Lateral Glide + Active Elevation
One question matters more than the name of this variation: will the patient notice a useful change in Pain-free flexion/abduction and the exact reaching task.? The careful re-test gets the final word.
The change we are looking for
Restore a painful/restricted elevation movement when a sustained lateral glide makes the motion immediately easier.
Primary target
Glenohumeral joint
The movement that tells us
Pain-free flexion/abduction and the exact reaching task.
Patient focus
Restore a painful/restricted elevation movement when a sustained lateral glide makes the motion immediately easier.
Therapist verifies
Pain-free flexion/abduction and the exact reaching task.
Success signal
Keep the technique only if the re-test shows a meaningful improvement in pain-free flexion/abduction and the exact reaching task. without symptom worsening.
Full clinical application
Position the patient
Standing or sitting with the shoulder girdle relaxed and the movement to be re-tested clearly defined.
Set the contact
Use a belt or broad manual contact to sustain a lateral glide of the humeral head while the patient controls the arm.
Apply the technique
Maintain the pain-free glide while the patient actively elevates the arm. Adjust the glide direction until the movement is clearly improved or abandon the technique.
Dose & re-test
6–10 repetitions for 2–3 sets if the PILL response is present. Re-test: Pain-free flexion/abduction and the exact reaching task.
Clinical pearl
Mulligan's practical rule is PILL: Pain-free, Immediate improvement, Long-lasting effect. If the first two are absent, change or stop the technique.
Safety / avoid
Do not push through pain to complete repetitions.