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Writer's pictureDr. Antonio Colletti

Why Manual Therapy for the Shoulder is Only Part of the Solution

Targeting the rib cage and coordinating stabilizers like the obliques creates lasting relief and better shoulder function. It’s not just about quick fixes—it’s about smarter, pain-free movement!


So, how do we fix this? Start with the rib cage. A stable rib cage creates an anchor point for the obliques, serratus anterior, and other key muscles that keep the scapula moving efficiently. When the rib cage is in the right position—think “rib cage down” with proper exhalation—your shoulder joint can function on axis without relying on compensations from your neck or lower back. This is where manual therapy becomes a team player instead of a standalone solution. Mobilizing the glenohumeral joint while also integrating rib cage stability drills makes every shoulder treatment more effective.


“We suffer more in imagination than in reality.” - Seneca


Shoulder pain often feels overwhelming, but like Seneca’s wisdom, addressing its true foundation—like rib cage alignment—can bring clarity and strength. By focusing on what we can control, such as improving mechanics, we transform discomfort into opportunity for growth.


Manual therapy can absolutely be a key tool in resolving these issues, but let’s be real: just mobilizing the shoulder joint isn’t enough to create long-lasting change. If you want a shoulder that feels better and functions better, you have to think about the bigger picture—and the rib cage is at the center of it.


Here’s the deal: the humeral head (the ball of your shoulder joint) needs to stay on axis to move properly. If it shifts too far forward, backward, or upward during movement, you’re more likely to experience pain or compensations. But here’s the kicker—this “on-axis” movement depends heavily on the rib cage. Think of your rib cage as the foundation that supports the scapula (shoulder blade), which in turn provides the stable platform for the humeral head to rotate smoothly. If your rib cage is flared, tilted, or lacking stability, the entire system can fall apart, forcing your shoulder joint to do all the work on its own. Spoiler alert: it’s not designed for that.


How Rib Cage Positioning Changes the Game


For example, after working on shoulder mobility with manual techniques, adding breathing cues like exhaling fully to “stack” the ribs and pelvis ensures the scapula glides where it’s supposed to. From there, engaging muscles like the obliques and serratus keeps the entire system in check. Suddenly, that limited shoulder range of motion isn’t just fixed temporarily—it’s supported by proper mechanics so it stays fixed.


Why This Matters for Long-Term Function


Don’t neglect the rib cage if you’re serious about improving shoulder mobility and reducing pain. Manual therapy for the shoulder joint is a fantastic tool, but its real power comes when combined with cues that address the body as a whole. Think of it as upgrading the entire system instead of just tweaking one part. And let’s be honest—doesn’t your body deserve the full upgrade?


So, next time your shoulder’s giving you trouble, remember: rib cage first, shoulder second. With this approach, you’re not just treating the symptoms—you’re fixing the root cause and setting yourself up for pain-free movement and better performance in the long run.


Ready to improve your shoulder mobility and reduce pain? Focus on stabilizing your rib cage to create the foundation for proper shoulder movement and prevent injuries. Build strength and alignment from the core out—it makes all the difference!

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