Thoracic Mobility: The Link in Neck, Shoulder, and Low Back Pain

August 13th, 2020
Thoracic Mobility

Frequently being hindered by neck, shoulder, and/or low back pain can be frustrating to say the least, greatly affecting abilities with tasks at work, home, and working out. But hope lies in the thoracic spine, the portion of the middle of the back located between the shoulder blades. Tightness/stiffness in the thoracic spine can many times be the culprit for that nagging neck, shoulder, and low back pain, where improving the mobility in the thoracic spine may be the key to unlock the aches and pains.

Anatomy

The thoracic spine consists of 12 vertebrae that attach to the bottom of the cervical spine (neck) and the top of the lumbar spine (low back). These thoracic vertebrae serve as attachment sites along the back for the ribs that come from the sternum in the middle of the chest. The primary motions in the thoracic spine involve flexion (bending forward), extension (arching back/sitting upright), and rotation (twisting), with rotation being the primary movement.

Potential Cause to Neck, Shoulder, and Low Back Pain

Prolonged periods of sitting, typing, working at a desk, or participating in sports that require constantly bending forward (particularly cycling/spin) can result in increased rounding of the thoracic spine (kyphosis). With an increase in thoracic kyphosis and decreased ability to rotate and extend the thoracic spine comes a forward head position, rounded shoulders, and increased arch in the low back (lordosis). The forward head posture is associated with headaches and overall neck tightness. When the shoulders round, it limits how well the shoulder blades can move along the rib cage when raising the arms overhead causing pinching in the shoulder joint. Lastly (but definitely not least), an increase in lumbar lordosis places increased stress to the lower back further resulting in low back pain.

Loss of thoracic mobility also greatly affects athletic performance. All sports to some degree (some much more than others) require the ability to rotate. Rotation is necessary when throwing, kicking, swimming, golfing, swinging a bat/stick/racket, and cutting/changing direction. When rotation through the thoracic spine decreases, compensations in the low back, hips, shoulders, and neck occur placing increased stress to these regions and result injury/pain may occur.

 

How Physical Therapy Can Help

A thorough biomechanical analysis will help to develop the most effective, individualized treatment plan. Assessing posture, functional movements (squat, lunge, overhead reaching), range of motion (neck, shoulder, hips, low back), and strength will further help to identify the most effective way to improve thoracic mobility and get back to pain-free living. Treatments often incorporate joint mobilization, soft tissue mobilization, stretching, strengthening, and improving functional movement patterns with a guided gradual return to physical activity. For a few examples of how to improve thoracic mobility, click the link below to help get things started…

Suffering from neck, shoulder, or low back pain? Give any one of our NJ locations (Cherry Hill, Haddonfield, Washington Township) a call to meet with one of our highly-trained physical therapists!

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