Thoracic Stiffness

How to identify if you have it and what to do about it

Your thoracic spine is located in your mid to upper back. It starts at the base of your neck (your cervical spine) and finishes at the top of your lower back (lumbar spine). Thoracic spine stiffness is a very common complaint that we see, particularly in the last year or so with many of us working from home with poor desk set ups.

The thoracic spine is made up of 12 bones and intervertebral discs which sit in between these vertebrae. Each vertebra connects to the one below by a facet joint on either side of the bony surface. The function of the facet joints is to act like tram tracks, directing movement. The orientation or direction of these facet joints will determine how much movement is available in each direction. The orientation of the facet joints in the thoracic spine allows for rotation (twisting movements) and side bending, or lateral flexion. In contrast, the lumbar spine (lower back) is predominantly responsible for flexion and extension (bending forwards and arching backwards). The rib cage also attached to the thoracic spine and therefore plays a role in breathing as well.

Thoracic stiffness can occur at any age, for a variety of reasons. You might have been sitting a lot for work or study with poor sitting posture. You might have returned to training for a sport involving rotation after a period off and you’ve pulled up a bit stiff (e.g tennis, hockey). Or maybe you’ve spent a lot of time on the couch in lockdown. It presents as a feeling of tightness across your mid to upper back, often feeling as though it needs to be “cracked”.

To check how much movement you have in your thoracic spine, try this little at home test:

Sit down, and cross your hands across your chest and try to slowly twist your upper body as far as you can to each side – you might notice that one side is more restricted than the other. Everyone is different, in terms of how far you should be able to turn, but you can compare your left and right which should be relatively similar. 

How to fix that stiffness!

The following exercises are helpful to improve thoracic mobility at home all by yourself. Depending on the direction you feel is most stiff, you might find for you one or two feel better for you than the others.

  1. Book openings – helps to improve rotation of your thoracic spine and stretch your pectoral muscles
  2. Thread the needle – helps to improve rotation of your thoracic spine and stretch the posterior shoulder muscles
  3. Thoracic extension over a foam roller – helps to improve extension of your thoracic spine
  4. Arm openings on a foam roller – encourages gentle thoracic extension (not as aggressive as the thoracic extension over a roller) and stretch your pectoral muscles

It is quite normal for some people to feel or hear a pop or a crack with these exercises. Don’t be alarmed if this happens (it often feels quite good!). If you feel an increase in pain then stop the exercise, but it will usually result in increased mobility, which is what we are aiming for. The other great way to improve your mobility is with a helping hand with some treatment and release work from a physiotherapist. Alternatively, Pilates could assist in building core and back strength to take the load off sore joints.

In some circumstances thoracic pain may be a sign of something else going on. If you have any of the following symptoms, you should seek advice from one of our physiotherapists regarding the cause of your pain.

  • Recent trauma to the spine (such as a fall or car accident)
  • History of cancer
  • Unexplained weight loss, fever or chills
  • Recent bacterial infection
  • Pain that is constant, severe and progressive
  • Weakness, numbness, tingling or burning sensations through either the upper or lower limbs

For further information, or to book an appointment, speak to the team at Instinct Health today.

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