In this past year we have spent more and more time sitting in front of our computers. As a clinician that is pigeonholed into being the back only doctor I have seen first hand the effect this has had on society. Everyone….and I mean everyone is spending more hours sitting at their desk slouched over a laptop, smartphone or even leaning in to a desktop computer out of mere eye strain. This forward lean puts an increase in stress on the thoracic spine (between your shoulder blades) and hangs your head forward over its centre of gravity stressing your upper back and neck muscles.
This position has its own host of issues for all of us, but for athletes there can be an extra limitation put on athletes that do overhead movement. Swimmers are one such athletic population.
Overhead movement requires a great deal of range of motion pre-requisite out of the shoulder (glenohumeral) joint, but can be hampered by an inability of the thoracic spine to extend. Your thoracic spine sits between your shoulder blades running from the base of your neck, down to your lower back. All of your ribs attach to your thoracic spine for reference. The thoracic spine is typically in a kyphotic position (slouched forward). This curve is normal, though sometimes not as excessive as seen in some people. The curve isn’t as important as one’s ability to extend their back, or straighten up that curve in their thoracic spine. This lack of extension out of the thoracic spine can put a significant limitation on shoulder movement overhead, and lead to injury with repetitive movements.
When there is a lack of extension from the thoracic spine, or there is too much of a kyphotic (slouched) curve the ability of one to reach overhead is then focused on the shoulder joint which can only be pushed so far before injury of one or more of the rotator cuff muscles occurs. This is common in swimmers, volleyball players, rock climbers etc. This type of injury has a direct correlation to the thoracic spine, and by extension a direct correlation to how much time is spent sitting slouched over a computer.
The fix is simple yet often ignored. Stretching focused on extending the thoracic spine, to gain increased range of motion in the opposite direction to when you are sitting at your desk. The difficult part here is that oftentimes we are good at compensating for a lack of thoracic spine extension by over-extending our lumbar (lower back) spine. So the key here, when doing the rehab exercises you must focus on the area of your spine that you are moving. A failure to do this will lead to no actual change in the range of motion and can potentially lead to an injury of your lower back as you force it to go further to compensate.
In these uncertain times it is necessary to stay home, and be safe. This doesn’t mean giving up on your athletic dreams, or becoming complacent. Doing the following few simple stretches can help to increase your thoracic spines ability to extend. On top of helping swimmers and overhead sports athletes, it will even help your comfort levels while sitting at your desk working.
Dr. Adam Wade 