Your patient presents with a major shoulder flexion deficit (35 degrees!) and a HARD end feel. You thinking frozen shoulder? Capsular pattern?
🧠Check the neck first.
Before we even TOUCHED her shoulder, we tested for cervical spine involvement. A simple cervical retraction with sidebend to the right (with overpressure) immediately unlocked her motion, leaving only a 5-degree limitation with pain just at the very end.
The primary driver wasn't in the shoulder at all—it was the cervical spine!
This is where the pec minor technique from the video comes in.
After addressing the neck's influence, she was still limited in IR and ER with pain during the motion. This pain-free pec minor inhibition was Phase 2 of the treatment to address the local tissue.
The result?
✅ Full, pain-free External Rotation.
✅ Minor limitation in Internal Rotation.
✅ Pain was once again ONLY at the very end of the range.
To clean up that last little bit, we went back to the neck. A simple chin tuck and sidebend to the right completely eliminated the remaining end-range pain, proving the neck's powerful ability to modulate shoulder sensitivity.
The lesson: The cervical spine can directly modulate shoulder pain and limitations in ROM. It's a classic example of regional interdependence. Always look for cervical drivers before chasing pain in the shoulder.
Give this sequence a shot in the clinic! Let me know your thoughts on this layered approach in the comments. 👇
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