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Regional Manual Therapy
Ribs & Chest WallFacilitated Positional Release (FPR)General regional overview

PNA Regional Principles · Overview

Ribs & Chest Wall — Facilitated Positional Release

What changes when Facilitated Positional Release (FPR) meets the ribs & chest wall? Start with the patient's movement, assess safely, and see what the re-test reveals.

3 specific variationsClinical re-test built in

Important: this is a clinical framework, not a complete technique protocol.

This page was generated from broader regional principles. It can help you frame assessment, patient comfort, safety and reassessment, but its generic positioning, contact and dosage text must not be treated as technique-specific hands-on instruction. Study a detailed, individually authored procedure and use supervised practical training.

Read the parent technique and its specific clinical methods

Specific variations

How this technique is applied in the ribs & chest wall

Each variation below is written so you can follow patient setup, contact, direction, dose and the re-test that decides whether the technique earned a place in the plan.

01
Ribs & Chest WallIntercostal region

Intercostal region — Facilitated Positional Release

One question matters more than the name of this variation: will the patient notice a useful change in Re-test the region's original pain, range or functional task.? The careful re-test gets the final word.

The change we are looking for

Improve pain, movement tolerance or tissue-related function when this target is clinically relevant.

Primary target

Intercostal region

The movement that tells us

Re-test the region's original pain, range or functional task.

Patient focus

Improve pain, movement tolerance or tissue-related function when this target is clinically relevant.

Therapist verifies

Re-test the region's original pain, range or functional task.

Success signal

Keep the technique only if the re-test shows a meaningful improvement in re-test the region's original pain, range or functional task. without symptom worsening.

Full clinical application
1

Position the patient

Supported sitting or side-lying with breathing unrestricted.

2

Set the contact

Support the region and position Intercostal region toward ease before adding the trained facilitating force.

3

Apply the technique

Move toward ease, add the trained low-force compression/distraction/torsion, then return slowly to neutral.

4

Dose & re-test

Brief holds, often around 3–10 seconds, repeated only a small number of times. Re-test: Re-test the region's original pain, range or functional task.

02
Ribs & Chest WallPectoralis minor

Pectoralis minor — Facilitated Positional Release

One question matters more than the name of this variation: will the patient notice a useful change in Re-test the region's original pain, range or functional task.? The careful re-test gets the final word.

The change we are looking for

Improve pain, movement tolerance or tissue-related function when this target is clinically relevant.

Primary target

Pectoralis minor

The movement that tells us

Re-test the region's original pain, range or functional task.

Patient focus

Improve pain, movement tolerance or tissue-related function when this target is clinically relevant.

Therapist verifies

Re-test the region's original pain, range or functional task.

Success signal

Keep the technique only if the re-test shows a meaningful improvement in re-test the region's original pain, range or functional task. without symptom worsening.

Full clinical application
1

Position the patient

Supported sitting or side-lying with breathing unrestricted.

2

Set the contact

Support the region and position Pectoralis minor toward ease before adding the trained facilitating force.

3

Apply the technique

Move toward ease, add the trained low-force compression/distraction/torsion, then return slowly to neutral.

4

Dose & re-test

Brief holds, often around 3–10 seconds, repeated only a small number of times. Re-test: Re-test the region's original pain, range or functional task.

03
Ribs & Chest WallSerratus anterior

Serratus anterior — Facilitated Positional Release

One question matters more than the name of this variation: will the patient notice a useful change in Re-test the region's original pain, range or functional task.? The careful re-test gets the final word.

The change we are looking for

Improve pain, movement tolerance or tissue-related function when this target is clinically relevant.

Primary target

Serratus anterior

The movement that tells us

Re-test the region's original pain, range or functional task.

Patient focus

Improve pain, movement tolerance or tissue-related function when this target is clinically relevant.

Therapist verifies

Re-test the region's original pain, range or functional task.

Success signal

Keep the technique only if the re-test shows a meaningful improvement in re-test the region's original pain, range or functional task. without symptom worsening.

Full clinical application
1

Position the patient

Supported sitting or side-lying with breathing unrestricted.

2

Set the contact

Support the region and position Serratus anterior toward ease before adding the trained facilitating force.

3

Apply the technique

Move toward ease, add the trained low-force compression/distraction/torsion, then return slowly to neutral.

4

Dose & re-test

Brief holds, often around 3–10 seconds, repeated only a small number of times. Re-test: Re-test the region's original pain, range or functional task.

Safety / do not apply when…

Do not manually treat unexplained chest pain, dyspnea, suspected rib fracture, acute cardiopulmonary symptoms or systemic illness.

Stop or modify if symptoms peripheralize, neurological status worsens, the response is disproportionate or the patient asks to stop.

Clinical rule

A technically correct technique is not automatically a useful technique. Keep it only when the patient's pain, range or function improves in a clinically meaningful way, then transfer that gain into active movement, loading or self-management.