The Spencer technique is a standardized series of shoulder treatments with broad application in diagnosis, treatment, and prognosis. The evolution of this technique is traced from 1916 to date to try to identify factors in the development of manipulative methods. Few suggestions about the basic steps to be followed in developing any new manipulative technique were seen. Of chief importance were changes in sequence, the addition of steps, and the combination of one technique with another, as in the addition of muscle-energy methods to each step. One change, accidentally introduced in the 1970s, displaced a critical step in the procedure. The principal element guiding the development of the Spencer technique appears to be clinical necessity interpreted in terms of anatomy and pathology.