Thoracic Spine Impairment and Dysfunction

Moms for years have telling us to sit up straight and have good posture. They were probably right! First sitting at school, then grinding away to our computers at work and now spending our social lives slouched over our mobile devices, all are conducive to long term orthopedic consequences.

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We go from standing tall early and end up with the thoracic spine alignment and function of Charles Montgomery Burns. It all started once we sat down at our desks in kindergarten!

baby-standing-tallmr-burns-homers-simpson

It’s more than than just posture. 21st Century living, disuse, overuse, stress, lack of mobility and local articular issues often lead to dysfunction and impairment of the thoracic spine.

The difference between impairment and dysfunction is semantics. The dictionary reads that impairment can mean being diminished, weakened, or damaged and dysfunction means malfunctioning. I like to think of dysfunction as starting locally and impairments as being part of a regional or systematic issue.

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For example a restricted rib in the thoracic spine after sleeping in a funky position vs. restricted thoracic rotation done a mal-alignment in the lumbo-pelvic-hip complex. Either way something is not working right and it is either located or manifesting in the thoracic spine. Here is a short video discussing different types of musculature that influence structure and function of the thoracic spine.

A poorly functioning T-spine can lead to; inefficient load transference, dysfunctional breathing, pain, headaches, decreased athletic performance and shoulder, elbow or neck injuries. I have had students, adults and athletes alike report any combination of these symptoms with the route cause being thoracic dysfunction.

poor-computer-posture-eric-beard

Thoracic spine dysfunction can be observed during basic movement patterns. Quick screens like having clients raised their arms overhead, perform spinal rotation in each direction and even holding a plank can help you assess thoracic mobility. If the arms can’t be raised overhead without compensation at other joints, or if there is an asymmetry in rotation or if the client has trouble elongating the spine then you might want to further investigate the T-Spine. Here is an older video of a mobility exercise that can be used simultaneously assess and improve thoracic mobility.

There is an array of corrective strategies to follow. One of which is the National Academy of Sports Medicine (NASM) Corrective Exercise Specialist (CES). The NASM CES methodology suggests inhibiting overactive tissues, lengthening shortened structures, activating inhibited muscles and integrating the changes back into functional movement patterns. NASM’s CES segues directly into their Optimum Performance Training Model to help complete the programming loop in comprehensive manner.

Another popular corrective approach is Grey Cook‘s Functional Movement Systems (FMS). The FMS training cycle flows from Mobility to Static Motor Control, Dynamic Motor Control and then to Strength. The FMS addresses joint mobility via motor control as well as places a spotlight on breathing which makes sense to me since breathing is such an important aspect of thoracic mobility.

I think there are many parallels and similarities between NASM’s approach and that which Grey promotes through the FMS. I enjoy drawing from both approaches.

Below are some videos that demonstrate some corrective techniques that can be used to enhance the health and function of the T-Spine.

Inhibit/SMR/Mobility

The levator scapulae and pectorals minor are often culprits restricting thoracic mobility. Here are some basic soft tissue release, inhibition or self myofascial release techniques to address the levator and pec minor.

Mobility

Mobility drills are helpful to open up these localized areas of dysfunction and to begin to restore local motor control. Here’s a version of one I like to use:

Motor Control/Activation

Integration/Strength 

Integration, total body functional movement patterns and strength exercises should top off the corrective program.

Regardless of your school of thought or the specific techniques you use. I think we can all agree that identifying and addressing thoracic dysfunction will go a long way in enhancing the effectiveness of our programming for our clients, patients and athletes.

Thanks for reading!

Eric Beard

ericbeard.com

Want more on the T-Spine? Check out the video I shot with Laree Draper and On Target Publications:

http://www.otpbooks.com/product/eric-beard-thoracic-mobility-video/

 

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