articipants assigned to this arm received the Graston Technique, an instrument-assisted soft tissue mobilization intervention, applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. The intervention was performed after a gentle Z-stretch of the targeted muscles as baseline treatment. A stainless-steel Graston instrument was applied using controlled strokes at approximately a 45° angle to the skin surface, following the direction of the muscle fibers and across the fibers to mobilize soft tissue restrictions. The treatment was applied for approximately 40-120 seconds over each targeted area.

Participants assigned to this arm received LIC applied to the identified myofascial trigger points of the pectoralis major and pectoralis minor muscles. Following a gentle Z-stretch of the targeted muscles as baseline treatment, sustained manual pressure was applied gradually over each trigger point until a tolerable level of discomfort was achieved. The compression was maintained for approximately 90 seconds per trigger point and repeated 1-3 times during each treatment session according to patient tolerance and clinical response. The technique was performed using the therapist's thumb, finger, or knuckle depending on the location and depth of the trigger point. Participants received four physiotherapy sessions over a two-week period, with sessions conducted on alternate days.