Decreased Thoracic Mobility and Shoulder Pain
Decreased Thoracic Mobility and Shoulder Pain
When I use the term “thoracic mobility”, most people have no idea what that means. But if you have rounded shoulders, a hunched back, a head that is forward of your shoulders, tennis elbow/elbow pain, rotator cuff issues, neck pain, upper back pain/stiffness, and/or shoulder pain you may have decreased mobility in your thoracic spine. Crossfitters with lack of thoracic mobility often struggle with active shoulders and have difficulty with pulling exercises like deadlifts and pull-ups as well as kipping, toes to bar, knees to elbows and may also have difficulty performing overhead exercises.
Your thoracic spine, more commonly known as your mid-back, consists of the 12 vertebrae or spinal bones that sit between your neck and low back. Your ribs attach to the thoracic vertebrae and as such your thoracic spine plays a role in breathing. Your scapulae (shoulder blades) sit on your thoracic spine and ribs thus have a close relationship with your mid-back. Your scapulae are attached to your mid-back by several muscles including the levator scapulae, trapezius, and rhomboids. Three of the four rotator cuff muscles originate in the scapular and insert into the humerus (upper arm bone) at the shoulder.
The cause for loss of thoracic mobility, in most cases, is sitting. We as a society sit when we eat, we sit when we relax, we sit for work, we sit to socialize. In fact the average person sits for over 4 hours per day. Now add in texting on a cell phone or working on a computer or even gaming and we find ourselves spending a great deal of time hunched over with our head forward and our shoulders rounded. As a result, our bodies begin to adapt to this posture and we end up with a stiff, sore, and at times “hunched” upper back. This hunching causes the scapulae, which sit on the thoracic spine to tilt forward and down resulting in impingement syndromes and pain in the shoulder joint.
Loss of mobility in the thoracic spine is particularly devastating for the CrossFit athlete. Lets look at the pull-up for example, although this applies to all pulling movements. When the athlete grabs the bar, the lack of motion in the thorax and scapular makes it impossible for the athlete to get the shoulders back and down to engage the lats and rhomboids. The body will automatically compensate for the lack of motion in the thoracic spine by extending the lumbar spine or low back. This pulls the pelvis away from the ribs, disengaging the abdominal muscles, obliques, and glutes. Now instead of hanging from the bar under control with the larger muscles in your back supporting your frame, the athlete tractions out the shoulder capsule and relies on the biceps and other smaller muscles of the arms to perform the movement. Aside from the obvious performance issues such as early fatigue and horrible form, the athlete is placing his shoulders, elbows, wrists, and neck at risk for injury, including but not limited to tennis elbow/pain, shoulder impingement, bursitis, rotator cuff tears, tendonitis, low back pain.
To regain mobility in the thoracic spine the athlete needs to address the lack of mobility in the spine, shoulders, and pelvis. If the athlete has anterior pelvic tilt due to tight hip flexors and weak glutes that will need to be addressed along with the mobility issues in the upper back and shoulders. To improve mobility in the upper back, the athlete should roll the thoracic spine, lats, and teres with a foam roller or pvc pipe. In addition the athlete should perform active mobility of the first rib, trapezius, and anterior compartment/pec minor with a lacrosse ball and mobilize the shoulder with a band. The athlete should also strengthen the rhomboids, mid/lower trap, deep anterior cervical muscles, abdominal muscles and glutes. of course if you are injured or experiencing pain, consult a health professional before beginning any exercise routine.
Christopher Olivieri, DC
About the Author
Dr. Olivieri graduated from the University of Massachusetts with a degree in Sports Medicine and went on to get his Doctor of Chiropractic degree from New York Chiropractic College in 2000, graduating with honors. He has a private family practice in Hingham, MA inside Reebok CrossFit Bare Cove., He regularly works with recreational and professional athletes alike, and specializes in the care of CrossFit athletes. Dr. Christopher Olivieri grew up in Hull, MA and currently resides there with his wife Jennifer and their three children Ariel, Christian, and Benjamin. Dr. Olivieri can be reached at 781-664-3769 or by email at firstname.lastname@example.org.