0:00 hello and welcome i'm dr tony camella physical therapist with e3 rehab in today's video i'm going to be showing you various exercises aimed at improving thoracic spine range of motion these will include a total of four progressions two which place an emphasis on thoracic rotation or twisting side to side and two for thoracic extension or bending backward there are subtle differences between these which will vary depending on individual needs goals etc for example one progression from each will include more shoulder movement if you are someone that finds these two challenging or they create shoulder discomfort you may benefit from performing one of the other options after i review these exercises i'm going
0:46 to provide some insight as to why these may be helpful if you're someone who experiences neck stiffness if you're looking to improve shoulder range of motion or even increase performance during various athletic activities additionally i'm going to explain why these may even be advantageous if you're looking to reduce pain at various joints but first let's start off with the exercises first up thoracic rotation progression number one there are four exercises in this progression in order from easiest to hardest level one side lying thoracic rotation start on your side with knees and hips bent and head supported keeping your eyes on your hand reach
1:32 your hand back toward the ground behind you rotating through your mid-back return to the start and repeat level two half kneeling thoracic rotation similar motion but in a half kneeling position rotate over the up knee reaching the arm as far back as you can return to the starting position and repeat level three half kneeling thoracic rotation on a wall place the knee closest to the
2:17 wall in a down position rotate outward over the up knee reaching the arm back trying to touch the wall return to the starting position and repeat compared to the previous exercise this helps maximize rotation and allows you to gently leverage through the front arm in order to rotate further and level four half kneeling thoracic rotation on a wall with the front foot elevated same position as before except now you will place the front foot on an elevated surface this position will move the hip into deeper flexion and therefore help minimize lower back
3:03 contribution rotate over the up knee reaching back towards the wall return to the starting position and repeat if you find any of these uncomfortable on the shoulder an easy modification is to place the hand behind the head or hold the arms across your chest as you rotate rotation progression number two these four exercises will be very similar to the previous progression except they move the shoulder through a larger range of motion if these are too challenging or uncomfortable on the shoulder progression number one might be a more appropriate starting option
3:50 however if your goal is to place additional emphasis on the shoulder these are a great consideration level one side lying thoracic windmill start on your side with knees and hips bent and head supported start with your arm out in front and slowly slide your hand along the ground like you are making a half circle return to the start and repeat if you cannot touch the ground just keep your arm at a height which is comfortable to you level two half-kneeling thoracic windmill in a half-kneeling position rotate over the up
4:36 knee trying to make a big circle with the arm as you rotate through your spine return to the starting position and repeat throughout the movement keep your eyes on the moving hand as this will help maximize thoracic rotation level 3 half kneeling thoracic windmill on a wall the knee closest to the wall will now be in the up position move your arm in a circle and rotate through your spine trying to keep your arm off the wall return to the starting position and repeat if you find that placing the knee and hip against the wall is
5:21 too hard you can place an object between your body and the wall or start at level two and progress as tolerated and level four half kneeling thoracic windmill on a wall with the front foot elevated same setup as the previous option except now you will place the front foot on an elevated surface again this position will move the hip into deeper flexion minimize lower back contribution and make it more challenging for thoracic rotation rotate over the up knee drawing a half circle and then return to the starting position and repeat
6:07 for thoracic rotation choose an exercise from either progression which is appropriately challenging to you parameters for these will vary based on individual needs goals etc but two to four sets of 10 to 12 repetitions on each side two to four times a week should be suffice for a majority of people after performing a given exercise for three to four weeks try and progress to the next level if tolerated thoracic extension progression number one there are three exercises in this progression and they all use a foam roller if you do not have access to a foam roller you can try using a rolled up towel
6:53 another object etc or try the second progression level one thoracic extension with head supported place a foam roller across your thoracic spine or middle back extend your spine back as far as comfortable hold one to two seconds and then return to a flexed position repeat this motion of extension and flexion along multiple points of the thoracic spine the goal is to extend through your mid-back so try not to let your lower back arch excessively level two thoracic extension with arms overhead same setup but this time take your hands and reach them overhead
7:39 extend back as far as comfortable hold one to two seconds then return to a flex position and repeat again try not to let your lower back arch excessively and level three weighted thoracic extension with arms overhead hold a weight and reach overhead extending over the foam roller you can use a plate kettlebell dumbbell etc hold the end position for one to two seconds return to the starting position and then repeat perform this movement with the roller placed at various points along the thoracic spine if your shoulder is sensitive to the overhead
8:25 position start with the head supported option and progress to the other ones as tolerated thoracic extension progression number two these three exercises will also move the thoracic spine through extension but will require the shoulder to be placed in an overhead position if these are too challenging or uncomfortable on the shoulder level one from the first progression might be a more appropriate starting option however if you do not have access to a foam roller and your shoulder can tolerate this position here are three exercises which can be performed using a bench couch ottoman etc level one thoracic extension on a bench
9:12 with arms overhead kneel on the ground and place your hands on a bench or another surface keeping your arms straight sit back to your heels moving your shoulder into an overhead position actively pull your chest through the arms while extending through your thoracic spine return to the starting position and repeat level two thoracic extension on a bench now place your elbows on a bench or another surface and hold your hands together as you sit back towards your heels bend your elbows and actively pull your chest through your arms in addition to
9:59 thoracic extension this places more tension on the triceps and lats so you may also feel a stretch in these areas hold the end position for one to two seconds and then return to the start and repeat and level three thoracic extension on bench with a dowel with your elbows on a bench or another elevated surface hold on to a stick or dowel with the shoulders in an externally rotated position sit back towards your heels bend your elbows and actively pull your chest through your arms hold the end position for one to two seconds
10:45 and then return to the start and repeat the stick will keep your shoulders in an externally rotated position which will place additional emphasis on stretching the lats for thoracic extension choose an exercise from either progression which is appropriately challenging for you again parameters for these will vary based on individual needs goals etc but a general recommendation is performing these for two to four sets of 10 to 12 repetitions two to four times a week after performing a given exercise for three to four weeks try and progress to the next level if tolerated
11:31 these are some of my favorite progressions and exercises for working on thoracic rotation and extension out of all these options you should be able to find an appropriate starting place for you however i think it's also really important to understand why improving this range of motion is so important like i said in the beginning there are various reasons or circumstances where you might benefit from possessing more range of motion here one of these reasons is for improving neck range of motion in an article by saying and colleagues researchers found that motion of the thoracic spine contributed to neck mobility when you move your neck into flexion and extension more than one third of that movement comes from the thoracic spine
12:16 the thoracic spine also contributes to neck side bending and rotation but to a lesser degree about 25 percent and 15 percent respectively so what does this mean well if your neck is feeling stiff or limited in any direction neck stretching may still be beneficial however to maximize neck range of motion you should also include exercises targeting the thoracic spine just like the ones mentioned previously this is also similar for the shoulder barret and colleagues found that increased thoracic kyphosis created an immediate limitation in shoulder range of motion miyashida and colleagues demonstrated that thoracic movements made major contributions to shoulder external
13:03 rotation in throwing athletes suzuki and colleagues found that increased thoracic extension increased scapular thoracic posterior tilting and shoulder external rotation and lewis and colleagues showed that changing posture to include more thoracic extension and less kyphosis increased shoulder flexion and abduction so if your goal is to maximize shoulder overhead range of motion abduction or external rotation exercises addressing the shoulder can still be helpful but to maximize function you should also be including thoracic mobility exercises
13:48 tennis golf baseball basketball football soccer cricket weight lifting crossfit and so on if the sport or activity you participate in requires dynamic movement of the shoulder the neck and or spine which most do then in order to maximize performance you would benefit greatly from improving thoracic spine range of motion and finally in terms of pain these may be helpful because they allow you to explore movement that you might not have been able to do previously or in other words they may allow you to express more movement variability this has the potential to reduce pain
14:34 discomfort or sensitivities around various joints such as the neck shoulder or even the low back in summary if you're looking to help with neck stiffness improve shoulder range of motion athletic performance or even potentially reduce pain incorporating some type of thoracic extension or rotation exercise is going to be extremely beneficial the progressions and exercises i showed previously are all great options just find an appropriate starting place for you and progress as tolerated all right that is it for today's video as always thank you for watching please do us a favor tap that like button subscribe and turn on notifications
15:22 if you have any questions or even suggestions for future content just drop those below in the comments we'll see you guys next time
