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An Easy Drill to Enhance Thoracic Extension

Thoracic mobility drills are commonly given to people to enhance mobility.  I have shown some common thoracic mobility drills in the past, and recently showed a newer muscle energy technique I have been using.  If you haven’t seen these yet, you should check them out:

 

One of my big principles of rehabilitation and corrective exercises is that you follow up mobility drills with some sort of activation or strengthening drill.  You want to use the body in this newly gained mobility.

For some reason, I feel like this is often ignored with thoracic mobility.

I would actually argue that a very common reason for having limited thoracic mobility is poor endurance into thoracic extension.  The muscles can’t maintain an extended posture and resort to the path of least resistance, a slouched posture.

If you are going to spend time working on thoracic extension mobility, you should follow that up by working on thoracic extension endurance.

In the video below I show an extremely easy way to start working on thoracic extension endurance.  Certainly not groundbreaking, but an important drill that is often overlooked.

 

An Easy Drill to Enhance Thoracic Extension

 

Learn How I Enhance Thoracic Mobility

If you want to learn more about how I enhance thoracic mobility, I have a presentation on Enhancing Thoracic Mobility.  I review some of the self mobility and manual therapy techniques I use to enhance thoracic mobility. This webinar will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

To access this presentation:

 

 

Enhancing Thoracic Mobility

enhancing thoracic mobilityLimited mobility of the thoracic spine is a common finding and something that tends to get worse over time.  To me, it’s one of those “use it or lose it” types of mobility in the body.  Several issues can occur from limited thoracic mobility, such as shoulder, neck, and even low back pain.

Thoracic mobility drills are common, but only part of the puzzle.  I have a new presentation where I’ll be reviewing some of the self mobility, manual therapy techniques, and corrective exercises I use to enhance thoracic mobility.

 

Enhancing Thoracic Mobility

This presentation will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

 

Access the Presentation

You can purchase access to this presentation for only $10, or join my online Inner Circle Mentorship program for only $10/month and gain access to this and ALL my past presentations, product discounts, exclusive content, member only forum, and more!

 

 

Thoracic Mobility Muscle Energy Technique

Have you ever worked with someone that never seemed to improve their thoracic mobility, especially thoracic rotation?

I work with the occasional person that doesn’t respond to many of the common thoracic mobility drills.  Sometimes their daily posture, especially if working a desk job for years, needs more than the simple drills.  Sometimes I feel that thoracic mobility limitations can be true mobility restrictions, but other times I also feel there may be some tone or guarding involved.

A common technique that can be used to enhance mobility drills, especially when tone is involved, is muscle energy technique, or MET.  Muscle energy is commonly used to enhance mobility in other areas of the body, like the shoulder or hamstring, but less frequently used for thoracic mobility for some reason.

In the video below I show a very easy muscle energy technique that you can use to enhance thoracic mobility into rotation.  This is very easy to perform on your own too.

Give it a try and let me know what you think, I’ve been pretty amazed at how much more mobility I can achieve in a short amount of time using this muscle energy technique, especially for those stubborn thoracic mobility limitations.

 

Thoracic Mobility Muscle Energy Technique

 

Learn How I Enhance Thoracic Mobility

If you want to learn more about how I enhance thoracic mobility, I have a presentation on Enhancing Thoracic Mobility.  I review some of the self mobility and manual therapy techniques I use to enhance thoracic mobility. This webinar will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

To access this presentation:

 

How to Improve Overhead Shoulder Mobility

The latest Inner Circle webinar recording on my How to Improve Overhead Shoulder Mobility is now available.

 

How to Improve Overhead Shoulder Mobility

Improving Overhead Shoulder MobilityThis month’s Inner Circle webinar is on how to improve overhead shoulder mobility.  In this webinar I’ll discuss:

  • We we are losing overhead shoulder mobility
  • Why it matters
  • The 4 main reasons why we lose overhead mobility
  • How the body compensates when we lose overhead mobility
  • How to assess for a loss of overhead shoulder mobility
  • What you MUST stop doing immediately with people that have lost overhead mobility – you are making them worse!
  • Corrective exercises to enhance overhead position
  • Manual therapy techniques to improve mobility

 

To access this webinar:

4 Ways to Improve Overhead Shoulder Mobility

4 Ways to Improve Overhead Shoulder MobilityOne of the most common areas we attempt to improve in clients at Champion PT and Performance is overhead shoulder mobility.  If you really think about it, we don’t need full overhead shoulder mobility much during our daily lives.  So our bodies adapt and this seems to be an movement that is lost in many people over time if not nourished.

I’m often amazed at how many people have a significant loss of overhead mobility and really had no idea!

That’s not really the issue.  The problem occurs when we start to use overhead mobility again, especially when doing it during our workouts and training.  Exercises like a press, thruster, snatch, overhead squat, kipping pull up, toes to bar, handstand push up, wall ball, and many more all use the shoulder at end range of movement.  But here are the real issues:

  • Add using the shoulder to max end range of overhead mobility and we can run into trouble
  • Add loading during a resisted exercise and we can run into trouble
  • Add repetitions of this at end range and we can run into trouble
  • Add speed (and thus force) to the exercise and we can run into trouble

 

4 Ways to Improve Overhead Shoulder Mobility

In this video I explain the 4 most common reasons why you lose overhead shoulder mobility and can work on to improve this movement:

  1. The shoulder
  2. The scapula
  3. The thoracic spine
  4. The lumbopelvic area

The first three are commonly address, but not so for the lumbopelvic area, which is often neglected.  I’m going to expand on this even more in this month’s Inner Circle webinar.  More info is below the video:

 

Assessing and Improving Overhead Shoulder Mobility

For those interested in learning more, I have a few Inner Circle webinars on how to assess and improve overhead shoulder mobility:

 

 

 

Enhancing the Balance Between Upper and Lower Trapezius

Enhancing the Balance between Upper and Lower Trapezius

The latest webinar recording for Inner Circle members is now available below.

Enhancing the Balance Between Upper and Lower Trapezius

This month’s Inner Circle webinars discussed strategies to enhance the balance between the upper and lower trap, a common dysfunction I see.  We’ll cover:

  • The impact on posture and trapezius balance
  • The relationship between imbalances of the trapezius and shoulder and cervical pathology
  • The relationship between imbalances of the trapezius and performance
  • Strategies for exercise selection
  • Coaching cues and programming considerations

To access the webinar, please be sure you are logged in and are a member of the Inner Circle program.

 

3 Myths of Scapula Exercises

Scapula exercises are very common and usually a needed component to any rehabilitation or corrective exercise program.  Like anything else, there seems to be a few commonly accepted themes related to scapular exercises that many people take for hard fast rules.  No program is right everyone!  Here are 3 myths of scapular exercises that I thought would good to discuss.

 

Pinch Your Shoulder Blades Together

Pinch your shoulder blades.  Squeeze your scaps together.  Retract your shoulders back.  Pack your scapula.  These are all common coaching cues given during scapular exercises.  The goal of all of these concepts is essentially to get into better posture and “set” your scapula back, ultimately resulting in better posture and better movement patterns when performing exercises.  Given that as a society we have an abundance of people with posture.  The classic Upper Body Cross Syndrome of forward head, rounded shoulders.

Normal scapulohumeral rhythm requires a sequence of shoulder and scapular movement simultaneously.  Pinching your shoulder blades together is essentially contracting your middle trapezius to fully retract your scapula and then move your arm.  While this isn’t nearly as bad on shoulder mechanics as lifting your arm in a fully protracted position, I don’t think it is most advantageous to lift your arm in a fully retracted position.  By holding your scapula back, which is essentially performing and isometric trapezius contraction, you are likely limiting the normal protraction and upward rotation that occurs with arm elevation and movement.

Scapula Exercises

If the goal of this common coaching cue is to improve posture and improve mechanics while exercising the arm, maybe a better cue would be to instruct thoracic extension.  Perhaps even combine this thoracic extension with upper cervical extension such as when performing the chin nod with postural exercises like we talked about recently.  This truly improves your posture.  Realize that you can still have a very kyphotic and rounded thoracic spine and retract your scapulas.  Retracting the your scapulas isn’t a bad visual, but the goal is to really get your thoracic spine extended.

 

Work on Mobility and Strength to Improve Scapular Symmetry

Scapula StrengthWe’ve all been guilty of assessing someone’s posture, finding this forward head rounded shoulder posture, and then assuming we need to work on things like pec and upper cervical mobility while strengthening the lower trap and deep neck flexors.  These are all good things to work on, however this is likely a simplistic view.

First let’s take a step back and get something out of the way.  Your scapulas are not symmetrical.  The vast majority of people are not symmetrical and I would bet even people that are close have subtle differences.  The fact is, we are unilateral creatures.  We are typically one hand dominant and we typically function with predominant movement patterns that are related to this.  This tends to really become an issue when we start to talk about people that perform a repetitive unilateral activity all day.  I’m not just talking about athletes like baseball pitchers, you sitting there at your computer using your mouse in your right hand counts too.

This inherently creates asymmetries throughout the body, including the hips, spine, rib cage, and of course the scapula.

In my opinion, scapular position is more related to rib and thoracic position than anything else, including tight muscles and weak or inhibited muscles.  The scapula rests on the rib cage and thus moves with the rib cage.  Do you need to work on these muscle imbalances?  Absolutely.  However, proper alignment is needed as well and should be assessed first.

Everyone says “mobility before stability,” right?  Well, I’d like to add to that.  How about this:

Alignment before mobility before stability.

 

Perform Scapular Exercises Bilaterally

Ah, the old YTWL exercises.  I’ve discussed why I really don’t do a lot of the classic YTWL exercises either prone off the table or on a physioball.  I don’t love the upper trap activity needed to stabilize the head and just don’t feel like you get the proper movement pattern you are looking to achieve.  Perhaps it helps with posture.  I am sure there are pros and cons.

However, and probably more importantly, we don’t really tend to perform movement patterns that invovlve moving your arms like in this fashion.  When was the last time you retracted both arms such as during the T exercise?

If I am looking to strengthen a muscle, I am going to stick to my unilateral prone exercises and focus on strength and motor control.  That is my priority.

Then, when function and movement patterns becomes my next priority, I wonder if it is best to work on reciprocal scapular activities anyway?  Far more often we uses our arms in this fashion – one arms pulls while one arm pushes.  This can be seen in some of our most common activities like walking, jogging, and running as well as unilateral overhead sports like tennis, volleyball, softball, and baseball.  Here is a great example from Northeastern University:

Are there times when you should work your scapulas bilaterally?  Sure.  Just off the top of my mind I would do this in swimmers (expecially for the breast and butterfly strokes) and people that have to push and pull large objects at work all day.  It goes back to specificity of training.

The take home message is that you don’t have to work your scapulas bilaterally, and there is some very clear reasons why you would actually want to do the opposite and work the reciprocal push-pull pattern instead.

 

I hope this at least stirred some thought and discussion.  There is a time and place for everything, however sometimes there seems to be an overwhelming approach in one direction.  Maybe these 3 myths of scapula exercises will make you stop and think next time your are working on improving scapular strength, what do you think?

 

Learn Exactly How I Evaluate and Treat the Shoulder

If you are interested in mastering your understanding of the shoulder, I have my acclaiming online program teaching you exactly how I evaluate and treat the shoulder!

ShoulderSeminar.comThe online program at takes you through an 8-week program with new content added every week.  You can learn at your own pace in the comfort of your own home.  You’ll learn exactly how I approach:

  • The evaluation of the shoulder
  • Selecting exercises for the shoulder
  • Manual resistance and dynamic stabilization drills for the shoulder
  • Nonoperative and postoperative rehabilitation
  • Rotator cuff injuries
  • Shoulder instability
  • SLAP lesions
  • The stiff shoulder
  • Manual therapy for the shoulder

The program offers 21 CEU hours for the NATA and APTA of MA and 20 CEU hours through the NSCA.

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The One Thing We Need to Do With Everyone

I am often asked by students or people attending one of my seminars, “what is the one thing you do that you find works the best.”  What a loaded question!  I wish it were that simple that I could teach everyone just one magic technique.  I have been reflecting on this question for several months, planning on writing a post to provide an answer.  I took me sometime to figure out how I wanted to answer the question, but I think I might have an answer

 

The One Things I Do That Works the Best

The one thing that I would say that I do that works “the best” is probably something we should all be doing with everyone.  It’s not a stretch, it’s not an exercise, it’s not the latest fad in equipment, and it’s not the lastest manual technique.  It’s actually so simple, that it took me awhile to figure it out.  It is assessing and Reassessing.

A proper assessment and reassessement is by far the best thing we can do for every patient and client we encounter.  This is really the key to understanding each individual, what they need, and what works for them.   Everything should start with a proper assessment and then after treament or training, reassess!  Do it every time you work with that person and even multiple times a session.

[quote]Ask them, “what is your primary complaint?”  Assess it.  Quantify it.  Treat it.  Reassess it.[/quote]

This simple concept can have many meanings.  At the simplest level, imagine if you were working with a weight loss client and didn’t assess their body weight.  How would you know what was or wasn’t working?  How would you know how much improvement that client has made?

For the clinician, we have many evaluation and assessment tools – range of motion, joint mobility, strength, flexibility, and many many more.  But these measurements are irrelevant to the patient.  They don’t really care if they gained 10 degrees of motion.  They simply want to feel better and move better.

OK, your shoulder hurts.  When does it hurt?  What can you do to recreate that pain?  Great – you just established a baseline that you can reassess.  Don’t get me wrong, you still want to take objective measure, but you now have a real life baseline assessment that the patient can feel.

This is why tools like the FMS and SFMA are valuable – systematic methods of assessing movement.  This is especially true in the fitness fields, where assessments are even more limited.  Quantify the quality and feel of movement to assess changes.

FMS

Ultimately, this is going to always lead to better outcomes – instead of just applying treatment or exercise and hoping it works, assess what really works and adjust as needed.

 

Assess and Reassess

How do you apply this?  The wrong way would be to just start working on someone that complains “my back hurts.”  “Well, hop up and let’s start throwing some massage techniques and exercises at it.”  In this example, there was no assessment, just treatment, so what do you reassess?  Pain?  That is not always the best assessment.

Maybe a better way would be to assess when and how the back hurts.  What movements bother you?  What can’t you do?  Now, provide care to that person and reassess what you just observed.  Simple, yet a powerful message when a person stands up and says, “wow, I can now touch my toes, that really worked!”

Here is an example of a recent patient I evaluated with complaints of left sided diffuse mid thoracic and rib pain.  I provided a comprehensive evaluation, but I will just cut to the chase and outline the important details.  His primary complaint was pain.  I could of just started trying to treat the area to reduce sympotms and essentially “chase the pain.”  However,  my primary focus was on his limited multisegmental rotation to the left.

Multisegmental rotation doesn’t tell us enough, so I dug deeper.  He had a moderate loss of thoracic rotation to the left.  I could of stopped here as the location of his symptoms were in this area, but I again dug deeper.  I was fine with his hip mobility.  However, I found that his pelvis was shifted with a left anterior tilt, causing his entire pelvis and SI joint to rotate to the right.  Subsequently, his lumbar spine was orientated slightly to the right, meaning his “neutral” was actually rotated to the right slightly, causing what looked like limited rotation to the left.

Thoracic Spine Mobility ExercisesWith my assessment in hand, I went to work.  First, I wanted to start at the thoracic spine to see what the precentage of invovlement may have been.  I worked on soft tissue, joint mobility, and few thoracic mobilization corrective exercises.  Reassessment at this point showed a fairly large improvement of thoracic rotation to the left.  I could of again stopped here, but I also wanted to check multisegmental rotation to the left, which only showed approzimately a 50% improvement in rotation to the left.

If I just stopped here, I would have restored half of his dysfunction, and I bet he would have slipped right back to where he started.

I next went to the pelvis and with a few exercises and manual techniques improved his pelvic alignment.  Reassessment of thoracic rotation and multisegmental rotation showed normal symmetrical movement, and naturally a reduction in his complaints of pain.

That is the power of assessing and reassessing.  Not just once, but multiple times in one session so that I can narrow down the effectiveness of each technique as best as possible.

 

The Power of Reassessment

That was a pretty good example of how I really narrowed down and enhanced by treatments by assessing and reassessing.  To summarize some of the key points:

  • Helps you individualize and find what works.  This is the no-brainer concept, to see if there was an immediate improvement that can be directly correlated to what you just did to the person.
  • Helps you find out what doesn’t work!  Don’t underestimate this one.  By properly assessing and reassessing you also find out what doesn’t work, which is just as valuable so you can shift gears and try another approach.
  • This is also diagnostic.  By assessing what does and doesn’t work you may also narrow down the exact dysfunction.  Perhaps their limited thoracic rotation is related to soft tissue changes rather than joint mobility.
  • Helps buy in.  Lastly, but probably most importantly, assessing and reassessing helps build buy in, confidence, and compliance from the person.  They will see immediate benefit in what you do.

 

That is probably what I would consider the one thing that we all need to do with every patient or client we see – assess and reassess, what do you think?

 

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