Thoracic Spine Health

I wanted to address a problem that is fairly commonplace in the gym environment.  A problem that if left untreated can greatly inhibit your future exercise goals, strength, lifting technique, posture, and cause you a great deal of pain in the long run.  I am talking about thoracic spine mobility. Many people do not even realize that they suffer some form of lack of mobility, and it take be hard to spot unless you know what you’re looking for.  Do you find yourself rounding your back excessively and always being yelled at by your trainer to straighten your back up?  Or do you find that you don’t have the ability lean backward and extend your spine?  Then I may be referring to YOU!!
To further explain the problem, let’s first break down how our spinal anatomy works.  In very basic terms, our back is composed of three main sections.  First we have the cervical spine, which is the area of our neck.  Below that are our 12 thoracic vertebrae which comprise most of our backbones.  Lastly we have our lumbar spine, or lower back, which will unfortunately suffer the pain of any mis-alignment or immobility from the two sections above it.  This is why thoracic mobility is so important to overall back health.  And posture isn’t the only thing that’s important.  Crucial lifts that are essential in working toward any exercise goal like deadlifts and squats cannot be performed at any significant weight, or safely for that matter, until thoracic spinal health is addressed.
Now there are two main problems with the thoracic spine:  First, the inability to create movement there ( flexion and extension).  This can be caused by a number of things.  Injuries to the back and spinal fusion surgeries are the number one culprit.  Another cause for immobility are hamstrings so tight that a sit and reach stretch makes you want to cry out in pain.  Mike Robertson said it best when he stated “The thought of lumbar flexion often leads people to a spontaneous disc herniation.”  Essentially what he is saying is that if you feel like your spine is going to explode if you bend too far forward, you are suffering from this problem.  Overactivity of the same exercises over time and “too heavy, too fast” causes an inhibition of the hip extensors, primarily the glutes. When the posterior chain of muscles in your body has to take on all the added stress from a weak core and stiff spine, you run into very tight and tense muscles that can pull on your spinal erector muscles and back bones.  If abdominal strength isn’t up to par and the low back is shortened and tight, you have an even greater increase in lordosis, immobility, and back pain.
 Secondly, too much sitting at desks all day and flexion of the spine over time can cause kyphosis.  Kyphosis is an exaggerated forward curving in your mid back.  The “hunchback” or rounded shoulder syndrome.  Kyphotic posture can lead to an extreme amount of stress being placed on the lower back and rotator cuff muscles. We also lose hip mobility as a result of several things we do on a consistent basis. Too much sitting; failure to correctly perform stretches and mobility work; and leg training in the gym which can lead to a stiffening of the hips, creating an imbalance between the hips and lower spine. Anterior pelvic tilt is often a cause as well. When you have anterior pelvic tilt, your upper body has a tendency to overcompensate. Think about your spine as an "S" shape that must be equal on both the top and bottom. If the bottom half S is small and thin, the upper part must be small and thin too. If the bottom part of the S is wide, the top part has to be very wide as well to compensate and balance out the bottom. You can do all the upper body exercises and stretches you want, but until you solve the problem at the hips, your results will probably not help.
To fix the first problem of immobility and tight hamstrings, you need to stretch.  Static stretches are good, but dynamic stretches and mobility work are best.  There are many stretches and drills out there that are beyond the scope of this blog, but here are a couple good fixes:
    •    Thoracic extension lunges- lunging forward in a big step while simultaneously retracting yuour shoulders and bringing your chest up nice and tall.  You should feel your spine stretch backwards and tightness stretching your hamstrings.
    •    Stretching of the hip flexors and low back, while working on increasing activation and strength in the abs and glutes.
    •    Laying on foam roller along length of spine, letting gravity push your spine back into place under your own body weight.
To fix the second problem of a weak core, kyphosis and anterior pelvic tilt:
    •    Strengthen the core- planks, isometrics (holding abs tight in place), anti rotations, and birddogs.  Birddogs are an excellent test to see if you can hold your spine in a straight posture without rounding.
    •    Facepulls- to help retract the slouched shoulders and align upper thoracic vertebrae.
    •    Fixing anterior pelvic tilt with- lunges, glute bridges, and hanging leg or knee raises.
    •    Finally, since people who suffer from kyphotic postures can produce very little or no extension in the thoracic spine, try a PVC or roller exercise to help that issue. To perform the exercise, lay on you back with your knees flexed and feet flat on the floor. Place a small piece of PVC pipe/ foam roller underneath your thoracic vertebrae and raise your hips slightly. Slowly work it up and down along the thoracic section of your spine, holding each position for about 20 seconds.
If you have thoracic spine issues, your trainer can help tailor exercises best suited to your problem in addition to the ones mentioned above.  If you are not already doing some of these corrective exercises, it would be a good idea to start.  Even if you are lucky enough not to fall into the “screwed up back” category, prevention is key.  Doing the maintenance exercises will ward off bad posture and keep you healthier, stronger, and injury free for a long, long time.

Nick Johnson