The pragmatic set included 6 interventions as follows.

1. Pragmatic posterior capsular stretch (PPCS)
2. Serratus anterior stretch (SAS)
3. Rotator cuff facilitation (RCF)
4. Acromioclavicular joint mobilization
5. Pectoralis minor stretch
6. Thoracic manipulation

Scapular strengthening exercises will be individualised focusing on Serratus anterior, trapezius, Levator scapulae, Rhomboids.

Serratus anterior;

• Dynamic hug
• Scaption with external rotation
• Diagonal PNF (shoulder flexion, horizontal flexion, external rotation),

Trapezius - Upper trapezius:

• Unilateral shoulder shrug,
• Rowing,
• Forward shoulder flexion,
• Shoulder abduction in scapular plane above 120 degrees.

Middle trapezius:

• Prone shoulder horizontal abduction
• Scaption, horizontal abduction with external rotation

Lower trapezius:

• Unilateral scapular retraction,
• Prone bilateral shoulder external rotation at 90 degrees of abduction,
• Prone shoulder abduction.

Levator Scapulae:

• Horizontal abduction with shrug,
• Horizontal abduction with ER,
• Prone shoulder extension.

Rhomboids:

• ER at 90° of abduction,
• ER at 0° of abduction,
• Horizontal abduction,
• Shoulder extension,

The pragmatic set included 6 interventions as follows.

1. Pragmatic posterior capsular stretch (PPCS)
2. Serratus anterior stretch (SAS)
3. Rotator cuff facilitation (RCF)
4. Acromioclavicular joint mobilization.
5. Pectoralis minor stretch
6. Thoracic manipulation Five to ten sweeps per minute are administered three to four times. The applied force is combined with deep breathing. The subject is asked to report discomfort and the applied force is adjusted.

The Shoulder Pain and Disability Index (SPADI) was developed to measure current shoulder pain and disability in an outpatient setting. The SPADI contains 13 items that assess two domains; a 5-item subscale that measures pain and an 8-item subscale that measures disability. SPADI was found to have reliability coefficients of ICC ≥ 0.89 in a variety of patient populations.Internal consistency is high with Cronbach α typically exceeding 0.90. The SPADI demonstrates good construct validity, correlating well with other region-specific shoulder questionnaires.

is a reliable tool to measure scapular medial border and inferior angle prominence. It is used to measure the distance from the root of the spine (ROS) and the inferior angle (INF) of the scapula to the thorax wall. The novel scapulometer has excellent reliability and fair validity to quantify medial border and inferior angle prominence of the scapula. Further research utilizing this instrument is recommended.

This VAS will be used in this study to measure Pain. Patients were instructed to assess the severity of shoulder pain experienced last week on a 0-10 cm horizontal line (0 = painless and 10 = worst pain imaginable). The VAS has been shown to have excellent test-retest reliability (ICC = 0.97) and high validity (r with a 5-point verbal descriptive scale = 0.71-0.78) to evaluate pain perception.