When manually treating the shoulder, there are many techniques that can be used. A common technique is joint mobilization. If a joint is stiff and not moving in its full range, a therapist can manually move one bone on another to help stretch out any tight structures crossing the joint. For instance, to improve range into forward flexion, the patient lies on their back with their arm as far into flexion as they can go, and the arm bone is moved down in comparison to the shoulder blade.
Here is the mobilization technique to improve shoulder abduction, or moving the arm out to the side and up. The patient’s arm is moved again to its end range, and the arm bone is moved down the body in comparison to the shoulder blade.
Another manual technique often used for the shoulder is to help improve joint mechanics, specifically how the scapula moves as the arm moves. If the two do not move well in relation to each other, shoulder pain with movement may result. If, for instance, during shoulder abduction there is pain in midrange, the scapula may not be moving enough. The therapist can then assist the movement by physically moving the scapula while the patient raises their arm, which may help to reduce or abolish the pain completely. This then suggests that the scapula is what needs to be targeted for exercise treatment.