41 year male, academic (completing his PhD), who goes to the gym recreationally 3-4x/week

Reason for coming to Barefoot Physiotherapy:

Client was bench pressing when he heard and felt a “pop” close to his sternum on the right side. He finished his work out, and later that night was in significant pain with any shoulder movement. This pain remained for 7 weeks and was aggravated by sleeping and any shoulder movement. As this issue was not resolving, the client presented to Barefoot Physiotherapy, as a last resort before considering surgical options.
Goal= Rehabilitate without the need for surgery. Return to training in the gym.

Presented with:

Palpable lump at the collar bone joints
40% neural irritation
Significant stiffness of the collar bone joints
45% range of motion of shoulder
Significantly tight muscles of shoulder, thoracic spine, chest and jaw
Poor/altered biomechanical movement patterns


Neural interface treatment
Right sternoclavicular joint mobilisations with overhead movement
Trigger point releases of Pectoralis Major and jaw muscles
Needling of right deltoid
Home exercise program consisting of motor control exercises of the shoulder and self-releases of right pectoralis major, right middle deltoid and jaw muscles
Education about the biomechanics of the shoulder joint and the collar bone with movement
Gym session with a Barefoot Physiotherapist to ensure appropriate exercise techniques to avoid re-aggravation

Outcome (5 sessions in 2 weeks):

No neural irritation
Increased mobility at the sternoclavicular joint and markedly less visual/palpable deformity
Full shoulder range of motion in all directions (100%) with good motor control
No pain
Significantly less muscle guarding and tightness around the shoulder, thoracic spine and jaw

Influence on the Result:

Client was fully committed to the process and completed all homework. He also had a good support system in place from his family and personal trainer.