Causes: bad posture, desk, over exercising, injury. Over time, a muscular imbalance occurs known as The Upper Crossed Syndrome which ELEVATES the first rib. Then, shoulder muscles (the subscap, and infraspinatus) get trigger points, weakness and pain. Now, the shoulder is unable to move normally. Then ppl compensate for the pain by rounding the shoulders FWD and jutting the head OUT further from the neck. The neck m (scalenes, serratus anterior, and scm) overcomp, worsening trigger points.