Spencer Muscle Energy Technique for Shoulder Dysfunction
The Spencer technique is a seven-step osteopathic manual therapy protocol specifically designed to restore shoulder range of motion and reduce pain in patients with shoulder movement restrictions, particularly frozen shoulder (adhesive capsulitis). 1, 2
What the Spencer Technique Is
The Spencer technique is a structured sequence of passive and active-assisted shoulder mobilizations that systematically addresses all planes of shoulder motion 1, 2. It involves the practitioner guiding the patient's shoulder through seven specific movements while the patient remains relaxed or provides controlled muscle contractions 2.
Primary Clinical Applications
Frozen Shoulder (Adhesive Capsulitis)
- The Spencer technique is most effective for stage 2 and 3 frozen shoulder, where pain and stiffness significantly limit shoulder function 1
- Treatment produces clinically meaningful improvements in pain (measured by VAS), range of motion in all planes, and functional disability (SPADI scores) 1, 2
- Effects are sustained at 2,3, and 6-month follow-up, indicating durable therapeutic benefit 1, 2
Other Shoulder Conditions
- Shoulder movement restrictions from various causes benefit from this approach 2
- The technique has demonstrated effectiveness in baseball players for improving shoulder function 1
Treatment Protocol Structure
Session Frequency and Duration
- Administer 3 sessions per week for a minimum of 3 weeks to achieve clinically significant improvements 1, 2
- Each session should include the complete seven-step sequence 2
Adjunctive Therapies
- Combine Spencer technique with moist heat application before treatment to prepare tissues 1, 2
- Add Codman's pendulum exercises as part of the comprehensive treatment program 1, 2
- This multimodal approach (Spencer technique + heat + exercises) produces superior outcomes compared to any single intervention 1, 2
Evidence Quality and Effectiveness
The Spencer technique shows strong clinical effectiveness specifically for frozen shoulder, with pilot study evidence demonstrating statistically significant improvements (P < 0.05) across all outcome measures 1. A case report provides additional support for sustained functional improvements over 6 months 2.
Important distinction: The Spencer technique differs from general muscle energy techniques (MET), which show limited effectiveness for low back pain according to Cochrane review evidence 3. The Spencer technique's specific application to shoulder pathology and its structured seven-step protocol make it a distinct intervention with stronger supporting evidence for its intended use 1, 2.
Common Pitfalls to Avoid
- Do not apply the Spencer technique to acute shoulder injuries or inflammatory conditions without appropriate medical clearance 1
- Ensure patient age and frozen shoulder stage are appropriate (ages 40-60, stages 2-3 show best evidence) 1
- Do not use Spencer technique as monotherapy—always combine with heat and home exercises for optimal outcomes 1, 2
- Avoid aggressive mobilization—the technique relies on controlled, systematic progression through the seven steps rather than forceful manipulation 2