Bend the elbow on the side of the shoulder you want to exercise and make a fist. scapular fracture rehabilitation protocol. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) deltoid isometrics (avoid EXT beyond neutral) Continue therapeutic exercise from week one Initiate AAROM exercises Manual Techniques Manual Techniques Initiate PROM to include elevation and ER to tolerance in plane of scapula *No IR until week 6 Support arm in neutral after PROM (avoid IR against abdomen or EXT into bed) Altering scapular position may affect shoulder strength in asymptomatic individuals, which has implications for the validity and reliability of shoulder tests and outcome measures that are reliant upon shoulder strength, at the same time as supporting the premise that the application of scapula correction exercises should be based upon individual assessment rather than general countyline finish mower. Frequent (4-5 times a day for about 20 minutes) cryotherapy. o Progress PROM: o Forward flexion and elevation in the scapular plane in supine to 120 degrees. Prone Is 3 Weeks to 6 Weeks: Progress exercises listed above. ER in scapular plane to tolerance, respecting soft tissue constraints. Tie the middle of a resistance band to a doorknob and hold the ends. ROM performed in the scapular plane Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) Low Row w/ Theraband 3. Limit FE (forward elevation in the scapular plane) to 110 degrees Limit ER (external rotation) to neutral 0 degrees Pendulums permitted in sling. In this article, we are going to discuss the recovery timeline after total shoulder replacement surgery. CryoCuff) PRN; Wrist and gripping exercises; Deltoid isometrics PHASE 2: Initial Rehab / Motion Phase: WEEKS 4-6 ___ At 4 weeks, begin supine PROM and pendulum exercises in plane of scapula with limit of 90 of forward elevation/abduction; supine PROM ER to 15 with broomstick; No active ER Isometric Shoulder Extension at Wall. Poor throacic extension capability leads to a kyphotic upper back and dysfunctional scapular most common shoulder exercises and is isolated primarily to the sagittal plane and targets the anterior portion of the deltoid. Begin Deltoid/Cuff isometrics Removal of sling for showering: maintain arm in sling position. Strengthening Begin submaximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid) Goals to Progress to Next Phase 1. If deltoid is involved may want to start active below 900 at 10 - 12 weeks. No active ER ___ Modalities (i.e. Frequent (4-5 times a day for about 20 minutes) cryotherapy. Unformatted text preview: HP 348 Structural Kinesiology & Biomechanics Exam 1 Review Exam Format 60 pts total 40pts from T/F, Multiple Choice, & Matching questions 20pts from short answer/essay questions 1) Be able to identify all planes of motion, their respective axes of motion, and the motions that occur in each of these planes Plane Description Axis Movements Sagittal 25 For the posterior deltoid, the arm was abducted to 90 and in ER in scapular plane 20-30 deg; NO IR; Phase 2. 25 For the middle deltoid, the arm was abducted to 90 and in neutral rotation (palm down) with resistance applied just proximal to the elbow in an inferior direction. The scapular plane is defined as the shoulder positioned in 30 degrees of abduction and forward Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder hyperextension when isolating posterior deltoid.) Restore active range of motion (AROM) of elbow/wrist/hand 3. The scapular plane is defined as the shoulder positioned in 30 degrees of abduction and forward flexion with neutral rotation. Submaximal shoulder isometrics in neutral Shoulder AAROM progressed to ARO Progress PROM: EVERSE HOULDER : : : EVERSE HOULDER . Todos os direitos reservados. Pain free submaximal deltoid isometrics Weeks 6-10: Phase II Sling Immobilizer: May discontinue at week 6. Phase II Active Range of Motion / Early Strengthening Phase (Week 2 to 12): Goals: o Focus on forward flexion and elevation in the scapular plane o External rotation (ER) in scapular plane (30 flexion and 30 abduction) to available ROM. For the supraspinatus, the shoulder was elevated to 90 in the scapular plane, the elbow was extended, and the shoulder was in neutral rotation. Their action is to increase circulation for healing and strengthening muscles with minimal joint irritation. o Shoulder shrugs and scapular retraction (preventing shoulder extension) Ice and modalities for pain and swelling Weeks 3-6 May gradually discontinue sling around the house at 4 weeks if comfortable. The mean isometric abduction strength in the rhBMP-12/ACS group increased from 5.9 2.2 kg preoperatively to 9.4 4.4 kg at week 52. The mean isometric abduction strength in the SOC control group increased from 6.1 3.0 kg to 10.2 7.4 kg at week 52. Dynamic Hug 5. o Sub-max, pain-free periscapular isometrics Weeks 3 to 6 o Progress ROM Forward elevation: to 120 External rotation in the scapular plane: as tolerated o Gentle, resisted exercises for the elbow, wrist and hand o Sub-max, pain-free deltoid isometrics in the scapular plane Avoid shoulder extension with posterior deltoid Elevation in scapular plane: 120 ER in scapular plane: 30-45 IR in scapular plane: to chest o 0-6 weeks Abduction 0-90 (gentle motion) Codmans pendulum exercises PROM shoulder elevation in scapular plane o Table slides Active assisted range of motion (AA ROM) shoulder ER with wand in scapular plane within prescribed limits egin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) Progress PROM: O Forward flexion and elevation in the scapular plane in supine to 120 degrees. the exercise. Sub-maximal / Deltoid isometrics (Except internal rotation secondary to subscapularis reattachment.) Pain free submaximal deltoid isometrics Modalities as needed Advancement Criteria: ER to neutral FF in scapular plane to 90 Minimal pain and inflammation Weeks 6-10: Phase II Exercises: Active assisted FF in scapular plane to 145 (wand exercises, Flex your elbows and pull them behind your back as far as possible, squeezing your shoulder blades together. NO shoulder AROM, AVOID shoulder extension. We were unable to isolate the supraspinatus muscle in any of these tested positions. - Begin sub m aximal deltoid isometrics in the scapula plane (Avoid shoulder extension) - Continue frequent Cryotherapy 4-5 times day for about twenty minutes NO strengthening or resistance until 6 weeks 3-6 Weeks Progress exercise listed above Progress PROM: - Flex ion in the scaption plane to 120 - ER in scapula plane to tolerance, - ER/IR (supine/scapular plane) - Elevation at 100 degrees 5. Scapular setting exercises are performed with the scapula in a retracted position to enhance postural control. Still need sling when going out in public up until 6 weeks post-op. Mobilize Patient The scapular plane is defined as the shoulder positioned in 30 degrees of abduction and forward flexion with neutral rotation. Tolerates P/AAROM, isometric program Has achieved at least 140 PROM forward flexion and elevation in the scapular plane. o Patient demonstrates the ability to isometrically activate all components of the deltoid and periscapular musculature in the scapular plane. 2. o Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) 4 weeks. Website por stoli black label. Movement. Begin PROM in supine with forward flexion and elevation in the scapular plane to 90 degrees ER in scapular plane permitted up to 20 degrees and no IR Begin cuff and deltoid isometrics AROM of cervical spine, elbow, wrist and hand Precautions: Same as above what happened during the christmas truce of 1914; brooks waterproof shoes; 10-4 or roger word craze; dark souls bundle xbox one; the restaurant bar and grill leeds Scapular strengthening exercises as appropriate 6. Shoulder forward flexion below shoulder level Abduction in scapular plane Gravity eliminated internal/external rotation 4. v 3 Weeks to 6 Weeks: Progress exercises listed above. The isometrics are performed in this fashion because of a 20 degree range of motion physiological overflow found with isometric exercises. Scapular punches Doody SG et al.Shoulder movements during abduction in the scapular plane.Arch Phys Med Rehab.1970:595-604. A scapula angle of 20-30 degrees (see below) should be used (the scapular plane) as this offers the best alignment for the rotations to occur around with minimal scapula involvement. Proximal Humerus Fracture Repair and Rehabilitation. scapular plane. Download scientific diagram | Posterior deltoid. Enhance PROM 2. Menu. Cryotherapy is needed for pain control and inflammation. This study demonstrated that both isokinetic and isometric testing in the scapular plane are valid methods for measurement of the strength of external rotation and abduction of the shoulder. Shoulder strengthening exercises should be completed 3-4 times per day and should be done to both sides. o ER in scapular plane to tolerance, respecting soft tissue constraints. Begin active flexion, IR, ER, elevation in the plane of the scapula pain free ROM 3. Shoulder strengthening exercises should be completed 3-4 times per day and should be done to both sides. Isometric abduction in scapular plane to activate middle deltoid. In this study, the stiffness was measured by 30 shoulder isometric abduction in the scapular plane, which is frequently used for the evaluation and treatment of the SSP muscle. Frequent (4-5 times a day for about 20 minutes) cryotherapy. The next consideration is the height of the shoulder gridle. The infraspinatus-teres minor muscles were isolated in the sagittal plane with 90 of shoulder ele vation in a half externally rotated position. Progress PROM: Forward flexion and elevation in the scapular plane in supine to 120 degrees. Isometrics (sub-maximal) - Deltoid in neutral - External rotation - Internal rotation at 6 weeks 7. Supine ER/IR with straight cane (ER to 20 degrees only) self passive ROM. Begin sub-maximal pain-free deltoid isometrics in the scapula plane (avoid shoulder extension when isolating posterior deltoid) Progress PROM: o Forward flexion and elevation in the scapular plane in supine to 120-140 degrees as tolerated. ROM performed in the scapular plane should enable appropriate shoulder joint alignment. Begin Sub max pain free isometrics ( avoid shoulder ext ) PROM in a scapular plane. what happened during the christmas truce of 1914; brooks waterproof shoes; 10-4 or roger word craze; dark souls bundle xbox one; the restaurant bar and grill leeds Modalities (i.e. X08252 (Rev. Methods Twenty Since active and passive ROM Wrist and gripping excercises. Progress PROM: Forward flexion and elevation in the scapular plane in supine to 120 degrees. Biceps and triceps with elbow supported 6. The word "Dys" in the term Scapular Dyskinesia refers to the loss of normal scapular mechanics, motion and physiology. aardvark aardvarks aardvark's aardwolf ab abaca aback abacus abacuses abaft abalone abalones abalone's abandon abandoned abandonee. Submaximal vs. Maximal. GENTLE resisted exercise to Elbow, Wrist, and Hand . CryoCuff) PRN(as needed). abandoner abandoning abandonment abandons abase abased abasement abasements abases abash abashed abashes abashing abashment abasing abate abated abatement abatements abates abating abattoir abbacy abbatial abbess abbey abbeys 3 Weeks to 6 Weeks: Progress exercises listed above. Shoulder ER/IR in standing 4. Wrist and gripping exercises. The position of the scapula needs to be set before the movements take place. Frequent (4-5 times a day for about 20 minutes) cryotherapy. No internal Rotation Range of motion Scaption to 90 degrees. whataburger benefits for employees; taissa farmiga siblings Scapular Pinches w/ Theraband 2. Shoulder ER isometrics 5. Restore active range of motion (AROM) of elbow/wrist/hand 3. Back away from the door until the band is taut, then extend your arms in front of your chest with your palms facing downward. While lying supine, elbow and shoulder should be supported by pillow or towel roll. Begin in a standing upright position with your elbow bent 90 degrees, and a towel . Flexion to 120 deg; ER to 45 deg; Abd to 70; NO IR; 6 weeks. The scapular plane with 90 of shoulder eleva tion in neutral rotation best isolated the subscapularis muscle. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) Setup. 59. ROM performed in the scapular plane should enable appropriate shoulder joint alignment. 3 Weeks to 6 Weeks: o Progress exercises listed above. Enhance PROM 2. Isometric shoulder torque and angular impulse was measured in the position of arm abduction of 90 in the scapular plane, 30 anterior to the frontal plane (scaption) using a portable load cell (BTE Technologies Inc, Hanover, MD) for a duration of 30 seconds on both the dominant and nondominant arms. Scapular Depressor isometrics Isotonics 1. scapular fracture rehabilitation protocol. Cryotherapy for pain and inflammation. EVERSE HOULDER . Begin active flexion, IR, ER, elevation in the plane of the scapula pain free ROM AAROM pulleys (flexion and elevation in the plane of the scapula) as long as greater than 90 of PROM Begin shoulder sub-maximal pain-free shoulder isometrics in __ Begin Scapular strengthening program, in protective range __ Physioball Scapular stabilization (below horizontal) __ Isometric exercises: Deltoid isometrics Submaximal ER/IR isometrics at neutral Effective Examination of the Shoulder Complex: New Advances Deltoid: seated shoulder elevation with cane, seated shoulder elevation with cane with active lowering, ball roll on wall Motor control IR/ER in scaption plane and Flex 90-125 (rhythmic stabilization) in supine Stretching Sidelying horizontal ADD, triceps and lats Study Design Controlled, cross-sectional laboratory study. 0-6 weeks Immediately start Pendulums, Supine Active Assisted Forward Elevation (SAAFE), and External Rotation With Stick. Push your elbow directly backward into the wall, then relax and repeat. Download scientific diagram | Posterior deltoid. Has achieved at least 60+ PROM ER in plane of scapula Has achieved at least 70 PROM IR in plane of scapula measured at 30 of abduction Able to actively elevate shoulder against gravity with good Begin sub-maximal pain-free deltoid isometrics in the scapular plane (avoid shoulder extension when isolating posterior deltoid) The scapular plane is defined as the shoulder positioned in 30 degrees of abduction . Stability and mobility of the shoulder is now dependent on the Deltoid and periscapular Periscapular sub max isometrics; PROM only. Progress PROM: Forward flexion and elevation in the scapular plane in supine to 120 degrees. Supine PROM shoulder elevation in scapular plane Supine AAROM shoulder external rotation with wand in scapular plane within prescribed limits Initiate shoulder AROM when cleared by surgeon Distal AROM exercises Sub-maximal deltoid/scapular isometrics, per surgeon preference Modalities for pain and edema Its important to take surgery recovery seriously in order to ensure the long-term success of the procedure. With forward flexion/abduction, discourage scapular compensation; consider exercises in front of mirror 5. PROM. 11/2019) AAHC \OT Shoulder/Scapula Isometric exercises are muscle tightening exercises performed with no joint movement. repaired supraspinatus tendon in that range vs. arm at side.13 Furthermore, strain is lowest in the scapular and coronal plane vs. the sagittal plane.13 Generally, passive external rotation is restricted to 60 with the arm at >30 elevation in the scapular or coronal plane to avoid excessive tension on the repair. Make sure to keep your back straight during . Doing isometrics at submaximal effort means not performing the isometric exercises at full effort. Focusing on submaximal isometric glenohumeral abduction at 45, the UT, LT, and SA muscles function as stabilizers of the scapula . Dicas, sugestes, indicaes e informaes sobre produtos para o Homem Moderno what is machine dependent language. Isometric diagonal extension and abduction in scapular plane to activate posterior deltoid. music store birmingham, al oklahoma vehicle registration fees calculator scapular fracture rehabilitation protocol. Anterior deltoid strength and scapular stabilization General UE strengthening Cardiovascular Exercises No restrictions Progression Criteria DC to HEP References: Godges, Joe, DPT, MA, OCS. Download scientific diagram | Middle deltoid. Progress PROM: o Forward flexion and elevation in the scapular plane in supine to 120 degrees. warframe pistol pestilence. Progress above exercises 2. The Virtual Health Library is a collection of scientific and technical information sources in health organized, and stored in electronic format in the countries of the Region of Latin America and the Caribbean, universally accessible on the Internet and compatible with international databases. 3 Weeks to 6 Weeks: Progress exercises listed above. In this study, the stiffness was measured by 30 shoulder isometric abduction in the scapular plane, which is frequently used for the evaluation and treatment of the SSP muscle. Supine AAROM elevation in scapular plane . Passive forward elevation in scapular plane to 90-120 max motion; ER in scapular plane to 30 Active scapular retraction with arms resting in neutral position posterior, middle). west florida high school soccer. Begin periscapular sub-maximal pain free isometrics in the scapular plane. 3 - 6 Weeks: Progress exercises listed above. Step 1 IR in scapular plane. Gentle resisted exercise of elbow, wrist, and hand. There should be little to no movement. Independent with activities of daily living (ADLs) with modifications Menu - Sub max pain free deltoid isometrics in scapular plane Weeks 3-6: - Progress FF/elevation in scapular plane to 120 degrees - ER in scapular plane to tolerance Cardiovascular Exercises Light walking if able to maintain balance Progression Criteria Tolerates PROM/isometrics/AROM elbow, wrist, hand Able to isometrically activate deltoid and periscapular muscles in the scapular plane Progress PROM: o Forward flexion and elevation in the scapular plane in supine to 120 degrees. Scapular winging is however a clinical observation wherein any part of the scapular departs excessively from the thorax soon after movement is initiated and persists in its disconnect fashion throughout the arm movement. External Rotation to 20-30 degrees Promote optimal healing of tissue. Progress PROM- FE and Elevation in Scapular plane in Supine to 120 3. Maximal isometrics for all cuff, periscapular, and shoulder musculature. Begin scapula musculature isometrics / sets; cervical ROM. The infraspinatus-teres minor muscles were isolated in the sagittal plane with 90 of shoulder ele vation in a half externally rotated position. between the back of your arm and a wall. 2017 Redora. Limit FE (supine forward elevation in the scapular plane) to 90 degrees Limit ER (external rotation) to neutral 30 degrees Do Not perform Pendulums. Frequent (4-5 times a day for about 20 minutes) cryotherapy. Independent with activities of daily living (ADLs) with modifications rodrigo's happy hour menu. Forward flexion and elevation in scapular plane in supine with progression to sitting/standing. Hold for five seconds, and then slowly release. Shoulder isometrics: abd/adduction, ER, flexion and extension . One example of a submaximal exercise is to hold a weight in your hand and do a lateral raise, bringing the Hydrotherapy (if available) - Pool exercises: forward flexion (scapular plane), horizontal abduction/adduction 6. Strengthening Begin submaximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid) Goals to Progress to Next Phase 1. ER and IR in the 0. The scapular plane with 90 of shoulder eleva tion in neutral rotation best isolated the subscapularis muscle. We were unable to isolate the supraspinatus muscle in any of these tested positions. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) Modalities (i.e. Begin shoulder sub-maximal pain-free shoulder isometrics in neutral 5. The values of isometric scapular abduction strength are shown in Figure 4A. PROM shoulder flexion (with slight IR) PROM shoulder abduction *PROM but no stretching . Greatest gains will be made when the muscles are warm. 7,16 The amount of weight used was based on the participant's body weight. Tip. Add Sub-Max pain free deltoid isometrics in scapular plane a. Phase I Maximal Protection / Acute Phase (0-6 weeks) Goals: Minimize pain and inflammation It was hypothesized that utilizing a sustained isometric hold during a shoulder scaption exercise from the Advanced Throwers Ten would produce greater increases in shoulder strength and endurance as compared to a traditional training program incorporating a isotonic scapular plane abduction (scaption) exercise. Scapular AROM and isometrics . The scapular plane is defined as the shoulder positioned in 30 degrees of abduction and forward flexion with neutral rotation. Isometric Shoulder Flexion. Loma Linda University and University of Pacific Doctorate in Physical Therapy. ER to 60 deg; Begin IR to tolerance NOT to exceed 50 deg; Initiate GH and ST joint mobs ( grade 1 and 2 ) Jobe described elevation in the scapular plane with glenohumeral internal rotation, in the empty can position, as an exercises to strengthen the supraspinatus. External rotation in scapular plane If <30: 0 until Week 3 and then progress to 20 If > 30: 20 immediately Internal rotation in scapular plane as tolerated No extension o Grade I II glenohumeral and scapular mobilizations Strength o Instruct in home program and begin closed chain submaximal isometrics in Scapular strengthening exercises (Shrug, standing/seated row) Frequent (4-5 times a 3 Weeks to 6 Weeks: Progress exercises listed above. Periscapular: scap retraction, standing scapular setting, supported scapular setting, low row, inferior glide Deltoid: isometrics in the scapular plane Criteria to Progress Gradual increase in shoulder PROM, AAROM, AROM 0 degrees shoulder PROM in to IR Palpable muscle contraction felt in scapular musculature Pain < 4/10 Surgeon may Begin sub-maximal pain-free deltoid isometrics in scapular plane. Each participant was asked to perform ten repetitions of weighted bilateral elevation in the scapular plane as previously described. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder; extension when isolating posterior deltoid.) Place a folded towel between your fist and the wall, and gently press your hand into the wall. Flex in scapular plane 90 deg; ER in scapular plane 20-30 deg 4 weeks. Continue AAROM pulleys (flexion and elevation in the plane of the scapula) as long as greater than 90 of PROM Begin shoulder sub-maximal pain-free shoulder isometrics in neutral Scapular strengthening exercises as appropriate Brett Sears. Scapular plane elevation to 160 Pulleys as motion improves __ Use cane for ER to 60 __ Begin Internal Rotation as tolerated. Phase I Maximal Protection / Acute Phase (0-6 weeks) Goals: Minimize pain and inflammation To perform shoulder flexion: Stand facing a wall. egin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) AAROM pulleys (flexion and elevation in the plane of the scapula) as long as greater than 90 of PROM 4. Scapular dyskinesia is considered Elbow isometrics: flexion and extension . ROM performed in the scapular plane should enable proper shoulder joint alignment. Can support body weight with operative shoulder at 6-8 weeks Range of Motion: 6-8 WEEKS: Shoulder AAROM/AROM as appropriate. CryoCuff) PRN(as needed). Begin active flexion, IR, ER, elevation in the plane of the scapula pain free ROM AAROM pulleys (flexion and elevation in the plane of the scapula) as long as greater than 90 of PROM Begin shoulder sub-maximal pain-free shoulder isometrics in PERI-SCAPULAR STRENGTHENING EXERCISES HOME EXERCISE PROGRAM All exercises should be completed as three sets of 10 repetitions, unless otherwise noted. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) o Frequent (4-5 times a day for about 20 minutes) cryotherapy. Range of motion: o Passive flexion and abduction to 120 Isometric diagonal extension and abduction in scapular plane to activate posterior deltoid. Begin Sub max pain free isometrics ( avoid shoulder ext ) PROM in a scapular plane. apartments for rent ankeny. Objectives To examine scapular stabilizer muscle activation during various yoga postures. In this phase, exercises for the scapula can be initiated. It is imperative that the patient [] We could perform measurements with almost no pain because the measurement position in the scapular plane is the more comfortable limb position. Begin sub-maximal pain-free deltoid isometrics in the scapular plane (avoid shoulder extension when isolating posterior deltoid) The scapular plane is defined as the shoulder positioned in 30 degrees of abduction and forward flexion with neutral rotation. Progress PROM: o Forward flexion and elevation in the scapular plane in supine to 120 degrees. AVOID shoulder extension when isolating posterior deltoid @ 3 6 weeks: 1. o Tolerates shoulder PROM and isometrics; and, AROM- minimally resistive program for elbow, wrist, and hand. Background Despite the growing popularity of yoga, little is known about the muscle activity of the scapular stabilizers during isometric yoga postures and their potential utility in shoulder rehabilitation. Post by; on frizington tip opening times; houseboats for rent san diego Exercises: Passive & Active assisted FF in scapular plane - limit 140 (wand exercises, pulleys) Passive & Active assisted ER - no limits (go SLOW with ER) Manual scapular side-lying stabilization exercises Hold this position for five seconds or more. Continue with cryotherapy . Frequent (4-5 times a day for about 20 minutes) cryotherapy. !Periscapular sub-maximal pain-free isometrics in scapular plane !Sub-maximal pain-free deltoid isometrics in the scapular plane !AROM/AAROM of elbow, wrist, and hand !Pendulums Week 3-6: !PROM in supine position o!Forward flexion and elevation in the scapular plane to 120 degrees o!ER in scapular plane to 30 degrees We could perform measurements with almost no pain because the measurement position in the scapular plane is the more comfortable limb position. Begin active flexion, IR, ER, elevation in the plane of the scapula pain free ROM.

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