Can targeted mobilization ease shoulder impingement?

This trial tests whether adding shoulder and neck mobilization to standard physical therapy (hot packs, TENS, ultrasound, and exercises) can better reduce pain and improve function in people with subacromial impingement syndrome. Adults diagnosed with this shoulder condition will be randomly assigned to receive standard care alone, or standard care plus shoulder mobilization, or standard care plus both shoulder and neck mobilization. Over three weeks, researchers will measure pain intensity, shoulder range of motion, and arm function to see if the added manual techniques make a difference.