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Patient exercises

Thoracic spine mobilising exercises



Got the hump?


The thoracic spine (the part of the spine that starts just below the neck to half-way down the back) is often a neglected part of the body, which is surprising considering that it is as prone to stiffness as other parts of the spine, but not so surprising since it is a difficult area of the body to stretch.

A stiff thoracic spine can cause pain between the shoulder blades but can also cause excess loading of the lumbar spine, the neck and shoulders, which in turn can lead to pain in these areas as well as headaches. In really extreme cases, a stiff thoracic spine can lead to an unsightly condition known as Dowager's (or Bison's) Hump, which is a thickening of the soft tissues at the base of the neck.

Like so many other modern-day problems resulting from work, people who spend hours either in the car or sitting poorly in front of computer screens are particularly prone to thoracic stiffness (and the attendant problems this can cause). People with poor posture are also at risk. On a more general level, since the thoracic spine provides much of the rotation and extension of the spine required for athletes, anyone that plays sport is likely to find their movement restricted and performance limited by stiffness in this part of the spine. Injuries in other parts of the body may well follow as a result.

The benefits of stretching the thoracic spine are many and varied. For starters, anything that relieves stress tension across the shoulders has to be a good thing. Greater flexibility and suppleness should improve performance on the sports field and better posture, which in turn helps self-esteem and promotes a general feeling of well-being.

NB Exercises should be completed either after prolonged activity (i.e. a long drive or sitting at work) or pre and post sport.


GUIDE TO MOBILISING THE THORACIC SPINE

The stretches shown below are a variety of the ways that you can stretch out and mobilise the thoracic spine. Some use specialist equipment but we have also given alternatives which can be easily done in the home or office. These exercises should provide a comfortable stretch but take care not to overstretch. If you feel any pain stop immediately.


Thoracic extension


1. The Barrel (or the Swiss Ball)

The barrel is a specialised piece of equipment found in Pilates Studios and one of its many uses is for lengthening and extending the upper spine. To do this, sit in front of the barrel with the lower back well supported. Clasp your hands behind your neck but take care not to push your head forward. Take a deep breathe in and as you breathe out begin to sink onto the barrel and slowly extend the upper part of the spine backwards. Make sure you maintain good contact of your lower spine on the barrel all the way through the movement. Once you reach full extension, take a breath in and slowly curl up to the starting position. Repeat times 10 slowly and continuously.

The same exercise can be performed at home over the arms of a sofa. To do this place a few firm pillows or cushions over the arm rest and sit with your back well supported. Clasp your hands behind your neck but take care not to push your head forward. Take a deep breathe in and as you breathe out begin to sink onto the arm rest and slowly extend the upper part of the spine backwards. Make sure you maintain good contact of your lower spine all the way through the movement. At full extension take a breath in and on the breath out slowly curl up to the starting position.


2. The Roll

This stretch is a lovely way to rebalance the spine after a long day in the office slumped over a computer, after a game of sport or just doing the housework. Place the roll lengthwise down the spine and lie on it with the knees bent. Make sure the head is well supported. Take a few deep breaths in to the lower ribs and enjoy the stretch. Hold this position for 5 minutes.

The Rolled Towel - If you do not have access to a roll, make your own with a towel. Simply take a towel and fold it into thirds. Then roll the towel so it forms a small bolster that you can lie on. Place a pillow on the floor and the rolled towel perpendicular to it. Then lie down so that the head is supported by the pillow and the towel sits between the shoulder blades. Take a few deep breaths in to the lower ribs and enjoy the stretch. Hold this position for 5 minutes

To further enhance either of these stretches use a resistance or theraband to stretch out across the chest. Hold the band in both hands in the starting position as shown. Take a deep breath in and pull the band apart and open across the chest. Return to the start position on the breath out. Repeat times 10



3. The Swiss Ball

Many people now have their own Swiss ball at home and they can be an ideal way of stretching out the upper spine. Lie on a bench or bed with the ball out in front of you. Place both hands palm down on the ball and gently press down on the ball. Draw the ball toward you whilst lifting the upper part of the spine. Try to keep the neck in line with the body and do not overextend the lower spine. Repeat slowly and continuously times 10

4. The Roll

Lie on the floor with the roll out in front of you. Place your wrists on the roll and gently press down. Draw the roll toward you keeping the elbows extended. Take care not to extend the lower spine and keep your neck in line with your body. Try to draw your



Thoracic Rotation



1. Lying Rotation

Lie on your side on the floor with the knees bent to ninety degrees; Place the arms out in front of you with the palms facing each other. Slowly slide the top hand over the bottom arm toward your chest and across to the shoulder. Allow the trunk to rotate and slowly extend the arm from the shoulder and then the elbow, reaching out with the fingertips and turning the head to look down the line of the arm. Make sure the pelvis and hips are still pointing forward. Reverse this sequence and finish by sliding the palm of the top hand beyond the bottom hand.. Repeat slowly and continuously six times then roll over and repeat on the other side.



2. Sitting Rotation

Sometimes by using the muscles which produce rotation we can get a better and longer lasting result. This exercise uses a theraband, which can be attached to a door handle. Sit on a chair and hold the theraband in your right hand. Slowly pull the cord toward you until the elbow is tucked into your side. Then, keeping the pelvis pointing forward, slowly rotate the upper spine to your right. Repeat times 10 and then do the exercise holding the theraband in your left hand and rotate to the left.



3.Thoracic Rotation with a stick.

Sit on a chair and hold the stick behind the base of the neck with the arms stretched out. Slowly turn the trunk to the right keeping the pelvis pointing forward and then repeat to the left. Repeat to each side times 10. In the office this exercise can be done by simply crossing the arms across the chest and performing the exercise in the same way.



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West London
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In Motion Physiotherapy
Winston Churchill Wing
St Mary's Hospital
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London
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