Diagnosis:

1. Patient seated with physician behind the patient
2. Physician places their fingers on the clavicular head, their opposite hand should hold the patient’s ipsilateral wrist
3. While holding the patients wrist, the physician flexes the patient elbow to 90° while abducting the shoulder to 90°
4. Internally and externally rotate the shoulder to assess the clavicular motion An anteriorly rotated clavicle will not allow for external rotation

Steps for Treatment:

1. Patient seated with physician behind the patient
2. Physician places their fingers on the clavicular head, their opposite hand should hold the patient’s ipsilateral wrist, the same position as diagnosing a rotated clavicle.
3. While holding the patients wrist, the physician flexes the patient elbow to 90° and externally rotates into the barrier
4. Patient is asked to press the wrist forward and downward against resistance, 3-5 seconds
5. Patient then told to relax for atleast 2 seconds 
6. Engage the new barrier and repeat at least 3 times
7. Passive stretch
8. Return to neutral
9. Reassess

Video Tutorial: