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Chapter 34 

Chapter 34
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date: 16 September 2021

“Seven Stages of Spencer” Technique

This is an example of the Lateral-recumbent Direct methodiiiiiiivvvi.

Historical Note

These techniques were developed by Charles H. Spencer, D.O. of Los Angeles CA. They were first presented before the section on technique at the Portland Session of the American Osteopathic Association Convention, August 1915, and published in the JAOA.vii

This technique is part of the standard Osteopathic medical student curriculum and is a very helpful technique for any practitioner to easily use. It has been demonstrated in a Randomized Controlled Trial to show continued significant improvement in range of motion in patients with pre existing shoulder dysfunction.viii

This is a direct articulatory technique used at the shoulder to increase range of motion via stretching soft tissues and increasing circulation and lymphatic flow to the injured area. This technique is particularly useful when restriction or fibrosis has developed in soft tissue during period of inactivity after an injury.

In each of the stages, the shoulder is taken in a certain direction to the physiological barrier. This is action is repeated with overall goal of increasing range of motion and decreasing the physiological barrier.


Patient is in lateral recumbent with dysfunctional shoulder lying up. Physician stands at side of table in front or in back of patient. Knees and hips of the patient are flexed on table for stability. *Of note, for illustrative purposes the p


i Kimberly, Paul. Outline of Osteopathic Manipulative Procedures. The Kimberly Manual. Millennium Edition. Walsworth Publishing Company; 2000: 235-238.

ii Nichols A. Atlas of Osteophatic Techniques. Philioadlphia, PA: Lippincott Williams & Wilkins, 2008.

iii Seffinger, Michael. Evidence Based Manual Medicine: a problem-oriented approach.1st Edition. Saunders Elsevier; 2007: 237-240.

iv Spencer H. Shoulder technique. J Am Osteopath Assoc 1916; 15:218-220

v Spencer H. Treatment of bursitis and tendosynovitis. J Am Oteopath Assoc 1926; 25:528-529.

vi Patriquin D, Jones J. Articulatory techniques. In: Ward RC, ed. Foundations for Osteopathic Medicine. 2nd Ed; Chap 55.

vii Ward RC, ed. Foundations for Osteopathic Medicine. 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2003

viii Knebl JA. J Am Osteopath Assoc 2002; 102:387–396