Thoracic Extension
by: Deidre Deacon
Description of Motion
Thoracic extension is the movement of the vertebrae when moving the trunk backwards or when raising arms above head bilaterally.1 During thoracic extension, the superior thoracic vertebrae glides inferior and posterior. Thoracic extension can be limited by the anterior longitudinal ligament.
Primary Muscles:
➢ 3 Erector Spinae (Iliocostalis, Longissimus, Spinalis), Semispinalis, Multifidus
Nerve:
➢ Dorsal and Intercostalis Nerves
ROM:
➢ Normal: 25-450
➢ Segments of the thoracic spine where ribs connect directly to the sternum have reduced ROM in flexion, extension, and sidebending.
➢ T1-8 segments have the most amount of axial rotation.3
➢ T9-12 segments have greater flexion/extension range.
Etiologies
➢ Stretching the thoracic extensors is great for individuals that sit at a computer all day in a slumped, forward head and rounded shoulder posture. Other common thoracic etiologies include kyphosis, scoliosis, and T4 syndrome. Stretching the muscles around the thoracic spine can allow more joint movement and rotation. Strengthening these back extensors, such as the erector spinae, can help improve posture and thoracic spine stabilization.4
Strengthening
➢ Y’s & T’s on Stability Ball
o Lie on your stomach on stability ball, with the ball under your hips. Lift your chest off the ball so that your body is level. With arms in a Y formation above your head, raise them and squeeze shoulder blades down and back. Return to starting position.
o To perform the T’s, straighten arms out to the side in a T formation and squeeze shoulder blades together. Lift the arms and return to starting position.
o Perform 2 sets of 10 in each position. To progress and make more difficult, add 1-3lb weights in the hands.
➢ Superman’s
o Start on your stomach on the floor or a mat. Legs are extended and feet are together. There are 3 levels of progression for this exercise.
o For Level 1, start with arms at your side. Lift your chest off the floor, inhale and hold position. Make sure to keep your neck level.
o For Level 2, start with your hands behind your head and elbows pointing out. Again, lift chest off the mat and hold.
o For Level 3, start with your arms overhead like you are reaching for something. Once again, lift your chest off the mat and hold at the top.
o Hold each position 5 seconds at the top. Do 2 sets of 10. It’s important to keep neck level and make sure you are not going into hyperextension in the back.
➢ Theraband Back Extension
o Attach theraband to a secure object at shoulder level while sitting on a stool. Hold theraband with both hands at chest level. Slowly pull backward with trunk straight and avoid hyperextension. Slowly return back to normal keeping trunk straight and from slouching. Repeat for 2 sets of 10.2
Stretches
➢ Towel or Foam Roller
o Begin with a towel or foam roller placed underneath the back while lying in supine. Interlock your fingers behind your head. Relax your spine and breath. You should feel a stretch over the roll. Hold for 30 seconds to 1 min.2
➢ Open Book Stretch
o Start lying on your side with your knees together at 90 degrees. Close your hands, like a closed book. Lift your top hand and gradually open that book backwards trying to touch the floor behind you. Hold this for 2 seconds and perform 10 times.
➢ Ball Extension
o Start by sitting on a thera ball. From here, walk your legs forward until your back and shoulder blades hit the ball. Relax your shoulders and head backwards. To increase the stretch, bring your arms out to the side. Hold for 30 seconds. Perform this 2 times.
References
1. Diane Lee, BSR, MCPA, COMP. Biomechanics of the Thorax: A Clinical Model on in Vivo Function. The Journal of Manual & Manipulative Therapy Vol. 1 No. 1 (1993): 13-
21. http://www.udel.edu/PT/manal/spinecourse/ThoracicEval/leethorax.pdf
2. Marin Physical Therapy website. Published 2014. Accessed November 20, 2014
http://www.marinphysicaltherapy.com/exercises/
3. Geoff Maitland, Elly Hengeveld, Kevin Banks, Kay English. Maitland’s Vertebral Manipulation. Toronto: Elsevier Butterworth Heinemann; 2005.
4. Yoo W. Effect of Thoracic Stretching, Thoracic Extension Exercise and Exercises for Cervical and Scapular Posture on Thoracic Kyphosis Angle and Upper Thoracic Pain. Journal of Physical Therapy Science 2013;25(11):1509-1510. doi:10.1589/jpts.25.1509.
