Which mobilization categories are included in the physical therapy plan to decompress the thoracic outlet?

• A. Cervical, thoracic, AC, SC, first rib, and glenohumeral joint mobilizations
• B. Lumbar spine mobilization only
• C. Ankle and foot mobilization
• D. Pelvic tilt mobilization

Answer: (A)

Thoracic outlet decompression relies on freeing the space where the brachial plexus and the subclavian vessels pass, which is formed by the first rib, the clavicle, and the surrounding scalene muscles as well as the mobility of the shoulder girdle. Mobilizing the cervical and upper thoracic spine helps reduce stiffness and abnormal alignment that can tighten the outlet. Mobilizing the acromioclavicular and sternoclavicular joints allows the clavicle to move more freely, increasing outlet space. Directly addressing the first rib with mobilization can relieve rib-directed compression at the outlet itself. And moving the glenohumeral joint improves overall shoulder girdle mobility, which can lessen compensatory postures that contribute to compression. In contrast, mobilizations aimed at the lumbar spine, ankles/feet, or pelvic tilt don’t influence the structures that form or limit the thoracic outlet, so they wouldn’t be part of a plan to decompress this region.