For most of our clients who present with the postural distortion pattern known as upper crossed syndrome, it is important, perhaps absolutely necessary, to include thoracic spinal joint mobilization technique into extension as part of the treatment plan to address the thoracic hyperkyphosis.
Another reason for shoulder impingement syndrome to occur is insufficient elevation of the clavicle. Most of scapular upward rotation is actually caused by elevation of the clavicle at the sternoclavicular joint, so if clavicular elevation is prevented for any reason, shoulder impingement syndrome can occur.
For scapular upward rotation to occur, scapular downward rotator musculature must lengthen. If scapular downward rotation muscles are tight, they might not be flexible enough to allow for scapular upward rotation, thereby causing shoulder impingement syndrome to occur.
The therapist performed a static assessment of the client’s posture and noted the typical upper crossed syndrome with a hyperkyphotic thoracic spine, a hypolordotic lower cervical spine, a hyperlordotic upper cervical spine, protracted head, protracted scapulae, and medially (internally) rotated arms.
When performing soft tissue manipulation/massage, it is always wise to begin with light to medium pressure, and then transition to deeper pressure.
Thoracic outlet syndrome is a condition that causes compression of nerves and/or blood vessels where the thorax outlets into the upper extremity.