Upper extremity: shoulder, clavicle, elbow and wrist
Shoulder
- Rotator cuff: supraspinatus, infraspinatus, teres minor and subscapularis.
- Supraspinatus starts and assists abduction and holds the humeral head in place. Infraspinatus and teres minor rotate externally; subscapularis rotates internally.
- Cuff tear: weakness and trouble with overhead use; supraspinatus is the usual one involved.
- Anterior dislocation usually follows abduction and external rotation, often with extension; the head goes forward and down. Check the axillary nerve (sensation over the deltoid).
- A humeral shaft fracture can injure the radial nerve and cause wrist drop.
Spencer technique
An articulatory sequence for the shoulder (with soft tissue, lymphatic and often muscle energy elements). Stabilize the scapula and clavicle throughout. A common order:
- Extension
- Flexion
- Circumduction with compression
- Circumduction with traction
- Abduction
- Adduction with external rotation
- Internal rotation (hand behind the back)
- Pumping with traction (stretch and lymphatic drainage)
Stage numbering varies between texts.
The rest of this guide is for founders
Founders get every guide, endless cases with an AI tutor, and Anki export of their misses. Here is what is inside:
- Shoulder
- Clavicle
- The radial head
- The ulna and the parallelogram
- Elbow and wrist disorders
- Carpal tunnel and OMT
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