Common Mobility Restrictions Through the Thorax
One of the most common mobility restrictions that we tend to see in our patients who have neck, shoulder, low back, or mid-back problems is a limitation through the thorax. This area includes our ribs, our thoracic spine, and all of the connective tissue in the area.
We’re going to discuss how we assess that in the office. To check thoracic mobility, I usually have a patient start on their hands and knees and then drop down to rest on their elbows. From here they will place one hand on their low back. Once they are in this position, they will rotate the trunk with that arm moving up towards the ceiling. This helps us check thoracic rotation. We will have the patient perform this motion on both sides to check overall mobility and compare side to side.
If someone was limited during this assessment, I would be able to apply a little bit of pressure to help them rotate maybe a little more and better determine what the cause of the problem might be. What we’re really looking for is people to have at least 50 degrees of thoracic rotation. If that’s not the case, then we can begin treatment and start with some exercises to help improve mobility.
Beginner Exercises for Better Thoracic Mobility
A good place to start with thoracic mobility is getting some extension into your routine. This can easily be done just by sitting in a chair. Sit in a chair and support your head, then just simply lean back over the chair, getting a nice arch in the back. Make sure to keep your low back near the back of the chair and do not push it forward. Although this may seem like you are getting a nice arch in your thoracic area, it is more lumbar mobility. This position can be held for a few seconds and then repeated multiple times to get some good motion through the upper back and rib cage.
A similar type of exercise can be done using a foam roller. Set the foam roller on the ground and lay your thoracic spine over it. Using your abdominal muscles arch your back over the foam roller to get that extension motion. A lot of people just want to go as far as possible with this and not isolate the movement. That’s where people will arch through their low back, letting them get extra range of motion where they might even have their hips come off the ground. That’s a way to cheat the movement and not maximize movement in the thoracic spine by compensating with other areas of the body.
The last exercise we are going to discuss is a cat cow. Start down on all fours, and arch your back up towards the ceiling. Pause for a moment and then do the opposite motion letting your back sink down towards the ground. Make sure to slowly move through these positions and repeat the motion several times.
These are three ways for us to really start working on the extension range of motion for the thoracic spine and the ribcage. These will also help the tissues in the surrounding areas.
How to Challenge Your Range of Motion for Better Extension and Rotation
Extension and rotation of the spine naturally occur together as they are coupled movements. When you are lacking in one of these movements, you are probably lacking in the other. We can train both of these movements to help get better with overall movement of the spine. This is something we like to work with in the office with our patients or even send home some exercises for you to work on.
We like to work extension and rotation of the spine laying down on your side to start.
Although there are several ways to work on mobility in these areas, this is how we like to start out. In this position we can utilize the spine, ribs, and abdomen. We can start by assessing how much movement you have and then work to build it up in the same position. As we progress, we can move to a kneeling position and even standing to work more against the challenge of gravity. Combined with breathing, we have many great ways to help with spinal mobility.
Check out the video for a great demonstration on our preferred exercises for improving spinal extension and rotation together. If you think you’re having trouble with either or both of these movements, come into the office for an assessment and guided treatment program.
Postural Control Through Your Mid-Back
An important thing to train is postural control throughout the mid-back. Now when we’re looking at that, I want you to be able to stack your pelvis over your ribcage. You will use your ab muscles to help maintain that so we’re not just dumping into the low back, focusing on using 360 degrees of our core. It takes a little bit of practice to get the proper posture and be able to maintain this position, but once we train you, we can progress from here.
Once the proper positioning is down, we want to focus on breathing here. Taking some relaxed breaths through the nose, making sure to feel the breath into your abdomen. Once you are able to properly breath in this position, we start to challenge you by adding movement and adding weight. One exercise we can do is a farmers carry. This exercise will help challenge your posture and breathing control. I like to use a jump rope to add another challenge for patients as well. This will help challenge you at a higher heart rate. These exercises can be seen in our video and you can always make an appointment to start working on these things in the office with us.
