Use crossed hands to put a longitudinal force through the shoulder and, therefore, the clavicle while holding back against the sternum with the ulnar border of the sternal hand. When tension accumulates, the sternal hand maintains the pressure and the pisiform pushes toward the table and along the clavicle by means of the hand deviating into an ulnar direction. It may be necessary to rotate the patient's head to one side or the other to optimize the accumulation of tension in the joint.
Extra considerations: Try varying the range of abduction and adduction in the shoulder to optimize the tension.
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