experiencelifemag.com Print › | Back › Back in Trouble Immobility in your thoracic spine can send pain into your shoulders, neck or lower back. Here’s how to correct the problem. By Matt Fitzgerald January-February 2009 Reclaiming Flexibility Improve Your Mid-Back Mobility Stabilize Your Lumbar Spine Assess Your Mid-Back Mobility Shortly after Jon Boyle, 23, competed in his first triathlon in 2005, he developed pain in his lower back and right shoulder. It bothered him most when he ran, but also while riding his bike and sitting at his desk, where he worked 10 to 12 hours a day as an Internet consultant. Guessing that postural imbalances were to blame, Boyle, who now lives in Boca Raton, Fla., sought help from Eric Cressey, CSCS, owner of Cressey Performance Training Center in Hudson, Mass. “Right away I saw that Jon lacked mobility in his thoracic [middle] spine and stability in his lumbar [lower] spine,” says Cressey, who specializes in balancing athletes’ bodies. He designed a strength-training program to correct these problems. “The pain went away completely within two months, and I’ve been pain-free for two and a half years now,” says Boyle. While most people will seldom feel pain directly along their thoracic spine, Cressey and other experts understand that its relative immobility can cause pain both above and below it in the back’s kinetic chain. Reclaiming Flexibility Considering how dramatically an inflexible thoracic spine can affect your body, it’s surprising how few people even know where it is. Located in the mid-back, the thoracic spine consists of the 12 vertebrae sandwiched between the five vertebrae of the lumbar spine and the seven vertebrae of the cervical (upper) spine. “The curvature of the spine naturally forms three main segments,” explains Cressey. These segments each have a primary function. “The lumbar spine and cervical spine are designed to provide stability, while the thoracic spine is designed to provide mobility,” says Michael Boyle, CSCS (no relation to Jon), a Massachusetts-based strength-and-conditioning coach and editor of www.strengthcoach.com. Specifically, the thoracic spine allows you to bend your trunk forward and backward (flexion and extension) and side to side, and to twist your trunk each way (rotation). For many of us, the thoracic spine does not extend and rotate as well as it should. “Sitting is the main culprit,” says coach Boyle. “When you’re seated, your thoracic spine is locked in a flexed position. Over time, people who spend most of the day sitting lose some of their range of motion.”  While an immobile thoracic spine doesn’t necessarily cause pain directly in the mid-back, it may lead to pain in the shoulders, neck and lower back. “It’s common for people who are knotted up at the thoracic spine to make up for the lack of mobility there with excessive movement in the lumbar spine,” says Cressey. The result is lower-back pain, which affects 80 percent of Americans at one time or another. The shoulders and neck also compensate for poor thoracic spine mobility, he adds. The shoulder blades gradually move away from the spine, making it more difficult to raise the arms overhead. This increases the likelihood of shoulder injuries and other problems. “You may get neck pain and tension headaches due to compensations that take place in the cervical spine and the neck,” says Cressey. To improve your thoracic flexibility, simply add a few extension and rotation exercises to your preworkout warm-up routine. (You’ll also benefit by adding lumbar stability exercises to your strength workouts.) Devote just a little time to mobilizing your mid-back, and you’ll feel the difference everywhere else. Matt Fitzgerald is a running and triathlon expert and the author of several books, including Maximum Strength (Da Capo, 2008) with Eric Cressey. Improve Your Mid-Back Mobility Your thoracic spine moves in four ways: It flexes both forward and side to side, extends (bends backward), and rotates (twists left and right). Virtually everyone has plenty of thoracic spine flexion. It’s the capacity to extend and rotate that is restricted in most of us. To improve your thoracic spine mobility, regularly perform exercises involving extension and rotation of the thoracic spine. Eric Cressey, CSCS, owner of Cressey Performance Training Center in Hudson, Mass., recommends you include these exercises in your warm-up routine. Supine Thoracic Spine Mobilization With Tennis Balls Duct tape two tennis balls together and place them on the floor. Lie face-up on the floor so the balls are underneath your mid-back, with one ball on either side of your spine. Your knees should be sharply bent, feet flat on the floor. Bend your elbows 90 degrees and press your forearms together in front of your face in a “prayer” position to spread your shoulder blades away from your spine and give the tennis balls better access to the muscles on either side of your thoracic spine. Allow the weight of your torso to sink into the tennis balls so that your mid-back arches around them. Keeping your lower back in contact with the floor, contract your abs and curl your torso upward slightly in a crunch. Scoot your butt forward on the floor and lie back again so that your spine extends over the tennis balls at a point just above where it did so previously. Continue to curl up, scoot forward and lie back until the ball has traveled from the point of your spine that’s about even with your belly button all the way up to just above the level of your shoulder blades. Quadruped Extension Rotation Kneel on all fours. Lift and bend your left arm and place your left hand on the back of your head. Now twist your torso to the right so that your left elbow swivels toward your right arm, which should be kept straight. Now rotate back toward the starting position, but go a bit farther, so that your eyes are directed toward the wall to your left. Be careful not to rotate from the hips — all of the movement should come from your mid-back. Complete 12 rotations and then reverse your arm positions and rotate the opposite way. Stabilize Your Lumbar Spine An immobile thoracic spine does not occur in isolation. It’s almost always coupled with inadequate stability in the lumbar spine. Michael Boyle, CSCS, a Massachusetts-based strength-and-conditioning coach, recommends this exercise to increase lumbar stability. Side Bridge Lie on your right side with your legs fully extended and stacked, and your right arm bent 90 degrees with your forearm on the floor. Lift your hips until your body forms a straight line from your neck to your ankles, with your weight on your forearm. You may do this exercise in front of a mirror to make sure your hips don’t sag toward the floor. Hold the bridge position for two or three 10-second increments and then switch sides. Do this exercise two or three times per week, and try to work up to 40 seconds total in 10-second bouts per side. Assess Your Mid-Back Mobility Only a physical therapist can accurately determine whether your thoracic spine lacks sufficient mobility, but there are a couple of simple self-tests that will give you an indication.  First, raise your arms straight overhead. “If your thoracic spine is stiff, it won’t be able to extend fully, and you won’t be able to get your biceps by your ears,” says Michael Boyle, CSCS, editor of www.strengthcoach.com. Your shoulders may feel restricted or even painful as you try, and you might also find yourself arching your lower back to make up for the stiffness in your mid-back. Eric Cressey, CSCS, owner of Cressey Performance Training Center in Hudson, Mass., suggests a second self-test. “Standing normally, have somebody take a picture of you from the side,” he says. “You should be able to draw a straight, vertical line from your ear to the lateral aspect [the bony protrusion on the outside] of your ankle. If you see a lot of deviations of your spine on one side or the other of that line, you’ll know you’re dealing with a postural imbalance that very likely includes a lack of thoracic spine mobility.”

Back in Trouble

Immobility in your thoracic spine can send pain into
your shoulders, neck or lower back. Here’s how to correct the problem.

Reclaiming Flexibility
Improve Your Mid-Back Mobility
Stabilize Your Lumbar Spine
Assess Your Mid-Back Mobility

Shortly after Jon Boyle, 23, competed in his first triathlon in 2005, he developed pain in his lower back and right shoulder. It bothered him most when he ran, but also while riding his bike and sitting at his desk, where he worked 10 to 12 hours a day as an Internet consultant. Guessing that postural imbalances were to blame, Boyle, who now lives in Boca Raton, Fla., sought help from Eric Cressey, CSCS, owner of Cressey Performance Training Center in Hudson, Mass.

“Right away I saw that Jon lacked mobility in his thoracic [middle] spine and stability in his lumbar [lower] spine,” says Cressey, who specializes in balancing athletes’ bodies. He designed a strength-training program to correct these problems. “The pain went away completely within two months, and I’ve been pain-free for two and a half years now,” says Boyle.

While most people will seldom feel pain directly along their thoracic spine, Cressey and other experts understand that its relative immobility can cause pain both above and below it in the back’s kinetic chain.

Reclaiming Flexibility (Back to Top)
Considering how dramatically an inflexible thoracic spine can affect your body, it’s surprising how few people even know where it is. Located in the mid-back, the thoracic spine consists of the 12 vertebrae sandwiched between the five vertebrae of the lumbar spine and the seven vertebrae of the cervical (upper) spine. “The curvature of the spine naturally forms three main segments,” explains Cressey.

These segments each have a primary function. “The lumbar spine and cervical spine are designed to provide stability, while the thoracic spine is designed to provide mobility,” says Michael Boyle, CSCS (no relation to Jon), a Massachusetts-based strength-and-conditioning coach and editor of www.strengthcoach.com. Specifically, the thoracic spine allows you to bend your trunk forward and backward (flexion and extension) and side to side, and to twist your trunk each way (rotation).

For many of us, the thoracic spine does not extend and rotate as well as it should. “Sitting is the main culprit,” says coach Boyle. “When you’re seated, your thoracic spine is locked in a flexed position. Over time, people who spend most of the day sitting lose some of their range of motion.” 

While an immobile thoracic spine doesn’t necessarily cause pain directly in the mid-back, it may lead to pain in the shoulders, neck and lower back. “It’s common for people who are knotted up at the thoracic spine to make up for the lack of mobility there with excessive movement in the lumbar spine,” says Cressey. The result is lower-back pain, which affects 80 percent of Americans at one time or another.

The shoulders and neck also compensate for poor thoracic spine mobility, he adds. The shoulder blades gradually move away from the spine, making it more difficult to raise the arms overhead. This increases the likelihood of shoulder injuries and other problems.

“You may get neck pain and tension headaches due to compensations that take place in the cervical spine and the neck,” says Cressey.

To improve your thoracic flexibility, simply add a few extension and rotation exercises to your preworkout warm-up routine. (You’ll also benefit by adding lumbar stability exercises to your strength workouts.) Devote just a little time to mobilizing your mid-back, and you’ll feel the difference everywhere else.

Matt Fitzgerald is a running and triathlon expert and the author of several books, including Maximum Strength (Da Capo, 2008) with Eric Cressey.

Improve Your Mid-Back Mobility (Back to Top)
Your thoracic spine moves in four ways: It flexes both forward and side to side, extends (bends backward), and rotates (twists left and right). Virtually everyone has plenty of thoracic spine flexion. It’s the capacity to extend and rotate that is restricted in most of us.

To improve your thoracic spine mobility, regularly perform exercises involving extension and rotation of the thoracic spine. Eric Cressey, CSCS, owner of Cressey Performance Training Center in Hudson, Mass., recommends you include these exercises in your warm-up routine.

Supine Thoracic Spine Mobilization With Tennis Balls

Duct tape two tennis balls together and place them on the floor. Lie face-up on the floor so the balls are underneath your mid-back, with one ball on either side of your spine. Your knees should be sharply bent, feet flat on the floor. Bend your elbows 90 degrees and press your forearms together in front of your face in a “prayer” position to spread your shoulder blades away from your spine and give the tennis balls better access to the muscles on either side of your thoracic spine.

Allow the weight of your torso to sink into the tennis balls so that your mid-back arches around them. Keeping your lower back in contact with the floor, contract your abs and curl your torso upward slightly in a crunch. Scoot your butt forward on the floor and lie back again so that your spine extends over the tennis balls at a point just above where it did so previously. Continue to curl up, scoot forward and lie back until the ball has traveled from the point of your spine that’s about even with your belly button all the way up to just above the level of your shoulder blades.

Quadruped Extension Rotation

Kneel on all fours. Lift and bend your left arm and place your left hand on the back of your head. Now twist your torso to the right so that your left elbow swivels toward your right arm, which should be kept straight. Now rotate back toward the starting position, but go a bit farther, so that your eyes are directed toward the wall to your left. Be careful not to rotate from the hips — all of the movement should come from your mid-back. Complete 12 rotations and then reverse your arm positions and rotate the opposite way.

Stabilize Your Lumbar Spine (Back to Top)
An immobile thoracic spine does not occur in isolation. It’s almost always coupled with inadequate stability in the lumbar spine. Michael Boyle, CSCS, a Massachusetts-based strength-and-conditioning coach, recommends this
exercise to increase lumbar stability.

Side Bridge

Lie on your right side with your legs fully extended and stacked, and your right arm bent 90 degrees with your forearm on the floor. Lift your hips until your body forms a straight line from your neck to your ankles, with your weight on your forearm. You may do this exercise in front of a mirror to make sure your hips don’t sag toward the floor. Hold the bridge position for two or three 10-second increments and then switch sides. Do this exercise two or three times per week, and try to work up to 40 seconds total in 10-second bouts per side.

Assess Your Mid-Back Mobility (Back to Top)
Only a physical therapist can accurately determine whether your thoracic spine lacks sufficient mobility, but there are a couple of simple self-tests that will give you an indication. 

First, raise your arms straight overhead. “If your thoracic spine is stiff, it won’t be able to extend fully, and you won’t be able to get your biceps by your ears,” says Michael Boyle, CSCS, editor of www.strengthcoach.com. Your shoulders may feel restricted or even painful as you try, and you might also find yourself arching your lower back to make up for the stiffness in your mid-back.

Eric Cressey, CSCS, owner of Cressey Performance Training Center in Hudson, Mass., suggests a second self-test. “Standing normally, have somebody take a picture of you from the side,” he says. “You should be able to draw a straight, vertical line from your ear to the lateral aspect [the bony protrusion on the outside] of your ankle. If you see a lot of deviations of your spine on one side or the other of that line, you’ll know you’re dealing with a postural imbalance that very likely includes a lack of thoracic spine mobility.”

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