Thoracic Spine Flashcards
Muscles that span between C spine to T spine
semispinalis capitis
splenius capitis
splenius cervicis
muscles that span between thoracic and lumbar spine
multifidi longissimus thoracis iliocostalis lumborum latissimus dorsi fascia
why is the thoracic spine almost always overlooked?
midback pain is usually less common and less severe than neck or low back pain
what does injury do to joints?
pain alters mechanics
altered mechanics stress ill adapted tissues
structures cannot handle load
adaptive pattern begins
what are the advantages to the thoracic spine being more stable?
they are less prone to aberrant motion and a degenerative cycle
what could be tight or overactive if there is upper extremity movement dysfunction?
pec major/minor anterior deltoid subscapularis latissimus dorsi levator scapulae upper trap teres major SCM scalenes rectus capitis
what could be weak or underactive in UE movement dysfunction?
rhomboids lower traps posterior deltoid teres minor infraspinatus serratus anterior longus coli longissimus capitis
common joints involved in UE movment dysfunction
sternoclavicular joint
AC joint
thoracic and cervical facet joints
possible injuries leading to UE movement dysfunction?
rotator cuff shoulder instability bicep tendonitis TOS headaches
tight or overacitve muscles assoicated with LE movement dysfunction
tibularis lateral gastrocnemius soleus IT band lateral hamstring adductor psoas
weak or underactive muscles associated with LE movement dysfunction
posterior tibialis flexor digitorum longus flexor hallucis longus anterior tibialis vastus medialis pes anserine gracilis sartorius semitendonosus gluteus medius hip external rotators gluteus maximus local lumbo-pelvic hip stabilizers
common joints involved in LE movement dysfunction?
1st MTP joint subtalar joint talocrural joint proximal tibio-fibular joint SI joint lumbar facet joints
possible injuries associated with LE movement dysfunction
plantar fasciitis
posteiror tibia tendonitis
anterior knee pain
low back pain
how do we assess the thoracic spine
breathing posture assessment (kyphosis, upper cross)
hyperkyphosis has negative effects on what?
scapular stability
cervical motion
respiration
what does hyperkyphosis do to scapular stability?
results in scapular protraction
which leads to rounded shoulders with the scapula in a forward position
scapular protraction leads to what?
shoulder pain
narrows joint space for movement
excss load on the ligaments in the shoulder
decreased shoulder strength
paradoxical breathing
shoulders elevate
reliance on accessory muscles for inspiration
diaphragm breathing
proper technique allows expansion of ribs laterally, greater space as opposed to elevation of ribs
wall angel
stand against wall with arms abducted to 90 degrees, elbows bent at 90 degrees
try to flatten back
ask patient to nod-tuck the chin
do symptoms occur?
when do they fail the wall angel?
if they can’t flatten the T-L junction
pain or tension felt
do symptoms occur when flattening back/tucking chin/passive over pressure into cervical flexion
what is a wall slide?
exercise involving squatting down while raising arms
focuses mobility on thoracic spine
what muscles can feel tight with a wall slide?
latissimus dorsi
pectoralis
what do you do if you do feel tightness during a wall slide?
stretch or adjust prior to the exercise
what does arm elevation screen for?
thoracic mobility
when can there be decreased extension of the thoracic spine, what is tight?
latissimus dorsi
pec muscles
what can you do in office?
active ROM wall angel/wall slide/arm elevation passive ROMS assess P-A mobility mobilize spine (genie, press P-A to gain extension) adjust
what are some other things you can do to increase thoracic extension?
use a foam roller and make sure the focus of extension is in the thoracic spine
cat/camel
trunk stability push-up
hands in line with shoulders
thumbs in line with chin
perform push up, should elevate as a unit
quadruped rollback
extension is noted during quadurped rollback
involvement of levator scapulae
can you change posture?
it is difficult, but it is possible
need patient compliance
brugger’s posture break
sit at edge of chair turn feet out slightly feet slightly wider than hip width tuck chin slightly (retraction) deep breath with abdomen slowly exhale while rotating arms outward, spreading fingers wide, lifting sternum
what are some common errors for good posture?
excessive lumbar extension
rib flare
upper throacic sinking
full scapula retraction
