Last month I discussed posturally related neck pain and mentioned that the posture of the neck is often closely tied to the position of the mid and upper back. This month we will move down the spine into the thoracic region and discuss the postural variations that can cause pain and dysfunction. The thoracic spine is characterized by those 12 vertebrae that have associated ribs. The first is approximately at the base of your neck where your shoulders begin and the last is somewhat more difficult to discern but is at your mid-lower back. The thoracic spine has an associated curve that is concave towards your front side known as a kyphosis.
Postural thoracic pain typically presents as pain in between the shoulder blades or pain at the top of the shoulders and into the base of the neck. My patients with this type of pain often speak of tightness, tension, knots, aching and sometimes burning around this area. A postural syndrome here can include or predispose one to neck pain, rotator cuff pain and injury, breathing problems and rib dysfunction to name a few. Ok slouchers, it’s time to raise your hand because this is the discomfort you feel after sitting for a long time. Several muscle imbalances, known as an “upper cross syndrome” are at play here which account for the pain that is felt. In an “upper cross syndrome”, the upper trapezius (shoulder to neck) muscles and pectoralis (chest) muscles are found to be short, tight, and overactive. In contrast, the deep neck flexors (longus colli, see “A Pain in the Neck” from last month), lower trapezius and scapular (shoulder) depressors are weak and inhibited. What that looks like in everyday life is shoulders that are rounded forward with a possibly increased “hunching” to the upper back along with a head that sits in front of the shoulders and chest.
This type of posture limits the amount of blood that can get through the lower trapezius and other scapular retractors, which leads to a limited oxygen supply, too much acidity, and then pain. Furthermore, it puts increased stress on the muscles in the back of the neck leading to neck pain and puts the shoulder in a poor position which may lead to rotator cuff syndromes and tearing. Last but not least, it limits the amount the chest can expand which limits the depth of your breath which can lead to a myriad of other troubles… no good.
Proper treatment of this type of condition is similar to last month’s… Stretching of tight, overactive muscles, activation and strengthening of weak inhibited muscles, manipulation to restore proper joint motion in the thoracic spine, and education so that you know your problem and what you are working towards. There also may be a component of retraining proper breathing technique since the patient may not remember how to properly use the diaphragm for inspiration.
At Pro-Motion, I am intensely interested in helping you stay pain free and as active as possible. If you have any questions please consult with your trainer, therapist or professional and feel free to contact me. Train smarter, not harder, and be well. I am always available for questions or consultation either through my email, website, or by phone at 307-699-3170.
In Health, Jeremiah
