The Immediate Effects of First Rib Mobilization on Pain and Range of Motion in Patients With Shoulder Pain

Participants in the mobilization group will receive either a seated or supine three stage progressive muscle energy technique (MET) plus a singular high-velocity, low-amplitude thrust (HVLAT) mobilization technique directed to their first rib on their symptomatic side based on the discretion of the treating physical therapist.

Participants in the sham mobilization (control) group will be placed in a supine, hook-lying position identical to the mobilization group; however, they will be instructed to inhale and exhale 3 times using diaphragmatic breathing (avoiding upper chest recruitment) as the physical therapist gently rests his or her hand over the area of the upper trapezius muscle just proximal to the first rib to simulate a sham mobilization hand placement. Therefore, physical therapists will not use any significant compressive force to the musculature, perform any tactile cueing for upper chest breathing, perform any mobilizations, nor perform any HVLAT techniques to participants in the sham mobilization group.