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Bullet Proofing the Spine part 2: The Thoracic Spine

Updated: Sep 25, 2023

The thoracic spine is the upper portion of the spine which is connected to the ribs. This portion of the spine is designed to have a slight kyphotic (forward) curve and dysfunction occurs when this curve becomes excessive, known as kyphosis.

thoracic spine and kyphotic spine

A kyphotic thoracic spine is usually the result of poor sitting or standing posture over a long period of time. This can greatly affect the health and mind state of the individual as well as the ability of the upper body to properly move. What follows is a list of some of the common effects of kyphotic posture.

Negative Effects of Kyphosis

Thoracic kyphosis causes the rib cage to contract and become smaller, compressing the organs found inside the rib cage. This can cause a range of negative health effects including...

effects of kyphosis on organs

  • Lungs- Poor respiration due to the ribs compressing the lungs and keeping them from fully expanding upon inhalation. This reduces the oxygenation of the blood, effecting energy levels and often increasing anxiety due to the well documented effects of shallow breathing on mind state.

  • Heart- As the heart becomes compressed, chest pain and heart palpitations may develop.

  • Stomach- Compression of the digestive organs decreases the blood flow to the organs and diminishes their ability to properly digest food.

The change in the shape and orientation of the rib cage effects the movement of the body in a number of negative ways, these include...

shoulder impingement and neck pain during over head activity

  • Over-head Movement- Any movement in which the arms go overhead is going to be greatly affected by thoracic kyphosis due to the new orientation of the shoulders. The compressed rib cage raises up the shoulder blades and draws the upper arm bone forward in the shoulder socket. Going over head will be less supported by the shoulder blades which can no longer properly bridge the arms to the trunk, and the humerus of the upper arm will be much more likely to cause shoulder impingement and potentially damage the joint.

  • Rotational Movement- The thoracic vertebrae are designed to allow for large degrees of rotation, but in the kyphotic posture the front of the vertebrae are wedged together, causing shear forces of the discs when attempting rotation of the trunk.

  • Neck Movement- A kyphotic spine thrusts the head forward and forces the neck to either jut forward, compressing the atlanto-occipital joint where the skull and neck meet. This creates headaches and reduces the necks ability to rotate or fully extend.

Thoracic kyphosis can also cause local damage to the vertebrae and discs of the spine. Kyphosis causes instability of the vertebral joints, especially at the apex of the curve. This area is more likely to experience damage to the intervertebral discs or to the vertebrae themselves when attempting movement, especially weighted movement.

Correcting and Bullet Proofing the Thoracic Spine

To keep the thoracic spine fully functional it's important to rehab or maintain it's two primarily dysfunctional movement patterns experienced in modern society, extension and rotation.

In reality these can't be completely separated because maximum extension requires the addition of rotation due to the design of the thoracic spine.

There are a number of ways this can be done but here are a few easy to incorporate movements which will develop these important movement patterns.

#1. Prone Thoracic Extension- This is as simple as laying on the stomach while arching the back and pulling the arms and shoulders up off the ground.

prone thoracic extension

This looks like the superman hold but in this version the feet stay on the ground. With the arms out in front of you, retract one at a time and alternate reaching as far as you can in front of you with the other.

Do this for sets of 20 or as a 20-30 second hold.

#2. Cat/Cow- This is a yoga movement pattern that is simple, can be done by anyone and is great at restoring the thoracic spine.

cat/cow exercise

Get on your hands and knees with your hands directly below your shoulders and knees directly below your hips.

Now you will flex your spine while letting your shoulder blades move to the outside of your rib cage. This creates a more extreme kyphotic position but sets you up for a full range movement in the opposite direction. Exhale fully as you move into this position.

Next reverse the spinal curve by arching the back and bringing the shoulder blades together. Also extend the neck and breathe in as you move into this position.

Repeat these movements 20-30 times and pause at each extreme and take one extra breath before moving into the next position.

#3. Quadruped Thoracic Rotation- This movement pattern helps to build rotation in the thoracic spine which helps further increase thoracic extension as well.

quadruped thoracic rotation

Get on the hands and knees in the same position as the cat/cow. Now take one hand and put your palm on the back of your head.

From here you will rotate to the side with the hand on your head and attempt to point your elbow to the ceiling. Getting the elbow pointed vertically to the ceiling is just a cue, but it's not the important part. What's important is to try to get more range of motion in the movement by rotating the upper back.

Really try to feel the rotation in the thoracic spine and attempt to get full control over it. Not only will you be restoring movement, but you will also be restoring neurological connection and control of the upper back and its movements.

Bring the elbow back down until it's pointed at the ground before repeating the movement. Be sure to breathe in as you open up the thoracic spine and breathe out as you come back down.

Repeat 20 -30 times.

#4. Bridge Reach- This is a fun movement to test your ability to use the thoracic spine properly after trying the previous patterns. It also makes for a great spinal warm up or addition to a consistent mobility routine to keep the thoracic spine in good condition.

Bridge Reach exercise

If you feel your kyphosis is fairly bad, then stick with the previous 3 exercises and continue this rehab 3-4 times a week until your confident you can do this exercise safely.

To perform this exercise, sit down on the ground with knees bent and feet flat on the floor. Put your hands behind you on the ground with arms straight. This should look like the crab walk position you probably experienced in physical education class as a kid.

From here you will push off of your hands and feet, bringing your hips up off the ground. Then take one hand and hold it in front of the face.

Now begin to push the hips into the air, arch the back and reach back as far as you can (without straining) with the hand that is in front of the face. Keep the eyes locked onto the hand as it reaches.

Then comeback down into the starting position, switch supporting hands and repeat the movement. Repeat these 10 -15 times on each side.

Also be sure to check out the first installment of the bulletproof spine series, The cervical spine if you haven't already. And check back in soon for the third blog post in the series, the lumbar spine.

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