|
Almost everyone will experience lower back and/or neck pain at some point in their lives, even if just in the form of a slight neck twinge after sleeping in an odd position. Spinal pain of the thoracic region (the upper & middle part of your back) is less common, however you might be surprised to discover how important this part of the body can be when it comes to pain and injury.  What is it?
The thoracic region refers to the part of the spine that is surrounded by the rib cage. It consists of 12 vertebrae with discs that sit between each of them. The thoracic spine isn’t an area that you might associate much with movement, however, this area can account for a surprising amount of flexibility, particularly in rotation. With joint attachments both between each side of the 12 vertebrae and a rib on either side, the thoracic spine has almost more individual joints than you can count. If each of these joints is not regularly moved through their full range they can tighten up and lose flexibility. This stiffness can become quite significant over time. Why is it important? Many people may not even notice this lack of movement, primarily because the neck and lower back provide much more range and can usually compensate for any loss of thoracic flexibility to complete everyday tasks. When there is no movement occurring in the thoracic region, this means that the structures of the joints in other regions are pushed closer to their limits of range, particularly during rotation. This results in more compression and stress on these joints and the structures surrounding them, such as nerves, blood vessels and muscles. Thoracic stiffness can be a significant risk factor for neck and lower back pain. This can also reduce the mobility of the chest wall, which can result in less efficient breathing mechanics and, in extreme cases, even reduced exercise tolerance. Thoracic spine movement is aslo important for normal shoulder function, as well as maintaining good posture. How can physiotherapy help? Your physiotherapist is able to assess your thoracic mobility and help you with treatments to improve your range of motion, both with manual therapy and home exercises. They may even help improve your thoracic flexibility as part of a treatment plan for neck and lower back pain. A posture improvement exercise program is also often required to improve the alignment of your thoracic spine and alleviate joint compression and muscle tightness.
0 Comments
Poor posture contributes to problems in breathing patterns. We see this issue frequently in people who spend a lot of time sitting each day. Maintaining a posture where your shoulders are rounded and your head is forward causes the muscles around your chest to tighten. These tight chest muscles can limit the ability of your rib cage to expand, and this can cause you to take rapid, shallow breaths.  More specifically, people with a more curved upper back (thoracic kyphosis) and internally rotated shoulders have limited movement of their thorax. When breathing in, the rib cage can’t fully expand and the lungs cannot fully inflate.
An increased arch in your lower back (lumbar lordosis), where the pelvis is tilted forward, decreases the range of motion of the lower lumbar spine and shortens the latissimus and lower back extensor muscles. This limits the range of motion of the diaphragm, again restricting the inflation of your lungs. The abdominal muscles are overstretched in this posture as well, limiting their function of helping to breath out. Some people may also find difficulty breathing with an exaggerated curve in their neck (cervical lordosis) due to compression of their larynx. Belly breathing pulls down on your diaphragm, which is a dome shaped muscle between your chest and your stomach, to suck air into your lungs. Belly breathing fully inflates your lungs so that you get as much air as possible, whereas chest breathing only partially inflates your lungs. Stress-related illnesses, sleep problems, respiratory problems, immune system weakening, and high blood pressure are all symptoms of long term shallow breathing. Try it for yourself While sitting in a chair, let your shoulders slump and your head hang forwards. Now in this position try and take a deep breath. How does it feel? Hard to do a belly breath right? Poor alignment in that slumped position means your diaphragm can’t descend easily making it hard to activate the posterior half of your diaphragm that attaches to your lower ribs and spine. To get enough air in, your body has to recruit its “back up” breathing muscles around the neck and chest to help breathe in, expanding the rib cage to get air travelling down into the lungs. These neck and chest muscles are not very efficient and are not designed to be used for the 17,000 breaths we take on average per day. They get tired, fatigued and tight, which can lead to headaches, neck and jaw pain. Now try sitting tall, with your head up and shoulders back, then take a deep breath into your belly. It’s easier, right? The process of putting yourself in a more optimal position for your spine allows the correct respiratory muscles to activate, drawing air into the lower lobes of the lungs where the best bloody supply is. *Clinical research findings* Forward head posture causes expansion of the upper thorax and contraction of the lower thorax, and these morphological changes cause decreased respiratory function. (JOURNAL OF PHYSICAL THERAPY SCIENCE 2019) Results indicate that forward head posture could reduce vital capacity, possibly because of weakness or disharmony of the accessory respiratory muscles. (JOURNAL OF PHYSICAL THERAPY SCIENCE 2016) Alteration of head and neck positions can have an immediate negative impact on respiratory function. Clinicians should be prompted to assess respiratory function when assessing individuals with forward head posture and torticollis and reduce the tension on respiratory system to avoid negative consequences. (BIOMED RESEARCH INTERNATIONAL 2018) |