Exercise Interventions for the Thoracic Spine

Question 1

Describe the thoracic spine

Answer 1

• 12 heart shaped vertebra that increase in size from T1-T12
• upper T spine resembles cervical vertebra
• lower T spine resembles lumbar vertebra
• ribs articulate with thoracic spine & sternum: true ribs 1-7, false ribs 8-10, floating ribs 11-12
• motions of the thoracic spine are limited by: flexion - limited by ligamentous structures, extension - limited by spinous processes & anterior long ligament, lateral flexion/rotation - limited by ribs

Question 2

What is the key construct for spinal control

Answer 2

• the ability to dissociate spinal & appendicular movements provides a static platform for force absorption & transference & is a product of mobility & neuromuscular control of the limbs & maintenance of a static-neutral lumbar position

Question 3

Define mobility

Answer 3

• the amount of freedom of movement at different spinal segments
• provides the basis for the development of motor control & optimal spinal function

Question 4

Define control

Answer 4

• maintenance of spinal integrity during skilled movement tasks depends on the ability to process sensory input, interpret status of stability/motion, and establish strategies to overcome movement challenges
• main creates an altered response resulting in the superficial muscles overworking the smaller deeper muscles

Question 5

Define energy

Answer 5

• the ability to produce or tolerate variable intensities & durations of work which allow a person to be efficient with a given task

Question 6

Define force

Answer 6

• the ability of the spine to produce force
• rate of force development (RFD)
• strength & RFD are impacted by musculoskeletal injury

Question 7

Define functional exercises

Answer 7

• performed in weight bearing with a focus on dynamic postures & movement strategies in all planes in order to improve performance during a specific task

Question 8

Define non-functional exercises

Answer 8

• performed in partial weight bearing, single plane of movement or isolated joints with the goal to regulate the amount of mechanical loading through the use of gravity, body segment lever length, & load

Question 9

Define segmental stabilization

Answer 9

• ability to stabilize the spinal segments in functional or non-functional positions

Question 10

Define segmental movement control

Answer 10

• ability to develop movement control of the spine through adequate recruitment of the “core musculature”

Question 11

Define spinal dissociation

Answer 11

• ability to stabilize the spine while resisting forces created by the moving extremities in functional or non-functional positions

Question 12

Define whole body control

Answer 12

• coordinated movements of the whole system

Question 13

Describe the pillar concept

Answer 13

• body segments stacked on top of each other need to be stable in both static & dynamic positions
• key areas to focus include the shoulders, trunk, & hips
• any impairment in one area can impact another area

Question 14

Difference between segmental mobility and segmental control

Answer 14

• Segmental mobility: stretching of the spine/segments to gain more motion
• Segmental control: slow movements focusing on controlling the motion throughout

Question 15

Exercises for motion

Answer 15

• thoracic extension on foam roller
• kneeling thoracic spine extension stretch (prayer pose)
• thoracic flexion quadruped with & without foam roller (child’s pose)
• Jefferson curl (deadlift motion with barbell)
• seated side flexion with/without rotation
• side-lying side flexion over Swiss ball
• side-lying thoracic rotation (side sleeping position)
• quadruped thoracic rotation (reach elbow or hand to ceiling)
• squat with extension & rotation (reach hand to ceiling)

Question 16

Exercises for control

Answer 16

• bird dog
• wall squat (face wall & don’t let knees touch wall)
• flexion/extension control quadruped (cat cow)
• sitting side flexion/mermaid (sit on moveable surface and use trunk to pull body back & forth)
• half circle in side-lying (open book)
• upper back rotation w/lunges (rotate on down and up motion)
• standing wood chop/lift (UE diagonals)

Question 17

Exercises for force

Answer 17

• deadlift (weighted)
• partner backwards fall (maintain a stiff trunk in trust fall)
• front lever (on pull up bar make body parallel to floor)
• side pull prowler (pulling something across the floor facing sideways)
• partner push (maintain stiff trunk while jumping and being pushed in different directions in the air)
• battle ropes
• side medicine ball throws (throw medicine ball sideways at a wall)

Question 18

Exercises for energy

Answer 18

• Y-lift on bosu ball/superman (belly on ball lift arms into a Y)
• kettlebell swings (hip hinge is doing all the work)
• pike (feet on ball and pike into handstand position)
• kneeling power-wheel rollout
• roman chair lateral holds (side-lying with shoulders off of table static hold)
• windmills with kettlebell (look up at hand holding kettlebell)
• one arm inverted row (chin up while lying parallel to floor)
• lateral cable walkout/Pallof press (arms out infant holding Theraband/cable pulling to one side)
• upper back extension (prone lift chest off table/floor)
• standing thorax extensions with chains or elastic band (flex thoracic spine and then extend straight up again band resistance)
• V-ups
• half Turkish get-up (hold kettlebell above hand & stand up from floor)
• lateral sit ups (side crunch)
• dumbbell/kettlebell side bend
• W-sit ball rotation/twister (Russian twists)