1. The patient is asked to sit on a hard surface (e.g. emergency room examination table).
2. The patient clasps their hands together, and the forearms and wrists are placed around the homolateral knee, which is flexed at 90 degrees, (the patient may need some assistance to keep the hands together – a separate person can do this, or the wrists can be gently tied together with a crepe bandage).
3. The head of the examination table is lowered slowly, and the patient is asked to lean backwards with his or her neck in hyperextension. In this position, they exert increasing anteriorly directed axial traction on the dislocated shoulder.
4. The patient also must push his or her shoulders (shrug) anteriorly, thus creating a rotational movement of the scapula around a vertical axis. This rotational movement increases the anteversion.

essential to the spontaneous reduction