
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mobilization. The hard thing to teach with this one is they got to keep this
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in the relative relatively the same position while pushing from their feetm
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so that they maintain this and it is truly a superior to inferior glide, and
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he's just going to rock again. The foam roll allows his upper body, this little
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position we're making to stay in one piece, unless I want to get even more
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aggressive. You guys could turn this into a mobilization with movement once again,
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by having him push with his feet and reach with his hands into as much
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flexion as he can get, and I'm sure Aaron can feel that's a very very intense
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technique, I would definitely be careful with this one maybe start with just 10
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or 15 repetitions reassess before letting somebody go and
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go and go and go and all of a sudden you look over and your patients been doing a
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very aggressive technique for a minute, and it's going to start having some
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shoulder pain Once again if this if this was a painful shoulder I could limit my
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range of motion to wherever I needed him to be, so that he stays out of that
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painful arc and stays right in that pain free zone and just touches the pain
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Same thing, we could do the same thing with the mobilization movement right,
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maybe he just has a little shoulder impingement and he goes right up to
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there he feels it and backs off. Alright so that is that is a ton of stuff for
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you guys to work on. We did lateral distraction, lateral distraction with
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more abduction, lateral distraction with more flexion, we did mobilization with
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movement, lateral distraction, we did a superior to inferior glide, we did a
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superior to inferior glide with flexion. I hope that gives you a ton of stuff to
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work work on with this particular technique Guys please be careful with the
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shoulder is a much more delicate structure than the hip, make sure that
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you assess, you try a few of these techniques, you keep the rep slow
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initially and then reassess if you got a good outcome -.Stop. if you reassess the
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next session and their shoulder mobility is fine, don't do this technique, there's
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no need to start pushing them beyond what is optimal. Remember hypermobility
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is a problem as well. I hope you guys get great outcomes, I look forward to hearing
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