Thoughts on Thoracic Mobility

My education at USC and my orthopedic residency were instrumental in teaching me how to be a good physical therapist. However, it has been my yoga practice and my own experiences with injuries that have really fine tuned my understanding of body movement and how closely each region of the body contributes to one another. In turn, I have been able to effectively resolve hundreds of injuries that clients had deemed unfixable.

 I took my first yoga class when I was 26 years old in my hometown of Encinitas where I immediately fell in love with Anusara yoga, a style of yoga that emphasizes back bending based on their principles of what is described as “heart opening”. In one of my first classes we moved into full wheel (a backbend for those of you not familiar with yoga). I remember feeling a pretty intense compressive pressure in my thoracic spine, and was surprised by how challenging the posture was for me. I began realizing how limited my thoracic mobility was when moving into various twists and sidebends, and how many poses were not accessible to me because of my thoracic mobility. Over the next few months I started to connect this immobility to the missing link of why my high school shoulder injury never fully healed. I spent hours in physical therapy, had numerous cortisone injections, and ultimately ceased playing dynamic upper body sports my senior year of high school. Through my undergraduate years I avoided throwing, any weighted dynamic upper body exercise, and any overhead weights. Luckily through yoga, I discovered this significant mobility impairment. Through a regular practice and additional at home work, I now (at 33 years old) can do anything I want to with my upper body, including pull ups, throwing, and push ups. I still avoid deep back bends 95% of the time (I have to be really warmed up to do them right and not collapse into my lumbar spine), but I know that each year my practice changes and someday it may be a more regular option.

 So how does thoracic mobility contribute to shoulder function? When you reach your arms overhead, a certain amount of thoracic extension is required. Without this mobility, you will stress structures in your shoulder to achieve the mobility that your thoracic spine isn’t providing. In addition, if you are limited in thoracic mobility, your ability to engage your midback (lower trapezius, middle trapezius, rhomboids, serratus anterior) will become impaired. In order for the humeral head (the long bone of the arm) to properly move in the glenoid, it works closely with the scapula in a movement called scapular humeral rhythm. My inability to recruit these key muscles for this movement was placing too much load on my rotator cuff by creating an over dominance in my pectoralis minor and upper trapezius. My thoracic mobility will likely always be a work in progress, but it is so much better than it used to be, and my current recreational capabilities are proof of that.

 As I hope you know, my company is working on creating a new online platform which will feature video sequences working on functional movement and range of motion through yoga and exercises. I’ve chosen thoracic mobility as one of the first four videos we are going to release because I believe it is so often overlooked when rehabilitating shoulders, necks, lower backs, hips etc. My own personal story on how I spend years in high school rehabilitating my shoulder and years after avoiding exercise, all to be resolved by improving my thoracic mobility and scapular recruitment, is testimonial to that. I hope that you check out this sequence, it will be accompanied by additional ones in the future for variety and maximal efficacy.

 Keep an eye out for our platform launch, scheduled ETA is March 2019.