RECOVER: May 8, 2015

On down the line - the thoracic spine

 

Spoiler summary: the upper back is not just the source of "bad posture" but the stable platform for the entire upper extremity and more.

In a recent post, I wrote a little bit about neck pain and some of the key "move right" factors that associate with it.  I reiterated that forward head posture tends to be the most common stressor that we see, and that it can cause pain all the way into the head and neck.  Unfortunately, it doesn't end there. Compensation in the way we move travels both ways... Which leads us to the upper back (a.k.a. the thoracic spine).

When people picture someone in "bad posture" they often think of the upper back. We imagine a rounded upper back and forward hunched upper body.  This of course makes total sense since the spine moves very similarly to a chain, link by link each segment pulled along for the ride -- where the head goes, the upper back follows. However, it's not just the head. Research has shown anything anchored to the spine can pull on it enough to change our movement patterns (often resulting in pain). For example, the arms and shoulders working forward will also tend to put this force on the upper back and the more time we spend in this position, the more likely it is to happen.  It's of course not the only thing that we see in this body area, but it's one of the most common.

So what's the problem?

One of the main issues that we see in our work and therefore complaints of discomfort that come with it, is that as the spine rounds the shoulder blades tend to fall forward and toward the outer edge of the ribs.  It's a bit of a downward spiral: the head and shoulders pull the spine forward, which makes us round, which makes it more difficult to keep the head and shoulders back -- and on it goes.  This position not only stresses the muscles of the upper back, which tend to have tender spots, but also increases the likelihood of extra pressure at the shoulder, elbow and hand. Everything from pain when a person lifts their arms to radiating pain in the elbows, forearms and hands can result.  This is especially true in the dominant hand since we tend to use it more frequently to complete tasks.

So how do we interrupt this pattern and right the ship?

The good news is, it doesn't have to be complicated if you deal with it early.  Taking a break to unwind achy tissues on a regular basis by squeezing the shoulder blades together in the back and extending the spine can go a long way to maintaining tissue balance.  Spending a few minutes exercising the lower trapezius or serratus anterior muscles which help combat these stressors, can be done without equipment on your floor at home.  Making sure your work set up is as close to the body as safely-possible keeps leverage against these tissues to a minimum and is a great personal ergonomic strategy.  And finally, anything that promotes better circulation (MOVE: cardiovascular exercise, FUEL: low inflammatory diet, RECOVER: stress reduction ENDURE: lowering environmental exposures like smoking andCONNECT: even laughing with friends) can all have an impact.

The equation doesn't have to be complicated....balance theELEMENTS and the body can do extraordinary things from the very top and on down the line.  Let us know if you have questions.

Now go do something extraordinary,

Mike E.