Why you should care about your thoracic spine
Author: Dr. Rick Parisien, Chiropractor
You may not know this, but your thoracic spine and its adjoining ribs serve an essential role in keeping you alive everyday. Like your brain has a skull to protect it, your remaining vital organs have a thoracic cage to protect them. Although your chances of being physically assaulted today are relatively low (lets hope…), from an evolutionary standpoint having a layer of armour surrounding what keeps you alive is pretty damn smart. In this article we’ll explore some of the under-appreciated aspects of that mid-back of yours, specifically its relevance to movement and performance.
Anatomy Lesson
Let’s start off with an anatomy lesson. The thoracic spine is the largest region of our spine with 12 vertebrae. Each thoracic vertebra forms a joint with the vertebrae above and below as well as two independent joints with the rib on each sides, which if you do the math makes for quite a few joints. Since we know joints are what allow human motion, then you may realize the relevance this region has in regards to human movement.
The movement in these segments allows for your lungs to expand and collapse with each breath your take. It allows extension anytime you reach overhead, rotation when your playing golf or swinging a tennis racquet, lateral flexion when practicing your fancy cartwheel (or reaching overhead with one hand), and most commonly flexion when binge watching Netflix on your coach.
Global Movement Implications
When analysing human movement in the context of athletic performance (across several joints), the relevance of thoracic spine mobility can be truly appreciated. Our body performs movement in a beautifully orchestrated sequence of mobility and stability called the joint-by-joint theory (this applies loosely to most movement patterns). Take the time to think about this… joints necessary for stability during dynamic tasks include our knees, lumbar spine, cervical spine and elbows while joints necessary for large amounts of motion during dynamic tasks include our ankles, hips, thoracic spine, shoulders and wrists. This sequence allows proximal stability for distal mobility throughout the kinetic chain; you need a solid base to push off of.
Lets take a closer look at this in the context of shoulder and hip performance. If you’re an athlete of any sort, two joints we often demand extreme ranges of motion and strength from include our shoulders and hips. From a biomechanical standpoint, these joints are strongest in a closed packed position (opposite of our end range of motion) meaning there is typically a trade off between strength and mobility with our joints. The unfortunate part of this is that activities like throwing a baseball, pressing a barbell overhead, sprinting or squatting involve tremendous amounts of range of motion from these joints. This is where the joint-by-joint approach comes into play. By having competency in our thoracic spine (as well as ankles and wrists) to extend, rotate and laterally flex through full ranges of motion, joints such as our shoulders and hips no longer need to account for as much range of motion to perform these tasks. Another way to think of this is imagine throwing a baseball with your mid-back being unable to move… by your thoracic spine not being able to rotate and extend, your shoulder is suddenly places through a much greater range of motion to achieve this same task of throwing a baseball.
Long story short, with our thoracic spine being in the centre of this “orchestra” of movement you can imagine its relevance to fundamental movement patterns let alone performing high demand activities.
Clinical Implications
Now that we’ve discussed its general relevance to global movement, lets get into the specifics with common clinical findings. When people complain of bad posture, the main culprit is often thoracic spine flexion or rounding of the mid back (hyper-kyphosis). You know that comfy position you get into on the couch or while working at your desk? When we round our mid-back we also typically dump our shoulders into a forward-internally rotated position (impingement) and carry our heads in an anterior or forward position, putting excessive strain in the soft tissues of our upper back and neck. Remember how we discussed the body working in a series of chain like connections? Well, when our mid-back is rounded, it forces the regions above (cervical) and below (lumbar) into additional extension to compensate (hyper-lordosis). This extension drives spinal pressure up potentially irritating a pre-existing disc or facet joint issue. Continuing down the chain, having our low back in excessive lordosis can place our pelvis into an anteriorly tilted position. This anterior tilt of our pelvis can place excessive tension on our hamstrings adding to the existing tension of our posterior chain.
Phewf… that was a lot. But you get the picture that I’m trying to paint. Biomechanically, our thoracic spine position sets the stage for areas above and below. Although these postural implications for our mid-back will do very little in the short run, it is over the long run that our tissues conform to the forces and demands we place on them. Wait what? Google “mechanotransduction” and you’ll learn a little about cellular adaptation to physical demands. In the context of our musculoskeletal system, our muscles, tendons, bones and fascia develop throughout our life via genetics and the physical demands we place on them. If we continually train these tissues (with adequate rest) to perform certain movements or tasks – they typically get better at them over time.
Final Words
With performance, posture and mechanotransduction in mind, getting into a daily movement or mobility routine is what makes most sense from a scientific standpoint; expose our tissues to specific demands (mobility) each day and they will adapt. If we’re talking sport injury prevention then we should be including this mobility routine before we perform certain activities as well. If we’re talking managing our back health then we should be including this routine anytime of the day other than the first hour of waking (intra-spinal pressure is higher first thing in the morning, why you’re taller in the morning than at night). Now we ask ourselves - how long should this routine be? The answer to that question is definitely case-by-case and the purpose you want your mobility work to serve. If you’re looking at “warming-up” and exposing tissues to certain ranges of motion before an activity, up to 5 minutes can likely do it (case dependent). If you’re looking to developing a mobility-flow routine (similar to yoga) with the purpose of creating long-term physical adaptation, then you may want to spend more than 5 minutes a day performing it. Although you’ll have immediate neurological improvements in your tissue compliancy, to develop true long-term physical adaptations you’re looking at a couple months of work to get the return on your investment.
Like we brush our teeth each day for our dental health, lets start moving our bodies on a daily basis for our joint health. Although each thoracic spine mobility routine should be specific to the individual, here is one to get you started that incorporates the majority of movements we can all benefit from:
