Updated: Aug 25, 2022
The thoracic spine, or your mid-back, is comprised of 12 vertebrae (T1-T12) which allow for movement in various planes. The thoracic vertebrae are the only part of your spine connected to your rib cage, thus making it inherently less mobile than the neck and the lower back. Therefore, it is important to maintain normal range of motion throughout the thoracic spine to optimize posture and body mechanics throughout your daily activities and workouts.
It is common to develop stiffness in your thoracic spine, especially in todays society. Many people spend a majority of their day sitting in a slouched position such as with desk jobs, traveling, or spending a little too much time on the gram. Some people may develop increased thoracic kyphosis, or excessive rounding of the upper to mid-back. Scoliosis is another underlying condition which may contribute to restrictions in this area.
Why is thoracic mobility important?
Restrictions throughout the thoracic spine can eventually lead to issues elsewhere in the spine or extremities. Lack of flexion, extension, and/or rotation will ultimately lead to compensatory movement patterns which may lead to pain or dysfunction.
Common issues which may develop from thoracic hypomobility:
- Shoulder pain/ impingement - During shoulder flexion, the shoulder blade must rotate upward and tilt posteriorly on the rib cage. If the thoracic spine is lacking extension, the scapula cannot fully tilt posteriorly, which can lead to pain or impingement in the shoulder when in the overhead position.
- Lack of overhead mobility and strength - In order to lift heavy weight overhead, your muscles have to be in the optimal position to work effectively. If you struggle to “lock out” your arms with weight overhead, it may not be a shoulder weakness issue, you may lack thoracic extension mobility.
- Neck pain or radiculopathy- The neck is very closely correlated with the thoracic spine. Increased thoracic kyphosis can lead to forward head posture placing the neck in a more extended position. Over time this may lead to tightness in the postural musculature spanning the cervical and thoracic region and possibly compression on the nerves in your neck leading to neck pain or pain down the arms.
- Low back pain - Since the thoracic spine is responsible for greater rotation than the lumbar spine, if someone is lacking thoracic rotation, they will likely compensate by over rotating through the lower back. This may lead to low back pain or injury.
- Thoracic outlet syndrome - This phenomenon occurs when the blood vessels or nerves are compressed between the first rib and collar bone leading to a variety of symptoms throughout the upper extremities. This may be exacerbated by increased thoracic kyphosis and tightness of the pectoral muscles.
How to test your thoracic mobility:
- Supine shoulder flexion test - Begin laying on your back with your knees and hips flexed and feet flat on the floor. Raise your arms overhead while keeping your back flat on the ground. Your arms should reach the floor with elbows extended. Compensations may include lower back lifting off the ground or elevation of the rib cage.
- Thoracic rotation test - Begin on your hands and knees and sit back onto your heels. Place one forearm on the floor at midline and the other hand on the small of your back. Rotate your trunk towards the ceiling as far as possible. Normal rotation should be ~35 degrees of rotation from horizontal. Test both sides.
- Overhead squat assessment - Stand with feet approximately 6 inches from the wall and arms extended overhead in a “Y” position. Squat down without allowing your arms or head to contact the wall. Compensations may include heels lifting off the ground, knees collapsing inward, excessive arching of the lower back.
How to unlock your thoracic spine: try these exercises!
- thoracic extension mobilization over foam roll
- half kneeling thoracic rotations
- thoracic extension at wall
- quadruped thoracic rotation
Mobility limitations can present at any age, it is important to implement mobility exercises into your normal routine to keep your spine healthy and avoid injury. If you feel you’re lacking thoracic mobility and would like an in-depth evaluation and personalized treatment plan to improve this area, contact Active Reload Chiro and Physio!