Impingement

In the last three weeks alone I have had three patients present to me with cervical and shoulder pain – all with classic shoulder impingement symptoms. For these patients I have found that the lower traps exercises are good, and mostly they are compliant with completing them. All presented with cervical 'stiffness', but on PAIVM assessment it was more the thoracic vertebrae showing signs of hypomobility. Treatment included mobilisation to the thoracic spine, soft tissue massage to the affected area, and a home exercise program including lower traps exercises and postural re-education. All three patients responded favourably within one week, and are continuing to improve on both a subjective and objective level. My supervisor reported that thoracic mob's can often work wonders, especially when all else has failed with nerve symptoms, for example tingling in the hands, which you would think would respond to cervical work, when it doesn't thoracic mobs sometimes help. He reported this may be due to the fact that all sympathetic nerve fibers originate from the thoracic spine, whereas the parasympathetic nerves come from the cervical and lumbosacral spine. Has anyone else found this whilst on clinic?