Eric Beard: Thoracic Spine Impairment and Dysfunction

“Sit up straight and have good posture.”

Our moms have been telling us those words for years.

They were right!

Sitting in school, grinding away on our computers at work and spending our social lives slouched over our mobile devices, it seems that everything we do is conducive to long-term orthopedic consequences. The negative kind.

We go from standing tall early and end up with the thoracic spine alignment and function of Charles Montgomery Burns. It all started when we sat down at our desks in kindergarten!

It’s more than just posture. Twenty-First Century living, disuse, overuse, stress, lack of mobility and local articular issues often lead to dysfunction and impairment of the thoracic spine.

The difference between impairment and dysfunction is semantics. The dictionary tells us that impairment can mean “being diminished, weakened, or damaged” and dysfunction means “malfunctioning.” I like to think of dysfunction as starting locally and impairments as being part of a regional or systematic issue.

For example, a restricted rib in the thoracic spine after sleeping in a funky position vs. restricted thoracic rotation due to a mal-alignment in the lumbo-pelvic-hip complex. Either way, something is not working right and it is either located in or manifesting itself through the thoracic spine. Here is a short video discussing different types of musculature that influence structure and function of the thoracic spine.

A poorly functioning T-spine can lead to:
Inefficient load transference,
Dysfunctional breathing,
Pain,
Headaches,
Decreased athletic performance and
Shoulder, elbow or neck injuries.
I have had students, athletes and adult clients report any combination of these symptoms with the root cause being thoracic dysfunction.

Thoracic spine dysfunction can be observed during basic movement patterns. Quick screens, like having clients raise their arms overhead, perform spinal rotation in each direction or hold a plank can help you assess thoracic mobility. If the arms can’t be raised overhead without compensation at other joints, if there is an asymmetry in rotation or if the client has trouble elongating the spine then you might want to further investigate the T-Spine. Here is an older video of a mobility exercise that can be used simultaneously assess and improve thoracic mobility.

There is an array of corrective strategies to follow. One of which is the National Academy of Sports Medicine (NASM) Corrective Exercise Specialist (CES). The NASM CES methodology suggests inhibiting overactive tissues, lengthening shortened structures, activating inhibited muscles and integrating the changes back into functional movement patterns. NASM’s CES segues directly into their Optimum Performance Training Model to help complete the programming loop in comprehensive manner.

Another popular corrective approach is Gray Cook‘s Functional Movement Systems (FMS). The FMS training cycle flows from Mobility to Static Motor Control to Dynamic Motor Control and then to Strength. FMS addresses joint mobility via motor control as well as focusing on breathing, which makes sense to me since breathing is such an important aspect of thoracic mobility.

I think there are many parallels and similarities between NASM’s approach and that which Gray promotes through the FMS. I enjoy drawing from both approaches.

Below are a few videos that demonstrate corrective techniques that can be used to enhance the health and function of the T-Spine.

Inhibit/SMR/Mobility

The levator scapulae and pectorals minor are often culprits restricting thoracic mobility. Here are some basic soft tissue release, inhibition or self-myofascial release techniques to address the levator and pec minor:

Mobility

Mobility drills are helpful to open up these localized areas of dysfunction and to begin to restore local motor control. Here’s a version I like to use:

Motor Control/Activation

A stability ball exercise for core stability and disassociation of the spine from the shoulders.

Integration/Strength 

Integration, total body functional movement patterns and strength exercises should top off the corrective program.

Regardless of your school of thought or the specific techniques you use, I think we can all agree that identifying and addressing thoracic dysfunction will go a long way toward enhancing the effectiveness of our programming for our clients, patients and athletes.

Want more on the T-Spine? Check out the Eric’s new video, Thoracic Spine Mobility