For many people, the source of their back pain begins in the lumbar spine or the cervical spine, located in the lower back and neck regions respectively. However, pain can still occur in the thoracic spine which is located in the middle-to-upper areas of the spinal column, between the lumbar and cervical spine.
So how can mobility exercises help manage pain in the thoracic spine? Staying in a sedentary position for most of the day can be detrimental to musculoskeletal health and cause stiffness in the thoracic spine. With daily exercises for 10 - 20 minutes, you can promote long-term improvements and strengthen the thoracic area of your back.
The thoracic spine, also known as the T-spine, is made up of 12 vertebral bones which are connected to your ribs, forming a cage to house your heart, lungs, and other vital organs. Contrary to popular belief, the T-spine is capable of rotating or twisting in various directions, although it’s limited in flexion -- the ability to bend, extend, or arch.
Much like the other two segments of the spine, the T-spine is susceptible to degeneration and injury. Thoracic spine can be caused by factors such as poor posture, lifestyle, and environment. Aging and poor mental health can also leave you more at risk for thoracic spinal pain.
Keeping the thoracic spine mobile and health should be prioritized in order to prevent other problems such as aching shoulders, neck injuries, or chronically flared-up lower back pain. As the spine segments connect the upper and lower back, the T-spine can be the key to maintaining back functionality and alleviating pain.
If the thoracic spine is unable to rotate, bend, flex, or extend varying degrees, the joints above and below it will need to compensate. This causes the spine to become less stable, as the scapula above the T-spine will be forced to alter the path of movement and the range of motion. When this occurs, the softer tissues on the upper half of the back would be more likely to become damaged.
And if the scapula cannot move optimally because the thoracic spine is too stiff, the lumbar spine will suffer as well. In order to compensate for the T-spine’s limited motion, the lumbar vertebrae will have to rotate more and more. The sudden instability of these vertebrae can cause the vertebrae to misalign or create pressure on the nerve roots, which will cause a lot of pain.
Mobility exercises are important for the thoracic spine, which suffers due to our sedentary lifestyles. With all the time you spend sitting at your desk, in a car, or on the couch, the T-spine gets almost no movement at all. It stays in a rounded position, limiting its ability to rotate as well as its full range of shoulder motions.
If you have poor thoracic mobility, you can perform the following exercises to improve thoracic rotation and extension. Do keep in mind that changing your posture will take time and consistency so make these mobility exercises a daily habit:
Set a P-knott, peanut, or foam roller on the floor and lay on it, perpendicular to your mid-back. Bend your knees with your butt and keep your feet on the ground while crossing your arms over your chest. You can also opt to place your hands behind your head to support the neck. Sit up slightly and crunch your abs to extend your T-spine over the foam roller. Repeat this while keeping your abs engaged and your ribs in line with your hips.
The cat-cow stretch, sometimes called cat-camel, is an exercise borrowed from yoga which can help the entire spine move as one unit. Begin by kneeling on an exercise mat with your knees and feet a hip-width apart, keeping the toes pointed towards the body. Lean forward and place your hands on the mat, positioning them directly under the shoulders at shoulder-width. Gently stiffen your abs to hold your spine in a flat position.
Once you’re ready, exhale and contract your abdomen as you push your spine towards the ceiling like a shocked cat. Hold this pose for 10-15 seconds and let your head fall towards the chest to maintain the spine’s alignment. Now, inhale and let your stomach fall to the floor so the arch of the lower back increases. Hold the cow pose for another 10-15 seconds and allow the shoulder blades to fall towards the spine before returning to a neutral position.
The bench T-spine stretch will require you to have a PVC pipe. Kneel in front of a box or a bench and hold onto the pipe as you keep your arms in a “V” position. This means you have to keep your elbows together while you sit back on your heels and drop your chest to the ground. Bend the elbows to pull up the PVC pipe behind your head and take 5 deep breaths in and out. Lower your ribs and reverse the motion to repeat.
The wall angel exercises can improve your T-spine extensions while minimizing the movement of the lumbar spine. Find a wall and press your heels, tailbone, upper back, and head towards it. Keep your chin tucked in as you raise your elbows to a 90-degree angle. The elbows and the back of your hands should be touching the wall as well. Raise your arms until the shoulders elevate but don’t allow the shoulders to hike past your ears. Make sure that your repetitions are slow and controlled so your body maintains contact with the wall.
|Exercise||Purpose||# of Reps|
|Foam Roller Extension||For extending the thoracic spine, mobilizing the joints, and massaging the T-spine||6 - 8 reps for each of the 3 spinal segments|
|Cat-Cow Stretch||For strengthening and improving the flexibility of the spine||10 reps per set|
|Bench T-Spine Stretch||For stretching the latissimus dorsi muscle, the largest muscle in the upper body, and improving the spine extension||3 - 5 reps per set|
|Wall Angel||For strengthening the back, improving shoulder rotation, and activating the upper back||10 - 15 reps per set|
Aside from mobility exercises, there are other ways you can help care for your thoracic spine. Small changes in your habits can improve your spine’s overall health. Here are a few things you can do:
Becoming overweight can strain your back and put added stress on its muscles, ligaments, and tendons. Eating healthy and keeping hydrated can keep your soft tissues elastic and your joints fluid. Maintaining your weight will also keep the rest of your body in shape.
As poor posture can cause a multitude of back problems, it’s important to correct the way you hold your body when you sit, stand, and walk. Take plenty of brisk walks when you can instead of sitting down for a long time. It’s also best to sit on chairs with a straight back or low-back support and ensure your feet are flat on the floor.
When you go to bed, you should sleep on your side with your knees bent to reduce the strain on your back. Put a low pillow under your head to support your neck, and place another pillow between your legs so your lower back is relaxed and comfortable. A firm mattress can also help with back problems.
Stretching can keep you flexible and maintain normal joint function. When you stretch in between work, you can introduce a good range of motion to your back and neck, reducing the risk of injuries. A good idea would be to take 5 - 10 minute breaks throughout the day and simply find a space where you can breathe and stretch.
It’s hard to live a full and active life if your back is chronically in pain. At the Spine & Rehab Group in NY and NJ, our expert doctors can create a treatment plan to improve your spine’s overall health. Contact us today to schedule an appointment.