Jon Sarji
I. Description of Motion:
There is limited amount of motion in the thoracic region due to stability of the trunk, but there is still some motion occurring.1 The reason for limited motion in the thoracic spine is due to the attachment of the ribs on the thoracic vertebrae themselves along with small and rigid vertebral discs.1 The thoracic spine allows 30 to 40 degrees of flexion.1 The most thoracic flexion occurs in the lower thoracic spine because the vertebrae start to orient their facets similar to the lumbar spine where the most flexion and extension occurs. Also the lower thoracic spine is not as cemented in place by the floating ribs.1
Muscles of Thoracic Flexion2
Rectus Abdominal
External Oblique
Internal Oblique
Mobilizing- Increasing Range of Motion
Thoracic Flexion Stretching
In a quadraped position push your back toward the ceiling while keeping hands and knees on the mat. Hold for 10 seconds 10 times twice a day.
Thoracic Extensor Stretching, Thoracic Matrix Stretching, and Banded Thoracic Flexion
Thoracic Lumbar Flexion
From a quadruped position reach forward with your hands while sitting back toward on your heels until a stretch is felt in your mid and lower back
Thoracic Matrix Stretching
In a seated position you will move slowly through full pain free range of motion. Full flexion and extension of the trunk with scapular protraction and retraction for mobility and stability of the spine.
Banded Thoracic Flexion
Wrap a resistance band around a structure that keeps the band parallel to the floor. Do a posterior tilt and let the tension of the band pull you in a stretch. In order to progress the stretch use a stronger band. Hold for 20 seconds for 2 sets, once a day.
Indications for Stretching
According to literature muscle strength is directly affected to the amount of motion available at a joint.3 Increasing range of motion in the thoracic spine can improve function of the lower trapezius in order to promote better posture and overall function of the upper extremity.3 The thoracic spine plays a role in respiratory function and with thoracic flexion is required for chest expansion during inhalation.4 Thoracic spine mobility influences cervical function and if there is dysfunction in the thoracic spine that plays a direct influence on the cervical region. According to literature 15% of thoracic mobility directly influences cervical rotation, an important role in driving.4
Strengthening
Thoracic Crunches
In a supine position lay your legs straight and do a posterior tilt. Keep your arms by your side, across your chest, or behind your head. Lift your head off the table while keeping your low back on the mat. Perform 2 sets of 10 repetitions, Do once a day. In order to advance the exercise increase the number of repetitions.
V. Potential Clinical Syndromes or Etiologies:
Ankylosing Spondylytitis- an autoimmune disorder that attacks the vertebrae and can fuse the bone together.
http://www.spondylitis.org/about/exercise_posture.aspx
Scoliosis- abnormal curvature of the spine
http://morphopedics.wikidot.com/spinal-scoliosis
VII. References
1. Neumann, Donald. Kinesiology of the Musculoskeletal System. Foundations for Rehabilitation. 2nd edition. St. Louis, Missouri: Mosby Elsvier
2. Spine Articulations. Available at: http://www.exrx.net/Articulations/Spine.html
3. Liebler EJ, Tufano-Coors L, Douris P, et al. The Effect of Thoracic Spine Mobilization On Lower Trapezius Strength Testing. J. Man. Manip. Ther. J. Man. Manip. Ther. 2001;9(4):207.
4. Wirth B, Amstalden M, Perk M, Boutellier U, Humphreys BK. Respiratory dysfunction in patients with chronic neck pain - influence of thoracic spine and chest mobility. Man. Ther. 2014;19(5):440-444. doi:10.1016/j.math.2014.04.011.
