Patient lies on the unaffected sidelying. Affected arm abducted till the barrier.
The therapist stands behind the patient, with caudal hand stabilizing the pelvis and the other hand providing resistance and stretch. Like pectoralis major, traction is useful.
PIR is achieved by isometric adduction, extension, meidal rotation.
Command:
PIR: push the arm towards the ceiling and towards me. Hold.
Primary parameters:
Strength of contraction: very little, duration 7-10 seconds. Tap to relax, ask for exhalation. Variations in strength, duration, type of contraction etc can be tried.
Action: Move the shoulder further into abduction and extension.