Rib Cage Mobilization from the Back with IR and ER of the Shoulder

  • Once the therapist identifies the most restricted rib, he applies an anteriorly directed pressure to the superior border of the rib to promote internal torsion/IR of that rib
  • The patient is then instructed to IR and then ER the arm while the therapist maintains steady pressure on the superior border of the rib
  • Since IR of the arm promotes IR rotation of the rib, the therapist follows the rib during IR and blocks the rib from moving into ER when the patient ER their arm
  • The patient is instructed to ER/IR their arm repeatedly 7-8 times while the therapist maintains steady PA pressure to the rib angle
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