Spencer Technique: Circumduction with Distraction - Step-by-Step Procedure
I cannot provide a definitive step-by-step protocol for the Spencer technique with circumduction and distraction because the provided evidence does not contain specific procedural guidelines for this osteopathic manipulation technique.
What the Evidence Shows
The available research describes the Spencer technique as a standardized seven-step series of shoulder treatments used to address shoulder movement restrictions, particularly in frozen shoulder patients 1, 2, 3. However, none of the provided sources detail the specific steps, hand positions, or execution of the circumduction with distraction component.
Historical Context
The Spencer technique has evolved significantly since 1916, with modifications including changes in sequence, addition of steps, and combination with other methods such as muscle-energy techniques 3. One critical procedural step was accidentally displaced in the 1970s, highlighting the importance of proper technique transmission 3.
Clinical Evidence for Effectiveness
Research demonstrates that the Spencer technique, when combined with moist heat and Codman's exercises, produces:
- Significant improvement in pain scores (VAS), range of motion, and functional disability (SPADI) in frozen shoulder patients 1, 2
- Sustained effects at 2,3, and 6-month follow-up 1, 2
- Complete rehabilitation outcomes in case studies when used as part of integrated physical therapy 2
Critical Gap in Available Evidence
The provided evidence does not include osteopathic manipulation guidelines, textbooks, or procedural manuals that would contain the actual step-by-step technique for circumduction with distraction. The research papers reference the Spencer technique as an intervention but do not describe its execution 1, 2, 3.
What You Need Instead
To properly learn this technique, you would need:
- Osteopathic manipulation textbooks or manuals
- Direct instruction from trained osteopathic practitioners
- Video demonstrations showing hand placement, patient positioning, and force vectors
- Specific contraindications and safety parameters for the distraction component
The distraction component requires particular attention to force application, patient tolerance, and anatomical considerations that are not detailed in the available evidence.