Upper Thoracic biomechanical assessment by Fellow in Training Renee Johnson PT, COMT.

Starting with head rotation assess the ability of T1 to transverse glide contralaterally (e.g. R head rotation = L translation). Next, assess the 1st rib, it should swing anteromedially IL and posterolaterally CL with head rotation (R head rotation = anteromedial swing R 1st rib, and posterolateral swing L 1st rib). With both of these assessments, test the end feel, especially if there is a restriction on kinematic movement testing. To assess the joint’s ability to go into extension, use a 4 point technique. First, the bilateral arm raise will reveal ability to inferiorly glide. Use active movement testing (AMT) with one thumb on the transverse process and other thumb on costotransverse joint to assess single arm raise and inspiration (looking for the first rib’s ability to posterior roll).