Do you have pain in your shoulders, neck or back? Do you sit for extended periods of time throughout the day?

You, like many other Canadians, may be suffering from the impact of sitting too long, too often. Sitting seems like a fairly harmless activity until you realize that it can significantly reduce your quality of life.

In 2013, the average Canadian spent 9 hours and 48 minutes of their waking time being sedentary (Statistics Canada, 2013). That is a considerable amount sitting in static postures, likely at work. If you experience neck, shoulder or back pain, it is crucial that you improve thoracic spine mobility and consider strategies for optimizing movement.

What is your thoracic spine?
The thoracic spine is the area of your mid-back between your cervical (neck) and lumbar (low-back) spine. The thoracic spine consists of 12 vertebrae and allows for flexion/bending forwards (20-45∞), extension/bending backwards (25-45∞), side flexion/bending to the side (20-40∞) and rotation (35-50∞).

As you can see, the thoracic spine is very mobile and is meant to move. Unfortunately, when we don’t properly use our thoracic spine, we compensate by using either the cervical or lumbar spine instead, putting a great deal of stress on these areas.

A randomized control study conducted by Tsang, Szeto and Lee (2013) observed that between 9.9-25.1% of all neck mobility comes from the upper thoracic spine. Although we think of our neck and our back as separate, this study highlights the influence that a stiff thoracic spine can have on the neck.

Effects of Poor Posture
The common posture we tend to sit in is with our head protruding forwards, our back hunched, our shoulders rounded forwards, and our pelvis tilted backwards. Increased time in this static posture can make you feel stiff and can limit your range of motion.

Poor posture can lead to muscle imbalances and can predispose you to developing what is called “upper cross and lower cross syndrome”. Both conditions occur when certain muscles are put in a shortened position for long periods of time and become tight. As a result, their opposing muscles become lengthened or weak.

In upper cross syndrome, shortened or “tight” muscles include: levator scapulae, sternocleidomastoid, scalenes, suboccipitals, and upper fiber trapezius. These muscles need to be stretched!

Lengthened, or “weak” muscles, include the deep neck flexors, erector spinae, middle fiber trapezius, and rhomboids. These muscles need to be strengthened!

In lower cross syndrome, shortened or “tight’ muscles include: the erector spinae muscles and hip flexors. Lengthened, or “weak” muscles, include the abdominals and gluteus maximus.

Strategies To Increase Thoracic Spine Mobility

The idea is to set small attainable goals throughout the day.

Quick fixes at work can make a huge difference. The goal is to change the habit of sitting in the same posture and get moving as much as possible.

Here are a few ways you can get started:

1) Set alarms at work to remind you to take breaks and get moving.
It is thought that changing your posture every 30 minutes is the best way to avoid tight muscles. This doesn’t mean that you need to stand all day, but rather, transition between postures and find a way to combine walking, standing and sitting.

2) Adjust your desk set up.
Make sure your feet are flat on the ground, hips and knees bent at a 90-degree angle, computer monitor (or phone) straight in front of you at eye level ensuring you do not have to strain your neck by looking up or down. Roll a small towel behind your lower back to avoiding tilting your pelvis backwards, and make sure your elbows are bent at 90 degrees.

3) Do these thoracic spine exercises.
We’ve included a few key exercises that focus on your thoracic spine for you to try at home or at work. Please see below.

4) Breathe deeply when stretching.
Our ribs are attached to the thoracic vertebrae and when you combine deep breathing with thoracic spine exercises it can help to deepen the stretch and improve mobility.

Remember, “your best posture is the next posture”, meaning there is no such thing as a “perfect posture”. Instead, move between postures to maintain a healthy spine. The above strategies are simple changes that you can implement today to reduce pain and live well.
Of course, Tramadol is one of the most powerful pain relievers, which not only makes the pain weaker, but actually relieves it completely. Last year I ended up in the hospital with a broken arm. After the doctor gave me this medicine, the effect came very quickly. However, then I felt a little nauseous, but the doctor said that it happens sometimes.

Thoracic Spine Exercises

Thread the Needle (T-spine rotation)
Start in a four-point position with hands and knees on the ground.
Keep one hand on the ground to support your body weight, while you weave the other hand under your torso to between the supporting arm and knee (on the same side of the body).
With your eyes following your arm, bring your arm across your body to face the wall.
As you rotate, you should feel your chest and your mid back opening up. Go as far as you feel comfortable.
You should end with your head facing the wall, looking up towards your supporting arm.
Hold for 5-10 seconds.
Repeat the motion, transitioning between the all-fours position to the spinal twist.

Synchronize the movements with your breath, breathing in through the nose and out through the mouth. Continue to breathe deeply while holding the stretch. If you’d like to deepen the stretch, you can sit back into a child’s pose position by slowly sitting back onto your heels.

Do 10 repetitions on each side, 3 sets, 2-3 times throughout the day, everyday.

Child’s Pose
Start in a four-point position with hands and knees on the ground.
Slowly sit back onto your heels into a child’s pose position, going as far back as you feel comfortable.
Bring your arms out straight in front of you to feel a nice stretch along your back.
Hold for 30 seconds.
If you’d like to deepen the stretch on one side, walk your hands out to one side, keeping the arms straight. Hold and then repeat on the other side.

Synchronize the movements with your breath, breathing in through the nose and out through the mouth. Continue to breathe deeply while holding the stretch.

Do 5 repetitions, 3 sets, 2-3 times throughout the day, every day.

Paraspinal Release with Lacrosse Ball (Lumbar spine)
Note: The paraspinal muscles are the low back muscles along either side of the spine. Make sure to avoid placing the lacrosse ball directly over the bony spine.

Sit on the ground with your feet flat on the floor. Place the lacrosse ball on the floor and position your back so that the ball is on a trigger point or sore spot.
Slowly lie down, relaxing your body onto the lacrosse ball.
Bring the knee that is on the same side as the lacrosse ball towards your chest to deepen the stretch.
Roll the lacrosse ball on the paraspinal muscles for about 5 minutes at a time or until you feel the trigger point releasing tension. If you feel pain at any point, stop the exercise.

Repeat this throughout the day as needed.

Cervical (Neck) “SNAG” rotation
Use either a towel, neck tie, or belt and place it gently along the area you would like to treat.
To increase cervical rotation on the right side, grasp the right side of the towel with the left hand and pull gently downwards. Grasp the left side of the towel with the right hand and hold at eye level.
As you pull downwards with the left hand, slowly rotate upwards to the right, guiding with the right hand. Allow your eyes to follow the direction of your hand.
Go as far as your feel comfortable. You shouldn’t feel any pain.
To increase cervical rotation on the left side, repeat the above with directions reversed.

Do for 6-10 repetitions. Repeat every 2 hours as needed.

Author: Casey Goheen BSc, MSc, MPT, Registered Interim Physiotherapist

Book with Casey at Twist Sport Conditioning 

Bibliography:

Statistics Canada. “Directly measured physical activity of adults, 2012 and 2013.” Health Fact Sheet. Statistics Canada Catalogue no. 82-625-X, https://www150.statcan.gc.ca/n1/pub/82-625-x/2015001/article/14135-eng.htm

Statistics Canada. “Commuting to work.” Health Fact Sheet. Statistics Canada Catalogue no. 99-012-X, https://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-012-x/99-012-x2011003_1-eng.cfm

Tsang, S. M., Szeto, G. P., & Lee, R. Y. (2013). Normal kinematics of the neck: the interplay between the cervical and thoracic spines. Manual therapy, 18(5), 431-437.