by Mitch Hauschildt, MA, ATC, CSCS
To quote my good friend Perry Nickelston, “The thoracic spine is a linchpin of movement.” Mobility in the T spine has a huge impact on the rest of the system and most of us don’t move well through that area of our body.
We need both rotation and extension at the thoracic spine. Poor rotation has a large impact on the shoulder complex by forcing unnatural scapular mechanics while reaching across our body. Poor rotation also impacts the lumbar spine, cervical spine and hip joints, as it will force them to compensate where they aren’t intended to rotate to make up for a lack of thoracic movement. And, we can keep stretching it out further and further.
Poor thoracic extension also impacts the shoulder complex because when we can’t extend at the spine, we will have to find it somewhere in the shoulder joint to get the hands overhead. Poor thoracic extension also tends to encourage lumbar extension and a head forward posture, both of which have their own set of issues. And again, I can keep moving throughout the chain to explain how a lack of thoracic extension changes the entire kinetic chain.
Speaking specifically about thoracic rotation, we have a number of strategies for improving movement in that plane. The Bretzel stretch is a classic technique for improving T spine rotation by binding up the lower extremity in such a way that forces all of the rotation to come from the thoracic area of the body. I use this stretch with my patients a lot. The problem with it is that many people don’t get up and down off of the floor easily. Also, if they have hip mobility issues, their positioning may need to be modified with towels, pillows or other equipment.
I also really like the lumbar locked position for more of a manual technique. Just like the Bretzel, it takes the lumbar spine out of the equation, forcing rotation to occur strictly at the T spine. This is a great technique because it is aggressive and produces almost immediate results. The downside is that it is a hands on, manual approach that requires someone to perform it and it can also be a difficult position for some people to get into.
A nice alternative for a lot of people is the TRX Thoracic Spine Rotation. It allows you to stay upright and is a comfortable position for most people to get into initially. It also allows for a similar effectiveness as a manual technique, but it is still patient
directed. This is because the patient’s bodyweight gives them a feeling of over pressure, helping people to mobilize their thoracic spine. My big football players love this movement because most of them need some help with the Bretzel to feel the movement.
Below is a video that I shot a few years back of this technique. It is simple, safe and very effective.