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2.2.3A.

Therapy for the pectoralis major,

clavicular part. Bilateral stretching.

Starting Position: P: Supine; knees and hips flexed to stabilize lumbar and thoracic regions and to prevent lumbar spine lordosis; smali, firm cushion may be placed between scapulae to permit maximum shoulder movement; thorax stabilized to couch with a belt; support under head and neck; chin tucked in to protect cervical spine; arms flexed above head. T: Standing at head of couch.

Grip: Using both hands, T grips medial sides of P’s upper arms at the elbows. T holds P’s arms flexed, fully laterally rotated and in approximately 90° abduction at the shoulders with P’s elbows flexed 90°. (If P is very strong, T can grip P’s forearms or hands. If T’s hands are large enough, he/she may be able to grip P’s elbows and forearms to maintain maximał lateral rotation).

Fig. 5 a. Starting Position.

Procedurę: Using this grip, T gradually and fully abducts at P's shoulders.

Stimulation of Antagonists: T reverses grip (to under P’s arms). T then asks P to move further in the direction of stretching, and resists that movement to stimulate P's antagonists.

Notę: The pectoralis major may also be bilaterally stretched with P sitting. P's back should be supported (with a chair, a cushion, T’s knee, etc.) with hips fully flexed to stabilize the pelvis and protect the lumbar spine. T stretches by using the above technique.

Fig. 5 b. Finał Position.

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