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Extended Clavicle
Diagnosis:
- Patient is in supine with physician behind the patient at the head of the table
- Physician places their fingers bilaterally on the clavicular heads
- Ask the patient to flex their shoulders to 90° and reach towards the ceiling, assess for posterior movement of the medial clavicle for asymmetry The clavicle that does not move posterior (flex) is the extended clavicle
Steps for Treatment:
- Patient is in supine with physician on the same side of the table as the dysfunctional clavicle
- Patient reaches their arm (ipsilateral side of the dysfunctional clavicle) to touch the physicans shoulder
- Physician places their hands so that one is reaching behind the scapula while the other holds the clavicle over the sternoclavicular joint
- Physician flexes the clavicle until motion is felt at the sternoclavicular joint by straightening the body and pulling the scapula anterior
- Patient is asked to pull the shoulder down against resistance, 3-5 seconds
- Patient then told to relax for atleast 2 seconds
- Engage the new barrier and repeat at least 3 times
- Passive stretch
- Return to neutral
- Reassess
