1. The Spencer Technique
Valerie Robinson, D.O.

2. Review of Anatomy Bones: clavicle, humerus, scapula
Joints: sternoclavicular, acromioclavicular, glenohumeral

3. Review of Anatomy Muscles Supraspinatus: abductor
Infraspinatus: external rotator
Teres minor: external rotator
Subscapularis: internal rotator
Pectoralis major: adductor
Deltoid: flexor, abductor, and extensor
Teres major: extensor
Latissimus dorsi: extensor and adductor

5. Range of Motion Flexion 180° Extension 50° Abduction 180°
Adduction 50°
Internal rotation 90°
External rotation 90°
Spencer technique has been proven to improve range of motion in those with shoulder dysfunction thus improving ability to perform ADLs

6. Background
The Spencer Technique was developed in 1915 by Charles H. Spencer, D.O. as an articulatory technique to increase ROM at the shoulder. It has been modified and personalized by many physicians through the years and even now there are debates on proper technique.

7. Uses
The Spencer Technique is useful in diagnosing and treating some shoulder conditions
Improves shoulder mechanics and range of motion
Stretches local tissues, improving lymphatic and circulatory flow
Treat adhesive capsulitis, post-operative or post-injury myofascial restriction, bursitis/tendonitis
May be performed with the patient lying on his/her side or sitting up.

8. Utilization
The Spencer Technique may be utilized as an articulation or a muscle energy technique.
To articulate, gently move shoulder into and out of Spencer position 8-10 times, coming to the barrier each time. This is a passive technique
To use muscle energy, move shoulder to the barrier, have patient actively resist, then move into new barrier. Perform 3-5 times. This is an active technique

9. The Technique Stage 1: shoulder extension with elbow flexion
Stage 2: shoulder and elbow extension
shoulder and elbow flexion
Stage 3: abduct to 90°, stabilize shoulder, move in circumduction with compression toward joint
Stage 4: abduct to 90°, stabilize shoulder, move in circumduction with traction
Stage 5: abduction
Stage 6: test internal rotation by placing pts hand behind back and pulling elbow forward
Stage 7: arm traction and deltoid pump. This may also be used to start treatment.

10. Demonstration
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11. References
JoAnn Ryan, D.O. “Spencer Technique for Shoulder (Articulation).” Lecture notes, October 17, 2007.
Lori A. Dolinski, D.O./PhD/MSc. “Chapter Six: Upper Extremities.” Handbook of OMT Review 6th ed. 2010: ProMedica Publishing Company. Pages 73-81
Henry M. Seidel, MD et al. “Chapter 21 Musculoskeletal System.” Mosby’s Guide to Physical Examination 6th Ed. 2006: Mosby Elsevier. Pages
JANICE A. KNEBL, DO, MBA et al. “Improving functional ability in the elderly via the Spencer technique, an osteopathic manipulative treatment: A randomized, controlled trial.” JAOA Vol 102, No 7, July 2002 pp
Anthony G. Chila et al. “Approach to the Somatic Component.” Foundations of Osteopathic Medicine. 2010: Lippincott Williams and Wilkins. Pp