Abstract
Based in the literature review it is hypothesized that addressing areas of hypomobility in the upper thoracic spine and cervical spine will lead to normalization of the biomechanics of the shoulder complex, thus reducing the abnormal loads placed on the shoulder and the articulations involved leading to greater range of motion within the shoulder complex. Current research is limited but seems to indicate that there is potential positive effect on SIS by addressing these spinal dysfunctions and that there is a need for further research in this area. This study will add to the growing body of evidence based research that SIS can be treated conservatively with lower cervical and upper thoracic joint mobilizations in addition to standard physical therapy interventions for SIS. The purpose of this study was to determine whether lower cervical and upper thoracic spinal manipulations are an effective way to treat SIS leading to regained range of motion within the shoulder complex. The research question of this study was: Is there a difference in treatment outcomes in patients with shoulder impingement syndrome who receive standard physical therapy treatment and manipulation to the lower cervical and upper thoracic spine compared to those who only receive the standard physical therapy treatment?