AP Mobilization to the L Sternochondral Joints to Increase Thoracic Rotation to the Left
- The patient is right side lying with the hips and knees flexed to about 45 degrees and places their left hand behind the head.
- Instruct the patient to rotate back to the left without separating the knees.
- The therapist places the pad of their right thumb on the superior border of the L sternochondral joint and applies an AP glide to promote external rotation (torsion) at each rib.
- The therapist assesses rib mobility from T1-T7 and identifies the most significant restriction needing mobilization.
- The anterior ribs can be very tender/painful so the therapist is looking for the most hypomobile rib, not the most tender.
- Posterior capsule tightness resolves most commonly after AP mobilization of the hypomobile 4th and 5th sternochondral joints on the opposite side.
- Pectoralis minor tightness often resolves after AP mobilization of the ipsilateral sternochondral joints from T3-5.