Functional Anatomy

Full

The patient moves the shoulders toward the ears in an upward direction

The therapist's right hand cups the inferior angle of the scapula and elevates the scapula. The left hand assists in controlling the direction of movement

• Start Position: Patient is sitting. Shoulders are slightly abducted, and elbows are flexed to 90 degrees
• Movement: Patient elevates shoulder girdle(s) to bring acromion process closer to ear
• Palpation: Upper fibers of trapezius-on a point of a line midway between inion and acromion process. Levator scapulae-too deep to palpate
• Substitution: Lowering ear to shoulder and contralateral trunk side flexion
• Resistance Location: Applied over top of shoulders
• Resistance Direction: Scapular depression

• Start: Patient prone. Arms at side, and shoulder at neutral position. Therapist supports weight of UE to reduce resistance of friction
• End: Patient elevates scapula through full ROM
• Substitution: Contra;ateral trunk side flexion

Full

Patient moves shoulders toward the waist in a downward direction

• Therapist's left hand is placed on top of the shoulder and depresses scapula. Right hand cups inferior angle of scapula to control direction of movement
• End feel: Firm/hard