Pectoralis Minor Release in Patients With Subacromial Impingement Syndrome

Physiotherapy treatment included passive manual joint mobilization, home-based strengthening exercises and advice on posture, twice a week. So, we will apply this conventional physical therapy to control group 1. Postural correction exercise * Patient can apply this exercise on prone lie position for against a wall as in figure 10. * patient will start with chin in exercise, will asked to pull his chine in and push the wall, then hold for 15 seconds and repeat for 3 times. * Patient will try to touch both shoulders to the wall and hold for 15 seconds. * Patient will be asked to straight all spine against the wall and hold for 15 seconds. 2. Scapular stabilization exercise Patient will lie prone with elbow extended, start to move his arm away from his body (horizontal abduction), with wait or without according to Lafayette muscle test results. Apply 2 cycle and each cycle will have 10 times repetitions

Treatment will be conventional treatment with pectoralis minor release and stretch. * Pectoralis minor stretch The subject lying in a supine position with a towel roll running the length of the thoracic spine. The subject's shoulder at 90° of abduction and external rotation and the elbow at 90° flexion while therapist applying a posterior force to the coracoid process, in this study stretch will be performed for two sequential repetitions, holding the stretches for 30 seconds with 30 second break * Pectoralis minor release the subject in a supine position with the test arm at his side while the therapist palpated medially into the proximal axilla, followed by proceeding superiorly towards the coracoid process then applied pressure in the anterior direction, similar to attempting to lift the muscle, therapist applying tensile force directly to the pectoralis minor. The opposite therapist hand will stabilize the scapula and humeral head maintain for 30 seconds and repeat 2 times