Your thoracic spine is the middle section of your vertebra between your neck and lower back and composes 12 thoracic vertebras and your rib cage. Thoracic mobility involves available movement of this portion of the spine and is very important for achieving or maintaining good posture. Good movement in the thoracic spine is essential to remain pain free for sports and modern day lifestyles. Poor movement at this area can increase thoracic conditions such as kyphosis (rounded upper back) leading to complications with back, neck and shoulders.

Thoracic issues can affect 4 main things:

1. Posture
2. Upper limb movements
3. Lower limb movements
4. Breathing

Posture, or the ability to keep a relatively normal thoracic curve, can be easily compromised due to long hours spent at desk jobs, on the internet, studying and certain sports like cycling, leading to negative changes in thoracic posture. These negative changes can lead to increased rounded thoracic curves and an inability to extend (straighten up) the thoracic spine due to stiffness and tension.

This tension results in the neck and head sitting forward (Poke neck posture) which is associated with neck, shoulder pain and headaches. Below the thoracic spine the pelvis often ends up in an anterior (forwards) tilt and the lower back more rounded in the reverse direction (lordotic) to compensate for the thoracic spine posture. This is associated with lower back pain and can lead to increased pressure in the lower spine and pelvis.

Decreased thoracic mobility and poor posture can result in reduced upper and lower limb movements. Most sports place a huge demand on the ability to utilise thoracic mobility coupled with good upper and lower limb movement to create better power output and subsequently an increase in performance. Sports such as swimming, golf, kayaking and tennis all require good thoracic extension and rotation; without good movement in the thoracic spine, competing in any of these sports will result in subpar performance.

Decreased thoracic mobility decreases the range of shoulder movements particularly elevation (lifting overhead) by changing the position of the shoulder blade on the rib cage. A simple test is to sit slouched and lift your arms up, then re test sitting up straight and in good posture. If you notice a difference in how far your arms lift behind your ears from one position to the next, then chances are your thoracic mobility needs improving.

One major area often seen in crossfit athletes and powerlifters is problems with squatting associated with stiff thoracic spines. Decreased thoracic mobility makes it harder to get under a bar, leading to wider hand placements (and too wide does not maximize power from the lower limbs). Secondly, a lot of missed lifts occur because the chest is unable to open up due to stiffness in the thoracic spine and decreased strength in upper back muscles which pushes the weight forward making the lift harder.

Changes to lower limb mechanics due to thoracic spine stiffness can be more subtle than seen in the upper limb. An increased thoracic curve leading to increased lumbar spine lordosis (arch) and an anterior pelvic tilt changes the forces on the lower limb which can have particularly detrimental effects in any sports that involve running.

One new area that is becoming more researched and is linked to thoracic spine stiffness is changes to breathing.  Normal breathing requires the ribs to move like a bucket handle (they lift to the sides). The stiffer the rib joints are where they join at the spine means less movement can occur at this joint and this can make it more difficult to take a breath when higher breathing rates and breath volumes are required, causing less air to be taken in overall. This factor is made worse in cardiovascular-based sports that require sitting or being bent over such as rowing, kayaking or cycling (particularly in a time trial position).  This can be demonstrated by placing your hands on the outside of your lower ribs and taking a deep breath in good posture and in a slouched rounded posture. The stiffer the spine or the more rounded the posture the less the ribs are able to expand properly which is important in sporting performance.

How can a sports therapist help with Thoracic Spine Stiffness?

A sports therapist is trained to assess all vertebral movements and posture. A thorough assessment should involve thoracic spine movements such as extensions, rotation, side bending and rib expansion. Other things may include shoulder movements such as streamline in swimmers, neck movements and lumbar spine movements as well. Sitting and standing posture should also be assessed. If there are specific sports positions that require assessing such as time trial position or boat position this should be assessed as well.

Treatment for a stiff thoracic spine can include joint mobilizations, manipulations, soft tissue massage, postural exercises, strength exercises and self-stretching. Self-stretching is very important and something that should be included in a regular stretching program for all athletes but more so for people at risk of problems such as desk workers, cyclists, swimmers, kayakers and other sports that require good thoracic mobility and posture.

There are numerous self-mobilization techniques that can be done at home, but it’s always best to be assessed properly to ensure correct technique and prevent causing further issues and pains.

Paul M.