- Low back has been under control. Feels low grade discomfort but it is not limiting any activities including jujitsu and skiing
- Reports chief complaint of a deep soreness in the lower right inferior angle of scapula
- Pulls and painful with bending forward
- Coughing, sneezing
- During jujitsu pulled guy on top of him and felt anterior R chest and posterior thoracic pain afterwards
- Pain with sitting up from lying, sitting forward
- Pushing down into seat belt scapular depression
- Reproduction of pain pressing down motion, mild pulling with end range cervical flexion and extension
- pain reproduced with active shoulder abduction
- Movement preference for thoracic rotation more so with left rotation compared to the right
- Posture with R upper torso lean to the R with moderate scapular winging on the R
- Initial Home Program
- Active rotation holding towel/pillowcase…start with 5 rotations to the left followed by 5 rotations from left to the right
- Follow that with progression of movement overhead as depicted below
- May try this as well to lengthen the R side, lay on whichever side is most comfortable
