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for this next presentation Iamp;#39;m going to teach you how to mobilize and manipulate the upper rib which is naturally known as the first rib the first rib could stay elevated typically because of a scalene muscles the anterior fibers and the mid fibers attached to the first rib and if they are held in a short position can hold the first rib up they call it like an inspirated rib and it can cause like thoracic outlet symptoms Alder nerve because of the lower connection to that first rivers in cat1 nerve root makes up the ulnar nerve and that first rib could could affect that so this is one way to adjust so now I tend to go from the head side my patient is prone so what weamp;#39;re going to do is find the level of C7 okay which is typically the most prominent vertebra come on to what you think is T1 thoracic level number one come across to the first rib and then what weamp;#39;re going to do is using the area of the pisi form the mobilization is going to go towards the auxiliary l