Download Chapter 6

Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Lesson Plans
Chapter 6 — The Shoulder
Selected Key Terms
Goals of the Lesson:
Cognitive: Students will be able to describe the bones, joints, ligaments, and fascia and name the nerves of the shoulder
region. They will be able to name the muscles of the shoulder region and identify their actions and attachments. Students
will be able to identify the factors predisposing to shoulder dysfunction and pain and name the common types of shoulder
dysfunction and injury. They will also be able to identify appropriate history questions to ask of a client with shoulder pain
and the therapeutic intentions of muscle energy technique and soft tissue mobilization.
Motor: Students will be able to perform proper observation, motion, and palpation assessments of the client and perform the
muscle energy technique and soft tissue mobilization for the shoulder region.
Affective: N/A
Learning Objectives:
The lesson plan for each objective starts on the page shown below.
6-1
Describe the bones, joints, ligaments, and fascia of the shoulder region. .................................................................... 114
6-2
Name the nerves of the shoulder region. ..................................................................................................................... 116
6-3
Name the muscles of the shoulder region and identify their actions and attachments. ................................................ 118
6-4
Identify the factors predisposing to shoulder dysfunction and pain. ........................................................................... 120
6-5
Differentiate between different types of shoulder pain. ............................................................................................... 121
6-6
Name the common types of shoulder dysfunction and injury...................................................................................... 122
6-7
Identify appropriate history questions to ask of a client with shoulder pain................................................................ 125
6-8
Perform proper observation, motion, and palpation assessments of the client. ........................................................... 127
6-9
Identify the therapeutic intentions of and perform the muscle energy technique and soft tissue mobilization
for the shoulder region. ................................................................................................................................................ 130
You Will Need:
Gather the following materials and teaching aids for the following lessons:
6-1
Unlabeled copies of Figures 6-1 to 6-6; computer and projector.
6-2
Unlabeled copies of Figure 6-7; computer and projector.
Page 113
Copyright © 2010 Wolters Kluwer Health  Lippincott Williams & Wilkins
shoulder complex
four typical joints
fifth functional joint
thoracic outlet
thoracic outlet syndrome
shoulder separation
step deformity
scapular plane
static stabilizers
dynamic stabilizers
instability syndrome
rotator cuff tendinitis
frozen shoulder
adhesive capsulitis
ligaments
glenohumeral ligament
coracohumeral ligament
coracoacromial ligament
transverse humeral
ligament
impingement syndrome
subacromial or
subdeltoid bursa
subscapular bursa
subcoracoid bursa
brachial plexus
long thoracic nerve
subscapular nerve
thoracodorsal nerve
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
6-4
White board and dry erase markers.
Legend: PPt: PowerPoint
Page 114
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-1
Describe the bones, joints, ligaments, and fascia of the shoulder region.
Date:
Lecture Outline
Content
 General Overview
 Bones and Joints of the Shoulder
Girdle
 Scapula
 Clavicle
 Sternum
 Sternoclavicular Joint
o Structure
o Function
o Dysfunction and Injury
 Acromioclavicular Joint
o Structure
o Function
o Dysfunction and Injury
 Scapulothoracic Joint
o Function
o Dysfunction and Injury
o Treatment Implications
 Bones and Soft Tissue of the
Glenohumeral Joint
 Glenohumeral Joint
o Structure
o Function
o Scapulohumeral Rhythm
o Dysfunction and Injury
o Treatment Implications
 Humerus
 Joint Capsule
o Structure
Text
page
240–
246
PPt
slide
2–8
Figures, Tables, and
Features
Figures
6-1: Anterior view of the
bones and joints of the
shoulder complex
p. 240, PPt 3
6-2: Posterior view of the
bones and bony landmarks
of the shoulder complex
p. 241
6-3: Glenohumeral joint
showing the articular
cartilage, joint capsule,
subacromial bursa,
supraspinatus, and long
head of the biceps
p. 243, PPt 6
6-4: Joint capsule,
interweaving rotator cuff
muscles and long head of
the triceps
p. 244
6-5: Ligaments of the
glenohumeral and the
acromioclavicular joints
and of the subscapular
bursa
p. 245
6-6: Subdeltoid and
subscapular bursa
Page 115
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Resources and
In-Class Activities
Resources
N/A
Related Chapters
N/A
In-Class Activities
Outside Assignments
Evaluation
Outside Assignments
Have students trace and
label on plain white paper
or tracing paper each of the
bones in the shoulder from
Figures 6-1 and 6-2 and
then teach a friend or
family member the names
and structures of the bones.
They should submit their
tracings at the next class.
Print out unlabeled copies
of Figures 6-1 to 6-6 from
the online image bank.
Group the class into pairs
Evaluation
and distribute one or two
of the unlabeled figures to
Study Guide, p. 290
each pair. Have the
students work together to
label all of the structures
on the handouts. Then,
show the labeled versions
of these figures to the class
using a computer and
projector and name the
structures in each one.
Materials
Unlabeled copies of
Figures 6-1 to 6-6;
computer and projector.
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder




o Function
o Dysfunction and Injury
o Treatment Implications
Labrum
o Structure
o Function
o Dysfunction and Injury
o Treatment Implications
Ligaments
o Glenohumeral Ligament
o Coracohumeral Ligament
o Transverse Humeral
Ligament
Coracoacromial Arch
o Structure
o Function
o Dysfunction and Injury
o Treatment Implications
Bursae
o Structure
o Function
 Subacromial or
Subdeltoid Bursa
 Subscapular Bursa
 Subcoracoid Bursa
o Dysfunction and Injury
o Treatment Implications
p. 246
Boxes
N/A
Legend: PPt: PowerPoint
Page 116
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-2
Name the nerves of the shoulder region.
Date:
Lecture Outline
Content
 Nerves of the Shoulder Region
 Structure
 Dysfunction and Injury
 Treatment Implications
Text
page
246–
247
PPt
slide
8
Figures, Tables, and
Features
Figures
Resources and
In-Class Activities
Resources
6-7: Brachial plexus leaves N/A
the neck between the
anterior and the middle
scalenes
Related Chapters
p. 246
N/A
Boxes
N/A
Materials
Unlabeled copies of Figure
6-7; computer and
projector.
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Outside Assignments
Have students trace and
label on plain white paper
or tracing paper each of the
nerves in the shoulder
region from Figure 6-7.
They should submit their
tracings at the next class.
In-Class Activities
Print out unlabeled copies
of Figure 6-7 from the
online image bank. Group
the class into pairs and
distribute the unlabeled
figure to each pair. Have
the students work together
to label each of the nerves.
Then, show the labeled
version of this figure to the
class using a computer and
projector and name the
structures.
Page 117
Outside Assignments
Evaluation
Evaluation
Study Guide, p. 290
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Legend: PPt: PowerPoint
Page 118
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-3
Name the muscles of the shoulder region and identify their actions and attachments.
Date:
Lecture Outline
Content
 Muscles of the Shoulder Region
 Structure
 Function
 Dysfunction and Injury
 Muscle Imbalances of the
Shoulder Region
 Positional Dysfunction of
Shoulder Region Muscles
 Shoulder Muscle Anatomy
 Muscular Actions of the
Shoulder
 Muscular Actions of the
Shoulder Girdle
Text
page
247–
255
PPt
slide
9–11
Figures, Tables, and
Features
Figures
Resources and
In-Class Activities
Resources
6-7: Brachial plexus leaves N/A
the neck between the
anterior and the middle
scalenes
Related Chapters
p. 246
N/A
6-8: Muscles of the
posterior shoulder region
p. 248, PPt 10
6-9: Muscles of the
anterior shoulder
p. 249, PPt 11
Tables
6-1: Anatomy of the
Muscles of the Shoulder
p. 251–254
6-2: Muscular Actions of
the Shoulder
p. 255
6-3: Muscular Actions of
the Scapula
p. 255
Divide the class into two
teams. Have a muscle
"quiz show" in which you
call out a shoulder muscle
to one of the teams and
have them identify the
action performed by the
muscle. If the team cannot
guess it right, offer the
other team a chance to
answer. Alternate between
the two teams and give a
point for each right
answer. Call out 10
muscles total.
N/A
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Outside Assignments
Assign each student 2 or 3
muscles. Have each
student learn the
attachments and actions of
the assigned muscles and
then present them at the
next class.
In-Class Activities
Materials
Page 119
Outside Assignments
Evaluation
Evaluation
Study Guide, p. 290
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Legend: PPt: PowerPoint
Page 120
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-4
Identify the factors predisposing to shoulder dysfunction and pain.
Date:
Lecture Outline
Content
Text
page
 Shoulder Dysfunction and Injury 256
 Factors Predisposing to
Shoulder Pain
o Instability of the
Glenohumeral Joint
o Weakness in the Scapular
Stabilizing Muscles
o Previous Injury, Including
Previous Dislocation of
the Glenohumeral Joint or
Separation of the AC Joint
o Hypomobility of the
Cervical or Thoracic
Spine, Which Limits Full
ROM of the
Glenohumeral Joint
o Postural Dysfunction,
Such as Rounded
Shoulders, FHP, and
Thoracic Kyphosis
o Muscle Imbalances
PPt
slide
12
Figures, Tables, and
Features
Figures
N/A
Boxes
N/A
Legend: PPt: PowerPoint
Page 121
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Resources and
In-Class Activities
Resources
N/A
Related Chapters
N/A
Outside Assignments
Evaluation
Outside Assignments
Have students interview a
friend or family member
who has experienced
shoulder pain. Have them
learn and list what factors
may have contributed to
the person's condition.
In-Class Activities
On a white board in front
of the class, list the 6
factors that predispose to
shoulder dysfunction and
pain. Have students call
out any examples of each
factor.
Materials
White board and dry erase
markers.
Evaluation
Study Guide, p. 290
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-5
Differentiate between different types of shoulder pain.
Date:
Lecture Outline
Content
 Differentiation of Shoulder
Pain
Text
page
256
PPt
slide
13–15
Figures, Tables, and
Features
Figures
N/A
Resources and
In-Class Activities
Resources
N/A
Boxes
N/A
Related Chapters
N/A
In-Class Activities
Pair off students and have
them brainstorm about and
list common primary and
secondary problems that
might lead to shoulder
pain. Have each pair share
their findings with the
class.
Materials
N/A
Legend: PPt: PowerPoint
Page 122
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Outside Assignments
Evaluation
Outside Assignments
Have students find two or
three reputable sources on
shoulder pain (feel free to
recommend sources to
them) on the internet and
jot down all of the primary
and secondary causes of
shoulder pain.
Evaluation
Study Guide, p. 290
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-6
Name the common types of shoulder dysfunction and injury.
Date:
Lecture Outline
Content
 Common Dysfunctions and
Injuries of the Shoulder
 Rotator Cuff Tendinitis
(Supraspinatus Tendinitis)
o Cause
o Symptoms
o Signs
o Lesion Sites
o Treatment
 Infraspinatus Tendinitis
o Cause
o Symptoms
o Signs
o Treatment
 Subscapularis Tendinitis
o Cause
o Symptoms
o Signs
o Treatment
 Adhesive Capsulitis (Frozen
Shoulder)
o Causes
o Symptoms
o Signs
o Treatment
 Impingement Syndrome
o Cause
o Symptoms
Text
page
257–
261
PPt
slide
16–17
Figures, Tables, and
Features
Figures
N/A
Resources and
In-Class Activities
Resources
N/A
Boxes
N/A
Page 123
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Related Chapters
N/A
In-Class Activities
Write several paragraphs,
each one describing the
signs and symptoms of a
different shoulder
dysfunction or injury.
Have students pair off, and
hand each pair one of the
paragraphs describing a
condition. Have each pair
try to identify the likely
condition, describe what
causes it, and discuss how
to treat the condition as a
massage therapist. Have
them pay special attention
to any contraindications
and need to refer a client.
Have each pair share their
findings with the class.
Outside Assignments
Evaluation
Outside Assignments
Have each student choose
one of the shoulder
dysfunctions or injuries
and do more in-depth
research on it, finding out
at least three new facts
about the condition that are
not covered in the text
book. Have them share
their findings in the next
class.
Evaluation
Study Guide, p. 290
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder







o Signs
o Treatment
Instability Syndrome of the
Glenohumeral Joint
o Cause
o Symptoms
o Signs
o Treatment
Bicipital Tendinitis
o Cause
o Symptoms
o Signs
o Treatment
Subacromial (Subdeltoid)
Bursitis
o Cause
o Symptoms
o Signs
o Treatment
Acromioclavicular Ligament
Sprain
o Cause
o Symptoms
o Signs
o Treatment
Suprascapular Nerve
Entrapment
o Symptoms
o Signs
o Treatment
Costoclavicular Syndrome
(Part of Thoracic Outlet
Syndrome)
o Cause
o Symptoms
o Signs
o Treatment
Pectoralis Minor Syndrome
Page 124
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Materials
N/A
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
(Part of Thoracic Outlet
Syndrome)
o Cause
o Symptoms
o Signs
o Treatment
Legend: PPt: PowerPoint
Page 125
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-7
Identify appropriate history questions to ask of a client with shoulder pain.
Date:
Lecture Outline
Content
Text
page
261
 Shoulder Assessment
 History Questions Specific to
Shoulder Pain
o Where Is the Pain? What
Is the Quality of the Pain?
o Is There a Loss of Motion
in the Arm?
PPt
slide
18
Figures, Tables, and
Features
Figures
N/A
Resources and
In-Class Activities
Resources
N/A
Boxes
N/A
Related Chapters
N/A
In-Class Activities
Have students pair off and
role play, one student
being the therapist and the
other being the client.
Have the client explain the
condition of shoulder pain
he or she is experiencing,
and have the therapist
practice asking the history
questions. The client
should respond with
plausible answers. If the
student playing the part of
the client really does have
shoulder pain, he or she
can answer from
experience!
Page 126
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Outside Assignments
Evaluation
Outside Assignments
Have each student come
up with three or four of
their own assessment
questions that they might
use to learn more about a
client's shoulder condition.
Evaluation
Study Guide, p. 290
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Materials
N/A
Legend: PPt: PowerPoint
Page 127
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-8
Perform proper observation, motion, and palpation assessments of the client.
Date:
Lecture Outline
Content
 Observation: Client Standing
 Anterior View
 Posterior View
 Side View
 Motion Assessment
 Scapular Stabilization Test
o Action
o Observation
 Abduction
o Position
o Action
o Observation
 Medial Rotation
o Position
o Action
o Observation
 Flexion With Internal
Rotation (Neer's
Impingement Test)
o Position
o Action
o Observation
 Lateral Rotation
o Position
o Action
o Observation
 Horizontal Flexion
Text
page
262–
267
PPt
slide
18–21
Figures, Tables, and
Features
Figures
6-11: Scapular
stabilization test
p. 262, PPt 20
Resources and
In-Class Activities
Resources
N/A
6-12: Shoulder abduction
test
p. 263
Related Chapters
6-13: Active medial
rotation
p. 263
In-Class Activities
6-14: Lateral rotation with
abduction performed
bilaterally is an easy way
to compare ROM of both
sides at the same time
p. 264
6-15: Passive abduction
p. 264
6-16: Passive
circumduction
p. 265
6-17: Isometric test for the
middle deltoid
p. 265
6-18: The empty-can test
to isolate the supraspinatus
Page 128
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Outside Assignments
Evaluation
Outside Assignments
Have students practice
performing observation,
motion, or palpation
assessment on a friend or
family member.
N/A
Evaluation
Have an assessment
workshop for the shoulder
region. First, demonstrate
observation, motion, and
palpation assessments on a
student volunteer in front
of the class. Then, have
students pair off and
practice performing these
assessments on one
another. Circulate through
the room, supervising the
students and assisting
where needed.
Materials
N/A
Study Guide, p. 290
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
(Adduction)
o Position
o Action
o Observation
 Passive Movements
 Abduction
o Position
o Action
o Observation
 Lateral Rotation
o Position
o Action
o Observation
 Circumduction
o Position
o Action
o Observation
p. 265
6-19: Isometric test for
lateral rotation
p. 266
6-20: Speed's test for the
long head of the biceps
p. 266
6-21: Motion palpation of
the glenohumeral joint
p. 266
Boxes
N/A
 Isometric Tests
 Middle Deltoid
o Position
o Action
o Observation
 Empty-Can Test
o Position
o Action
o Observation
 Resisted Lateral Rotation
o Position
o Action
o Observation
 Long Head of Biceps
(Speed's Test)
o Position
o Action
o Observation
 Additional Test
Page 129
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
 Motion Palpation and
Mobilization of the
Glenohumeral Joint
o Intention
o Position
o Action
o Observation
Legend: PPt: PowerPoint
Page 130
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Objective 6-9
Identify the therapeutic intentions of and perform the muscle energy technique and soft tissue
mobilization for the shoulder region.
Date:
Lecture Outline
Content
Text
page
267–
 Techniques
290
 Guidelines to Applying
Techniques
o The Intentions of
Treatment for Acute
Conditions Are as Follows
o The Intentions of
Treatment for Chronic
Conditions Are as Follows
 Muscle Energy Technique
o Therapeutic Goals of
Muscle Energy Technique
(MET)
o The Basic Therapeutic
Intentions of MET for
Acute Conditions Are as
Follows
o The Basic Therapeutic
Intentions of MET for
Chronic Conditions Are as
Follows
o Assessment of Muscle
Length of Glenohumeral
Joint and Passive Range of
Motion
o Contract-Relax and
Postisometric Relaxation
PPt
slide
22–26
Figures, Tables, and
Features
Figures
6-22: Assessment of the
ROM of glenohumeral
joint in lateral rotation and
length of the medial
rotators
p. 269
6-23: CR and PIR MET of
the shoulder medial
rotators
p. 269
Resources and
In-Class Activities
Resources
Video Clip: MET and
Wave Mobilization for the
Shoulder: Release of
Pectoralis Minor
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Outside Assignments
Have students practice
performing the muscle
energy technique and soft
tissue mobilization for the
shoulder region on a friend
or family member.
Related Chapters
N/A
6-24: CR and PIR MET of In-Class Activities
the shoulder lateral rotators Have a technique
workshop for treatment of
p. 270
the shoulder region. First,
6-25: Side-lying position
demonstrate the muscle
CR and RI MET for the
energy technique and soft
lateral rotators
tissue mobilization on a
p. 270
student volunteer in front
6-26: CR MET for the
of the class. Then, have
pectoralis major
students pair off and
p. 271
practice performing these
techniques on one another.
6-27: PIR MET of the
Circulate through the
pectoralis major
room, supervising the
p. 271
students and assisting
6-28: CR MET of the
where needed.
Page 131
Outside Assignments
Evaluation
Evaluation
Create test for Chapter 6
from the Brownstone Test
Generator.
Instructor’s Notes
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Techniques
o Treatment for Loss of
Shoulder Motion
 Soft Tissue Mobilization
o Background
o Guidelines for the
Therapist
 Acute
 Chronic
o Level I: Shoulder
o Level II: Shoulder
pectoralis minor
p. 271
6-29: PIR MET for the
supraspinatus
p. 272
6-30: PIR MET to increase
medial rotation
p. 272
6-31: MET to increase
inferior glide of the
glenohumeral joint
p. 273
6-32: PIR MET to increase
external rotation in
abduction
p. 273
6-33: Eccentric MET to
increase shoulder elevation
p. 274
6-34: Serratus anterior and
subscapularis
p. 277
6-35: Fingertip release of
the serratus anterior
p. 277
6-36: Fingertip release of
the subscapularis
p. 278
6-37: Thumb release of the
subscapularis
p. 278
6-38: Muscles of the
anterior chest and shoulder
p. 279
Page 132
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Materials
N/A
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
6-39: Fingertip release of
the anterior shoulder
muscles
p. 280
6-40: Scooping strokes
with the thumb for the
anterior shoulder muscles
p. 280
6-41: Anterior shoulder
muscles
p. 280
6-42: Hands used to
unwind the torsion that
develops in the soft tissue
of the glenohumeral joint
p. 280
6-43: Superior view of the
supraspinatus and the
coracoacromial ligament
p. 281
6-44: Thumb release of the
belly and myotendinous
junction of the
supraspinatus muscle
p. 281
6-45: Fingertips perform
TFM at the tenoperiosteal
junction of the
supraspinatus
p. 281
6-46: Teres minor,
infraspinatus, and
supraspinatus
p. 282
6-47: Double-thumb
Page 133
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
technique to release the
infraspinatus and the teres
minor
p. 283
6-48: Fingertip release of
the belly and
myotendinous junction of
the supraspinatus
p. 283
6-49: Posterior rotator cuff
muscles, the posterior
deltoid, and teres major
p. 283
6-50: Release of the
posterior shoulder muscles
p. 283
6-51: Attachments to the
coracoid process and the
anterior shoulder complex
p. 284
6-52: Fingertip release of
the clavicle attachments
6-53: Thumb release of the
inferior border of the
coracoid process
p. 285
6-54: Attachments to the
anterior shoulder complex
p. 285
6-55: Release of the
muscle attachments to the
anterior humerus
p. 286
6-56: Posterior rotator cuff
muscles, the triceps, and
Page 134
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
radial nerve; muscle
attachments to the
posterior shoulder complex
p. 286
6-57: Double-thumb
release of the rotator cuff
muscles, posterior joint
capsule, the triceps, and
the radial nerve
p. 287
6-58: Muscles of the
anterior shoulder complex;
posterior deltoid,
supraspinatus,
infraspinatus, and teres
minor and major
p. 288
6-59: Sitting MET and OM
p. 289
6-60: Subdeltoid
(subacromial) bursa
p. 289
6-61: Using the web space
of the hand, perform slow,
gentle strokes on the
subdeltoid bursa
p. 289
Boxes
Unnumbered box: Clinical
Example: Acute
p. 275
Unnumbered box: Clinical
Example: Chronic
p. 276
Page 135
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins
Massage and Manual Therapy for Orthopedic Conditions (Second Edition)
Chapter 6 — The Shoulder
Tables
6-4: Essentials of
Treatment
p. 277
Legend: PPt: PowerPoint
Page 136
Copyright © 2010 Wolters Kluwer  Lippincott Williams & Wilkins