The hip flexors have been getting the spotlight as the evil which contributes to injury. However, the THORACIC SPINE also has a significant influence on injury. The thoracic spine is the area between our shoulder blades. It has a tendency to be stiff because gravity works against our bodies pushing down on our shoulders. Gravity pushes our body down at the shoulder which flexes the thoracic spine. After hours of sitting, letting gravity take it’s toll, the upper back region stiffens. Think of a hunchback. A flexed thoracic spine limits our ability to stand up straight. Stiffness of the thoracic spine can contribute to injury to the neck, shoulders and low back.
The pictures above show the side view of the back before and after stretching. There is increased curvature at the base of the neck and the low back. After stretching, his neck and low back is in a better alignment. Also, there is an improved ability to raise the shoulder. This shows how tightness in the thoracic spine can influence other regions of the body.
While running, the arm swings backward causing a rotation to occur in the thoracic spine. Meanwhile, the same side leg swings forward. The twist of the spine helps to load the core — think of twisting a slinky. However, if the thoracic spine is stiff the low back takes the load. The most frequently injured and degenerated region of the spine is the L5 – S1 (lower back region). Not surprising, this is also the region of the lower back which has the ability to twist the most.
The thoracic spine supports the lower back, and its bony anatomy allows for rotational movement. However, if the area is stiff, motion is mainly absorbed in L5-S1 leading to overuse injury.
In running, a stiff thoracic spine contributes to injuries of the low back. The overly flexed thoracic spine can limit rib expansion, hinder breathing, and limit loading to the core.
On top of using a foam roller or lacrosse balls to help loosen up the spine, there are stretches which help mobilize and utilize the muscles.
Mobilizations of the Thoracic Spine
I like to follow up mobilizations with strengthening exercises to train the new motion. For those exercises please refer the the strength post for how to train the thoracic spine.
These mobilizations will not only enhance mobility for runners but are great for any athlete.
Thanks to Gary Gray at the Gray Institute for the remarkable knowledge.
Janet Yiu is a Doctor of Physical Therapy who earned her degree from University of Southern California in 2010. Janet competed in cross country at the high school, NCAA Division I college and post college level. Her treatment philosophy is to treat the whole body using the kinetic chain model instead of just the injury itself. A fellow of Applied Functional Science (FAFS) from the Gary Gray Institute, Orthopedic Certified Specialist by the American Board of Physical Therapy Specialties, and Certified Strength and Conditioning Specialist, Dr. Yiu has worked with numerous clients of all skill and age levels including runners, triathletes, high school athletes and individual who want to enhance their fitness. Read more from Dr. Yiu at her website, 3-D Runner.