The thoracic spine is an integral component of shoulder and low back health. I mentioned this in my first blog while discussing the joint by joint approach to treatment. I often see shoulder and low back problems being caused by a lack of mobility in the mid back. If we cannot extend through the thoracic spine while raising our arms overhead, whether when throwing a ball or reaching for the top shelf, compensations will happen. A common compensation is extension the low back. This can cause repetitive micro traumas and can eventually lead to low back pain. A quick test to see if thoracic mobility is a problem is the lumbar locked rotation test.
If unable to reach 50 degrees of rotation each way you have a mobility restriction in the mid back and you’ll need to have ways of increasing it. The first exercise that I go to is foam rolling the thoracic spine. This is something that I see a lot of people doing at the gym. I love seeing this at the gym, but I do want to make a few tweaks to the form that I see when at the gym. I try to tell my patients to keep their ribs depressed and to not allow the ribs to flair out because when they start to rise the lower back starts to extend and we are failing to properly target mobility for the thoracic spine. Start by just rolling up and down the back a few times to aid in bringing blood flow to the area. Then, place the foam roller on the mid to low back and use each exhalation to help fold the back over the roller. Perform 3-4 exhalations before moving up the spine. The hands can aid in supporting the neck. I threw in some bad technique there where I allowed my ribs to come up. We do not want this.
The second thoracic mobility exercise I really like is the cat-camel. To do this begin on all fours, while maintaining a stable shoulder and scapula, sink the chest down to extend the thoracic spine then arch and round the back. During the extension phase keep the head tuck instead of jutting the chin out. Repeat this 10-20 times. I like this because it is good for getting motion into the spine and in this case thoracic extension. The last few reps I let the shoulder go, which is what we do not want to do. I apologize for the dark video.
The last exercise in this series is the side-lying thoracic rotation stretch. Lay on your side with the top leg supported by a foam roller, pillow, etc. in a 90/90 position. Have the arms out in front and with the top arm rotate away from your leg while attempting to get the top shoulder to the ground, while maintaining the knee contact on the foam roller. When at the end of the range take some 3-5 deep breaths and feel yourself getting deeper into the movement with each exhale. Repeat 10 times each way.
Go back to the original test to see if these 3 exercises were able to increase your mobility
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Movement Ready 