Thoracic Spine Exercise Progressions

Last week we talked about stubborn thoracic spines. I had a question asking for video to help the understanding, which will definitely help since movement is hard to describe in writing.

In this video, I talk way faster than necessary (sorry about that!), but I go through type I and type II thoracic motion using arm drivers. I did it all with lunges, which is a nice progression, but you can start with more basic arm drivers.

The progression in the video is as follows:

  • Type I Thoracic spine motion:
    • Left leg lunge with right hand left thoracic rotation and left hand right lateral flexion
    • Right leg lunge with left hand right thoracic rotation and right hand left lateral flexion
  • Type II Thoracic spine motion:
    • Left leg lunge with left hand left thoracic rotation and right hand left lateral flexion
    • Right leg lunge with right hand right thoracic rotation and left hand right lateral flexion

I then did a couple of variations using lateral lunge and rotational lunge.

It’s likely in the clinic I would not start with all this in one go, it gets messy. Start simple and build up. Depending on the patient you may have to stay at the more simple exercises, though some will be able work through several steps in one session.

The best way to start is with rotation, either with both hands driving or one. Then when it comes to lateral flexion I usually fix rotation (on a doorframe or wall) and then drive lateral flexion on its own. Once they get the hang of that you can start driving both motions at the same time, then progress onto the lunges.

Here is a video of these:

Movement is a skill, skills need to be developed and in that your patients can gain confidence, which is probably 90% of the battle in a lot of cases.

Enjoy playing around with this, you can add little weights in the hands, combine it with bands or cables…the options are endless!

Physioblogger

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