By Steven Tran – Sydney CBD Chiropractor
Are you suffering from low back pain or neck pain? Do you have slumped shoulders? Shoulder pain when lifting items overhead?
This could be the result of poor thoracic spine mobility. What is the thoracic spine? What happens when the thoracic spine loses mobility? How to test for thoracic spine mobility? What can your chiropractor do for thoracic spine flexibility? What exercises can I do to perform my thoracic mobility? Today’s blog answers everything you need to know about thoracic spine mobility.
The thoracic spine (upper back) is an important section of the spine that is often neglected; it is a common problem area in today’s society as we are more sedentary.
The spinal column is made up of five segments and each segment of the spine has different functions and roles. Below is an image of each section of the spine.
The thoracic spine is made up of twelve vertebrate that starts from your shoulder level down to the waist and it plays a crucial role with the ribcage; protecting your lungs and heart. Although the range of motion in the thoracic spine is small, adequate mobility is required to allow for movement in flexion, extension, side-bending and rotation. Patient who present with lack of mobility in the thoracic spine, commonly have a sedentary lifestyle and/or job.
To have mobility is to have access to move freely and easily through all planes of movement. When the thoracic spine loses its mobility, the lumbar spine commonly picks up the slack and will compensate for the limited mobility the thoracic spine now provides, leading to fatigue of the low back muscles and low back pain. Looking above the thoracic spine, we have the shoulders and neck. A lack of movement in the thoracic spine can create discomfort and pain in the shoulder and neck. Study done by Heneghan et al, 2017, showed that thoracic spine movement dysfunction is linked to pathologies and pain in the neck, shoulder and elbow.
An important role of the thoracic spine is to also assist with neck movement. The thoracic spine contributes to 21% of neck rotation and 33% of neck flexion. This shows us that poor mobility in the thoracic spine can lead to the development of pain in the neck.
In the modern era, a significant proportion of the populations are affected by sedentary lifestyle. Sitting for prolonged periods has gradually become the norm with workplace, travelling and transportation. Research has found correlations between sitting >8 hours a day and increased neck, shoulder and low back pain.
It is common to find office workers who spend majority of their time sitting hunched forward and with their head jutted forward. Holding this hunched position for several hours per day reduces the thoracic spine mobility.
If you are affected by neck pain, shoulder pain or low back pain, an important factor that may be contributing to your pain may be a lack of mobility in your thoracic spine. To negate this effect from prolong long postures it is important to incorporate physical activities in your busy schedules, as it will promote soft tissue and joint mobility. Working to improve your thoracic spine mobility can not only improve posture, but also reduce pain in other areas of your body.
It is also important to pay attention to signs of fatigue and discomfort while working. While seated, muscles are activated to help support and upright posture. Over time these muscles can fatigue, which may lead to inappropriate postures and compression can affect mobility as well as impede the flow of blood, impinge nerves and injure soft tissue. Thus taking frequent micro breaks every 20mins to perform light stretching at your desk is also important.
Here are 3 simple self-assessment tests you could try to see if you lack thoracic mobility.
The seated wall angel test looks for a combination of your ability to lengthen muscles of the shoulders and mobility of the thoracic spine. In the seated position we limit involvement of the low back and hip. Thus allow you to rule in or out deficits involved.
If the client present with poor thoracic spine mobility, what we could see are;
The supine flexion test looks for your ability to lengthen the shoulder muscles and capabilities of the thoracic spine. In the supine position, minimal stabilization is required from the body. Thus allow better movement as muscles are relaxed in this position. This test will help indicate a muscle length problem or thoracic extension deficit.
The aim of this test is to identify whether there is a rotation restriction. Rotation through the thoracic spine facilitates stability of the cervical spine and optimizes function of the lumbar spine.
The client should demonstrate approximately 35 degree of rotation in each direction from this position. If the client has a rotation limitation in the thoracic spine, it is challenging to compensate for in this position.
Your chiropractor or other health professional will perform a series of range of motion, muscular and orthopaedic testing on the thoracic spine and surrounding joints. Your chiropractor will try to reproduce pain and/or identify your movement restrictions and explain your diagnosis to you.
Treatment with hands on therapy such as spinal manipulation and muscular release will aim to restore normal joint range of motion in the thoracic spine. Prescription of advice and exercises specific for you and your thoracic spine will also be performed.
Check out the video below to learn more about the three simple exercises to improve thoracic mobility. Try them out at work to take breaks from sitting in a static position. If you are working a sedentary job, it is important to take movement breaks as often as possible.