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Decreased Mobility in the Thoracic Spine: Protecting Your Upper Back, Neck, and Shoulders

EnFuse Staff
support@EnFuseFitness.com

Category: Health & Wellness

Decreased Mobility in the Thoracic Spine: Protecting Your Upper Back, Neck, and Shoulders

Have you ever experienced neck, shoulder, or low back pain but have no recollection of an injury to that specific body part? If so, this pain may be a result of decreased mobility in the thoracic spine. The thoracic spine, also known as the upper and midback, is made up of 12 vertebra, and your rib cage.1 It is responsible for flexing (bending forward), extending (bending backward), and rotation.1 Decreased mobility in the thoracic spine can occur for a number of reasons.

One example is to call attention to the fact that many of us spend the bulk of our days seated. Most people are unaware of their sitting posture and the detrimental effects it can have on their neck, shoulder, and low back. Often times, people tend to sit with their shoulders rounded along with a forward head posture because it is what feels most comfortable for them. Overtime, pain can occur as a result of this altered posture. The thoracic spine can become tight which can refer pain to the neck, shoulder, and/or lumbar spine.

Decreased Thoracic Mobility and Neck Pain

As mentioned above, a large portion of today’s population spends most of their day sitting. This can lead to irregular posture creating increased load and stress on muscles, ligaments, bones, and joints.2 If the upper thoracic spine is tight, it can cause the cervical spine to shift forward creating a forward head posture. This creates extra stress on the posterior neck muscles, increasing tension which can often lead to headaches and neck pain.1 The upper thoracic can also refer pain up into the cervical spine making certain movements that occur at the neck uncomfortable.2 If one is experiencing neck pain, mobilizing the thoracic spine may help decrease the pain and or discomfort one feels in their the neck. The decrease in mobility in the thoracic spine leads to increased mobility in the cervical spine as compensation. The cervical spine has to work harder than it should and one may experience pain as a result.2

Decreased Thoracic Mobility and Shoulder Pain

Those with decreased thoracic mobility often experience increased thoracic kyphosis or rounding of the upper back.2 This causes the shoulders to round forward.

Quick Experiment!

As you are reading this section, sit with your shoulders rounded forward. Now, try to elevate your arms in front of you. Your range of motion should be restricted if you remain slouched.

Now, sit-up straight for me. Retract and depress your scapulae (shoulder blades) and elevate your arms. If you have no pre-existing shoulder injuries, you should be able to elevate your arm through the full range of motion (ROM) without pain.

If the thoracic spine is tight / lacks mobility, the shoulder blades can be pulled outward which can lead to a decreased range of motion (ROM) and pain when the arms are elevated forward or to the side. Additionally, thoracic immobility may also lead to an increased risk for shoulder injuries such as shoulder impingement, rotator cuff tendonitis and or tears.2 Next time you are sitting, be more aware of your posture and how it can affect your range of motion.

Decreased Thoracic Mobility and Low Back Pain

Low back pain can also occur as a result of decreased thoracic mobility.2 Often, people with decreased mobility in their thoracic spine compensate using their lumbar spine during flexion, extension, and rotation. The lumbar spine is built for stability where as the thoracic spine is designed for mobility. The decrease in thoracic mobility allows for the lumbar spine to move more than it is designed to. The lumbar spine is meant to resist excessive rotation. Therefore, one can experience low back pain as a result of increased movement. By increasing the mobility in the thoracic spine, the lumbar spine will be able to provide stability versus mobility.2 The lumbar spine can also experience excessive lumbar extension to compensate for excessive thoracic flexion.1 This causes increased pressure on the disks in the spine which can cause pain in the lower back.1

Exercises to Increase Thoracic Mobility

Tennis Ball Self-Mobilization1

Typically, this exercise is performed on the upper thoracic spine to increase mobility.

1.  Place two tennis balls in a sock, or tape two tennis balls together so that they look like a peanut or figure 8.

2.  The middle of the two tennis balls should be placed on the spinous process of the spine. One tennis ball should be on the left side of the back and the other on the right side of the back with the middle of the tennis balls on the spinous process.

Note:  The spinous process  (bony projection off the posterior (back) of each vertebra) of the spine is the “bump” that you can typically feel on your spine.

3.  Lying down, place the tennis balls at nipple level on your back

4.  Head and neck should be supported

5.  Arms can either be by your side

Tip:  To increase the intensity of the mobilization arms can be crossed at the chest at the level of the tennis balls.

6.  Keep the tennis balls in one position for 30 seconds to a minute, then gently move your body down on the table / floor to move the tennis balls up closer to the neck.

7.  Stop when tennis balls are approximately 2 inches from the neck.1

Foam Roller 1

Typically, this exercise is performed to increase mid and lower thoracic mobility, as well as increase thoracic extension which is often limited in those who spend multiple hours per day sitting.

1.  Foam roller is placed at mid back (for women around “bra line”)

2.  Head and neck are supported as you use your legs to roll yourself back and forth over the foam roller.

Note:  It is important to relax your thoracic spine over the foam roller (allowing your thoracic spine to gently relax over the foam roller) to gain / improve mobility in the joints versus just foam rolling the tensed muscles.

Tip:  To increase intensity, elbows can be brought closer together spreading the shoulder blades further apart.

If there is one area that is “tighter” than others, gently extend thoracic spine over foam roller while continuing to support head and neck. Hold for 20-30 seconds in this one position.  Repeat 2-3 times.

Note: It is important to maintain a neutral spine in the lower back as well. Lower back should not be hyperextended. 1

Open Book - Thoracic Rotation

1. This stretch is performed side-lying with legs flexed to approximately 90 degrees- Stretch should be felt in upper back.

Note: If stretch is felt in lower back, you may be rotating more from your lower back. Take a towel, roll and place it under your ribs to help side-bend the side that is lying on the table.

2. Start with arms extended and together.

3. Rotate thoracic spine moving upper arm and then following arm with head and neck to opposite side.

4. Perform 2 (sets) x10 (repitions) on each side.

Note: This stretch is intended to open-up the thoracic spine and increase thoracic rotation.

Pec Stretch

Often times, those who have a tight thoracic spine also have tight pectoralis (chest) muscles. When tight, these muscles can pull the shoulder forward further adding to that rounded shoulder posture.

There are multiple ways to stretch the pec muscles.

1.  A simple stretch is to bring your arms overhead like you are making the letter “Y”.  This can be performed in a doorway by having one arm on each side of the door frame and walking legs forward.

Note: The stretch should be felt in the front of your body near the shoulder and chest / breasts.

2.  Another way to perform this stretch is to lie on your back on a foam roller with the foam roller along your spine. Arms should be brought overhead to make the letter “Y”

3.  This stretch can be held for 3 (sets) x30 seconds 

Latissimus Dorsi Pull Downs

In order to prevent rounded shoulders leading to decreased mobility in the thoracic spine, lat pull downs can be performed to strengthen the scapular muscles used to retract the shoulder blades and maintain proper posture while sitting.

It is important to remember to retract and depress the scapula (bring shoulder blades together and downward) while performing this exercise.

Note:   pay attention to the positioning of your head when performing this exercise as well. Your head and neck should be neutral to avoid forward head posture.

This exercise can be performed for 3 (sets) x 30 (repetitions) using a lighter weight as first.

We first want to focus on high repetitions using a lower weight because the scapular muscles are primarily designed for endurance. Eventually, as the muscles become stronger, as in you are able to sit upright maintaining proper positioning, we can focus more on strengthening using a higher weight and reducing repetitions.

Example rep / set scheme: 3 (sets) x 15 (repetitions).


We hope that you found this article helpful!  If you are looking to take your health, wellness, and training to the next level and need some guidance, set-up a consult with one our licensed trainers- support@EnFuseFitness.com

In Health,
Team EnFuse

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References:

http://www.mygcphysio.com.au/services/articles-useful-info/thoracic-spine-upper-back-mobility-why-its-so-important-to-everyone/

http://www.marksdailyapple.com/the-importance-of-thoracic-spine-mobility/

Images:

http://www.marksdailyapple.com/the-importance-of-thoracic-spine-mobility/

http://fixtheneck.com/images/slouched_postureTR.jpg

http://fixtheneck.com/images/Kephotic_Lordotic.jpg

http://abbottcenter.com/bostonpaintherapy/wp-content/uploads/2010/05/doorwaystretch.jpg

http://www.ptonthenet.com/images/articles/3868_Image13.jpg

https://shawchiroandsport.com/wp-content/uploads/Foam-roll-thoracic-spine-300x243.jpg

http://byebyelowerbackpain.com/wp-content/uploads/2017/01/Open-Book-Stretch.jpg

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