Upper Thorax Compression

For a down pump-handle position with reduced posterior thorax expansion, inverted activities are proposed to improve gas exchange and expansion by supporting fuller exhalation and refilling. Upper thorax compression is inferred from shoulder movement limitations. A scapula that is abducted and internally rotated can shorten posterior structures and limit internal rotation. Reduced anterior chest wall expansion can move the scapula into abduction and internal rotation. The mixed pattern of limited internal rotation and horizontal abduction with normal-looking external rotation likely reflects anterior-posterior compression in the upper thorax. Limitations in paired shoulder categories suggest increased anterior-to-posterior compression in the upper thorax. External rotation may appear normal because thoracic or scapular compensation changes the testing orientation. Inverted activities are recommended for the atypical mixed pattern because they support anterior and posterior expansion together. Shoulder internal rotation and horizontal adduction are especially important indicators of upper thorax compression. People with upper thorax compression may respond well to coached inverted…