Significant physical examination findings are summarized below. Active range of motion (AROM) of the cervical spine and upper extremities was within normal limits for all motions. Muscle length examination revealed tightness of the bilateral pectoralis minor muscles, and manual muscle tests revealed weakness in the bilateral middle and lower trapezius muscles. Neer and Hawkins-Kennedy tests were positive for shoulder impingement on the right, and upper-limb tension tests were positive for median nerve entrapment in the arm. The Neer and Hawkins-Kennedy tests have shown sensitivity of 75% to 88.7% and 92.1%, respectively, for subacromial impingement and a high specificity value of 96%.18,19 Palpation revealed increased bulk with an active myofascial trigger point (MTrP) in the right upper trapezius muscle and right levator scapulae muscle distal attachment