T-spine Flashcards
common conditions of T-spine
Scheuermann’s disease
Osteoporosis
Excessive kyphosis
Muscle strain
Scoliosis
Scapular dyskinesis
Thoracic Outlet Syndrome
T/S contributes to an estimated _% of total force and kinetic energy generated during a , ~% of total _, and is linked to the upper limb
T/S contributes to an estimated 55% of total force and kinetic energy generated during a throw, ~80% of total trunk rotation, and is linked to the upper limb
Thoracic mobility program resulted in_% and % lower risk of problems
Thoracic mobility program resulted in 28% and 22% lower risk of shoulder problems
Exercises should be classified according to
Exercises should be classified according to mobility, motor control, work capacity and strength
Common Muscles that might get tight and influence movement of the thoracic spine
Lats
Erector spinae
QL
Pecs (major and minor)
Obliques
Rectus abdominus
Diaphragm
Serratus posterior inferior
UFT
Passive techniques to help with relaxation of muscle
Foam rolling, trigger point release, breathing, myofascial releases (therapist or self)
scoliosis coupled movement follow law 1 or 2?
1 -> L sB, R rot
coupled movement of row and rotation + punch and rotation
row/rotation -> same side
punch/rotation -> opposite side
give exemple of spinal dissociation in static spine
Birddog, deadbug, wall squat, pallof press
Note: can also be progressed to strengthening exercises
spinal dissociait dynamic exemple
Cat/cow, open book, thread the needle, sitting side flexion (mermaid)
exemple of whole body coordination
: Upper back rotation with lunge, Woodchoppers or lawn movers, row with knee drive, punch with knee drive
exemple of pillar development static exercise
deadlift, prowler pushes
exemple of pillar development dynamic exercise
battle ropes, med ball throw
What You Might See With Increased kyphosis
Hypertonic flexors of T/S
Hypertonic rib depressors
Weak/inhibited extensors
Weak/inhibited rib elevators
what you might see with decrease kyphosis
Decreased kyphosis
Hypertonic extensors of T/S
Hypertonic rib elevators
Weak/inhibited flexors
Weak/inhibited rib depressors
what to do to help someone that have an increased kyphosis
: superman, foam roller T-spine extension, open book, 90-90 breathing, diapghram breathing
what to do to help someone that have an decreased kyphosis
child pose, hugging a Swiss ball, crunch, dead bug, pec fly, 90-90 breathing with a balloon
the scapula and humerus move in _ ratio
1:2
when the arm is abducted, _ degrees and _ degrees occurs by rotation of scap and _ degrees by rotation of humerus at shoulder joint
180, 60 , 120
thoracic osteoporosis rehab
Moderate weight bearing exercises (walking)
Resisted upper extremity weight training
Postural training exercises
Balance training exercises
scoliosis is named for side of
convexity
Typically in right handed individuals there is a mild _ thoracic, _ lumbar S-curve, or a mild _ thoracolumbar C-curve
right, left, left
when is surgical option for scoliosis is advise
Surgical Options (typically >30degrees)
Failed conservative
Debilitating back/leg pain
Severely restricted ADL and function
when does bracing is advised for scoliosis
Between 10-25 degrees observation
Typically bracing is prescribed when curve hits 25 degrees and adolescent has yet to reach skeletal maturity
scoliosis bracing is use to
release load on concave portion and increase load on convex portion of curve
what is the schroth method
Utilizing exercises to bring body into the natural curve
De-rotate, elongate and stabilize in the 3 planes of movement
what can you use to help treat scoliosis with conservative treatment
schroth method
what might be causing the hypo mobility of T-spine
What is causing the hypomobility?
Soft tissue restriction–> soft tissue mobilizations
Overactive sympathetic Nervous System breathing
Posture dysfunction–> Fryette’s laws
Articulation issue–> joint mobilizations
pain between shoulder blades often associated with lack of
thoracic rotation
L thoracic spine lateral flexion can be encouraged at T7 by
blocking excessive lateral flexion below T7
Significant improvements in shoulder impingement syndromes following
thrust manipulation of the Thoracic spine at 48 hr follow up
Tx of T.O.S
Scapular positioning
Anterior tilt, protraction
Clavicle mobilization
1st rib mobilization
UFT, scalene, pec minor/major release
Strengthening of scapular stabilizers
Neuromeningeal mobilizations
Sleeping position/ADL position education
when to use cyriax method
When patients cannot avoid provocative positions
Lay on uninvolved side
Avoid prone
Goal of technique is to fully unload the neurovascular structures
May not have relief first few times with technique
Continue to repeat technique over time
which technique can you use before sleeping to fully unload neurovascular structure
cyriax method
what can also cause GH limitations
clavicule position that might decrease costoclavicular space
