Thoracic Spine (Mid-back) 101

by Stephen Patti, DC

Hey guys! Dr. Steve coming to you here with some information about your MID-BACK.

The thoracic spine (T-spine) is the section of the spine located between the neck (cervical spine) and low back (lumbar spine) and is made up of 12 vertebrae. What makes the T-spine unique is that it is the only part of the spine that directly connects with the rib cage via small joints called costovertebral joints. Though small, these articulations are incredibly influential and notably limit the motion of the T-spine in comparison to the more mobile cervical and lumbar spine. To learn a little more of the anatomy of the thoracic spine check this out. 

A few important considerations with respect to the thoracic spine are alignment, mobility and the effect it has on the shoulder blades (aka scapulae).
Alignment:

• A “normal” thoracic spine forms a kyphosis or convex curvature when observed from the side. An abnormal curve of the T-spine, such as a hyperkyphosis or a lateral curvature, will disrupt the normal biomechanics of the spine, rib cage, scapulae and shoulder joints. Severe lateral curvatures, known as scoliosis, will also create irregular movements patterns.
  

Mobility:

• A poorly moving thoracic spine will not only cause pain and irritation, but it will also make lifting weight overhead unsafe since a dysfunctional T-spine causes an unstable shoulder joint. A healthy thoracic spine should be able to extend slightly and, therefore, enable our shoulder blades to sit in an optimal position to function correctly. Always remember that is important to have proper mobility before introducing stability or strength.
  

Scapula:

• The T-spine directly affects the position of the rib cage and, therefore, contributes to scapular position and shoulder mechanics. There are 17 muscles that attach to each scapula, which is why they are a main player in shoulder mobility and upper body as a whole. The scapulae need to move freely while also providing stability to the shoulder joint. This starts with the T-spine being able to move without restriction.
  

There are a number of injuries that can be avoided by having a healthy thoracic spine that moves properly, including; rotator cuff impingements, shoulder dislocations and bicipital tendonitis. Listed below are a few things you can do to get your thoracic spine moving the way it should in order to help with proper biomechanics and injury prevention.
 
Exercises to help mobilize T-spine

• Wall Angels:

• Thread the Needle
  

• Cat-Cow
  

• Arm Openings
  

• Child's Pose
  

• Extended Side Angle Pose
  

• Rolling out with a lacrosse ball
  

Refer to this video that demonstrates how you can use a lacrosse ball to help with tight muscles in your thoracic region

The exercises listed above are a great starting point to improve your thoracic mobility.

In addition to these at home exercises, chiropractic adjustments are an even better way to get the joints of the spine moving. Adjustments provide input into the joints to stimulate mechanoreceptors and facilitate in breaking up adhesions within the joint, reducing muscle spasm and pain, and improving overall joint function.