When patients complain of shoulder
pain or limitations in motion,
one common treatment we use
is called the Seven Steps of Spencer
It's a very good technique for
patients with adhesive capsulitis
or restrictions in motion
or use of the shoulder.
You start with stabilizing the scapula.
Make sure you have good hold of it,
and then you're gonna go through
each of the seven steps, seven times
So I'm gonna start with holding the scapula
and extending the shoulder seven times.
Patients usually tolerate extension
well, and then you get to flexion
And you get it until you
could gauge the barrier
Seven, and you're stretching them out
and increasing motion with each time.
Then you want to do circumduction
with some compression.
You can switch arms here to get better traction
and I circumduct in each direction
holding out to the humerus, getting
the glenohumeral joint engaged,
and seven, and then I'm gonn
After you do circumduction with compression,
you do circumduction with traction.
Pull it up
and you're moving the shoulder
increasing the motion each time
And then after circumduction with traction,
you want to do ABduction of the shoulder
so you wanna go all the way up.
They may have some discomfort
and then when you get to the next step,
I believe that's seven...
which is internal rotation, this is
when you've got their confidence
and even though it's gonna feel a little bit
uncomfortable, you're gonna increase the motion
I should stabilize the scapula,
and the last step is, Traction
You pull on the shoulder
and bring it back to neutral
position - relaxation
and ask how the shoulder feels and see if the
motion has increased when you started the procedure
That's the seven steps of Spencer