Manual Therapy Combined With Breathing

Inclusion Criteria: * being between 18 and 65 years of age; * the presence of at least one of the following clinical findings: positive Neer Impingement Test, positive Hawkins-Kennedy Impingement test, or painful arc during active abduction or flexion * experiencing pain in at least one of the resisted tests for internal rotation, external rotation, abduction, or flexion * being able to participate in the face-to-face treatment program consisting of a total of 18 sessions Exclusion Criteria: * a history of upper extremity fracture; undergoing shoulder surgery on the affected side within the past 12 months * significant shoulder weakness or loss of active shoulder function; the presence of systemic musculoskeletal disorders * symptom reproduction during active or passive cervical movements; the presence of consciousness disorders, cognitive impairments; and having any diagnosed cardiovascular disease