This blog is looking at the dysfunctional thoracic spine (in some part), in that it has restricted mobility and has the potential to impact you in a variety of ways.
Some individuals develop kyphosis, which is the classic hunch-back type posture, this is commonly seen not only in your office workers, but athletes such as mixed martial artists, the mirror muscle gym goers (those that essentially work their chest muscles rather then their back), as well as labourers, whether due to poor technique or heavy loads, mostly both. There are other aspects of this, however I won't go into further detail.
Having a kyphotic posture results in limitations in the spines ability to move, in extension (backwards), flexion (forwards), laterally (sideways) and rotation. Muscles surrounding the spine and other structures also play a role, in that usually the anterior muscles (muscles at the front of your body) are tight, a classic example is the pectoralis major, commonly known as the pec muscles; whereas the posterior muscles (muscles at the back of your body) are generally weak. This causes rounding of the shoulders which can contribute to the hunch back posture, and in combination of the tight anterior neck muscles (which is commonly seen in the same office workers) have a chin poke posture you can develop the above symptoms mentioned- headaches, upper back pain to name a few. However by having this posture, this not only affects the spine, but also impacts the mobility of the shoulders, in that you have restricted range to move, which can also lead to shoulder impingement issues or rotator cuff tears.
A great example to demonstrate this, is to sit hunched forward, flex (or move) your shoulder overhead, note how far you can move your arm, next sit in correct sitting posture, and repeat this movement, you will notice that you can move the shoulder further. The same principle applies to with neck movement, i.e. turning your head to look over your shoulder, particularly when checking blind spots when driving; thus posture is very important.
This does not only affect the average person, or 'Regular Joe', this follows true for those participating in sports, such as Crossfit, and Olympic Weightlifting etc, that require overhead movements. You would know, or will soon know, that thoracic mobility has massive impact on this movement pattern.
Therefore I wanted to provide some examples of corrective exercises to not only assess whether you may be restricted, but also how you can use these to address the issue of poor thoracic mobility.
I highly recommend that you make a booking with your physiotherapist for an assessment if you experience something of the above, or you find that when you attempt some of the below exercises you feel restricted/tight or pain. By doing this you will ensure that you have been thoroughly assessed, and will have the best treatment plan to address your dysfunction/ poor movement patterns and the like.
With exercises such as the below, particularly if you experience thoracic mobility issues, it is not something that you can regularly do for i.e. 2 weeks, when you start to feel some improvement, or the pain reduces; you must do these regularly, most days of the week, if not every single day, like you should for any exercise program you have been prescribed for a condition or injury. You will get the best results if this is done regularly, like any prescribed exercise.
Keep in mind the below exercises are examples, and only represent a fraction of the rehabilitative exercises and programs that would be prescribed to you by your physiotherapist.
Like any myofascial release, you will be rolling along the foam roller (your bottom on the floor) with your hands behind your head. You will position yourself with the foam roller underneath you. You will work the range from your shoulder or just underneath, to essential the bottom of your shoulder blades, or for the ladies, your bra line is a good indicator. You use your feet as leverage to perform this exercise better.
One way of foam rolling is to have your elbows touching or almost touching, this opens the release up to the rhomboids and other musculature. Otherwise you can keep the elbows apart (as shown).
You will be positioned with the foam roller underneath you, I have recommended in the past to patients that you want to work three areas with the foam roller.
Firstly you would position yourself with the foam roller at the bra strap line, or just under your shoulder blades; second position is mid-shoulder blade level, or midway between top of shoulder blades and bottom; and third position is just under the shoulders, or at the top of shoulder blades. Each position will not be at a significant distance from the other, and you can work more then the three mentioned foam roller positions.
With your hands behind your head, either elbows together or apart (discussed below) and bottom on the floor. I would start patients off with the knees bent, some practitioners would progress to knees straight when greater mobility is reached. You will then look at taking your head to the floor.
Some patients I have seen, using the foam roller is too much, as their thoracic mobility is very poor. I have then used a rolled up towel, or if accessible, a smaller diameter foam roller.
This is a beginning type exercise, and will you start in a side lying position, for comfort it is best to place something like a towel or foam roller under your top knee.
With your hands on your head, your arms will form book coverings, and your aim is to open the book, by rotating your trunk and trying to look over your shoulder.
The most common mistake individuals do with this exercise is that they don't secure their hips. You should not rotate, or move your hips back during the exercise. Usually the hips start to roll back as a compensatory action for poor thoracic mobility. A great way to have a feel for this, is for someone to place the side of their leg along your bottom/hips from behind, to limit your ability to move your hips back, you will notice a difference immediately if you had the habit of rolling the hips back (whether you knew or not).
Essentially this has the same principles as the short lever, however you keep your arms straight. You will typically find that you can rotate further.
You will start in a side lying position, with your top leg position (as in photo demonstrations) in a 90deg angle on a foam roller or medicine ball etc.
For comfort you can support the head on a rolled towel. Begin rotating the top shoulder toward the floor. Maintain contact with the foam roll / ball as rotation occurs. Once maximally rotated, reach the down arm out at an approximately 45 degree angle from the body. Reach the opposite arm toward the ceiling.
Yours in health,
Cook, G., Burton, L., Kiesel, K., Rose, G., & Bryant, M. (2010). Movement: Functional Movement Systems. Loftus Publishing: USA.