Articulatory Techniques
Comprehensive OMT reference hub, interactive cheat sheets, and board review notes for COMLEX Level 1, 2-CE, and 3.
Key Takeaway
Articulatory techniques are DIRECT, PASSIVE, low-velocity, high-amplitude (springing) modalities that carry a joint repeatedly through its restrictive barrier to increase range of motion. Master the 7-Step Spencer Technique for frozen shoulder (adhesive capsulitis) for COMLEX.
Classification & Mechanics
Articulatory techniques (also called Springing or Low-Velocity, High-Amplitude techniques) employ low-velocity, repetitive, rhythmic movements to carry a joint through its restrictive barrier. The repetitive movement stretches tight capsular and ligamentous structures and stimulates synovial fluid distribution.
| Modality Feature | Articulatory Technique | High-Velocity Low-Amplitude (HVLA) |
|---|---|---|
| Classification | Direct, Passive. | Direct, Passive. |
| Velocity | Low-Velocity (slow, rhythmic, repetitive). | High-Velocity (rapid impulse). |
| Amplitude | High-Amplitude (moves through full range). | Low-Amplitude (micro-distance). |
| Target Tissue | Joint capsule, synovial fluid, capsular ligaments. | Joint mechanoreceptors & muscle spindles. |
The 7-Step Spencer Technique (MANDATORY FOR COMLEX)
The Spencer Technique is the classic 7-step articulatory protocol for shoulder adhesive capsulitis (frozen shoulder) and glenohumeral restriction. Patient is positioned in lateral recumbent position on the unaffected side.
| Step Number | Spencer Motion Step | Description & Setup |
|---|---|---|
| Step 1 | Extension | Flex elbow; carry arm posteriorly into extension with post-isometric relaxation. |
| Step 2 | Flexion | Extend arm anteriorly overhead into flexion. |
| Step 3 | Circumduction with Compression | Abduct arm to 90°; apply axial compression into glenoid fossa while sweeping small clockwise/counterclockwise circles. |
| Step 4 | Circumduction with Traction | Apply distal traction along humerus while sweeping small clockwise/counterclockwise circles. |
| Step 5A | Abduction | Abduct arm toward ceiling with post-isometric relaxation. |
| Step 5B | Adduction with Traction | Adduct arm across chest with distal traction. |
| Step 6 | Internal Rotation | Place dorsum of patient's hand behind their lumbar back; move elbow anteriorly into internal rotation. |
| Step 7 | Joint Distraction / Pumping | Abduct arm; cup hand over shoulder & pump humerus out of glenoid fossa. |
High-Yield Board Traps & Practice Drills
Q: What is the primary clinical indication for the Spencer Technique?
A: Adhesive capsulitis (frozen shoulder), post-surgical shoulder stiffness, and subacute/chronic glenohumeral somatic dysfunction.
Q: Is the Spencer Technique direct or indirect?
A: DIRECT and PASSIVE. The physician carries the shoulder joint through its restrictive barriers.
Source
Based on the publicly available table of contents and topic organization of OMM Review: A Comprehensive Review of Osteopathic Medicine. All notes are original; no copyrighted text, figures, or full source material is included.