This information is not intended to treat, diagnose, cure or prevent any injury. This information is not intended as a substitute for the advice or medical care of a qualified health care professional and you should seek the advice of your health care
professional before undertaking any lifestyle changes.
If you have pain – please go and see you physiotherapist, osteopath, chiropractor or who ever it is that you see as a your health care provider
If you have been struggling with beat up achy shoulders or a sore neck then it’s time to stop addressing the symptoms and start getting to the root cause of pain and dysfunction
Yes, if you have sore shoulders it’s probably not the shoulder that needs treatment. That rotator cuff that everyone keeps talking about is often always the scapegoat for shoulder pain
So, what is the root cause of shoulder pain ?
For many it’s actually lack of mobility of the Thoracic spine. The Thoracic spine should be able to bend, flex, extend and rotate to varying degrees. Loss of mobility in the Thoracic spine results in poor scapula function and ultimately poor biomechanics resulting in shoulder pain
How did this all happen ?
Let’s take a look at the joint by joint approach and apply it to the typical everyday athlete
Ankle – mobility
Knee – stability
Hip – mobility
Lumbar – stability
Thoracic spine – mobility
(for the sake of this article I am going to focus on hip, lumbar and thoracic spine)
Bob the everyday athlete
Wakes at 6 and sits down to eat breakfast
7:30 he drives in the car for 30 mins where he arrives
8 – 12 he sits at his desk in front of his computer
12 – 1 he goes to spinning class at the gym
1 – 5 he sits down at the desk in front of the computer occasionally getting up
5 – 5:30 drives home
5:30 – 9 eats dinner, sits on the sofa and relax for the evening
As you can see Bob sits a lot. All that sitting puts his hips flexors into a shortened position and results in his hips tightening
As a simple compensation his lumbar joint which is supposed to be a stable joint becomes overly mobile. Essentially if the hips don’t move the body has to get movement from somewhere
If the lumbar joint becomes overly mobile then as a compensation the thoracic spine typically will over stabilise and often get tight and stiff
The fact that Bob sits in front of a screen with rounded shoulders slouching for many hours simply exacerbating the issue
The scapula sits on the thoracic rib cage held in place by a number of muscles. If the scapula is unable to move freely because of the tightness of the thoracic spine and movements of the scapula such as elevation, depression, protraction, retraction, upward and downward rotation may become compromised and results in dysfunctional movement
Let’s look at one example of how the thoracic spine posture affects your shoulder. In a normal thoracic spine/scapular relationship, as you reach upward, the scapula tilts backwards (posterior tilt) to make space in the shoulder joint for the rotator cuff. In a case of thoracic kyphosis (rounded forward upper back), the scapula is unable to tilt backward.
The result is a closing of the gap between the upper arm bone (humerus) and the acromion and impingement of the rotator cuff.
The thoracic spine fix
In order to create change in the thoracic spine it needs to be mobilised particularly in extension and rotation and that new range of motion needs to be locked in.
Think of it like a computer – we need to upload the new software and then download it to make sure we don’t lose it
Some of the drills below focus on finding range of motion and some will rewire your neuromuscular system
Here are my top 5 drills
Foam roller T spine
Begin exercise in supine position with t-spine placed directly on the foam roller with both hands supporting body weight.
Next, roll the t-spine across the foam roller.
Never perform exercise to the point of pain, but make sure that your muscle is feeling just short of the pain threshold as this will help to establish the best mobility in the muscle tissue.
Quadruped T spine rotation 1&2
Get into a quadruped position with the knees under the hips and the hands under the shoulders with the spine in a neutral position.
For the first position, place one hand on the upper back or back of the neck.
Begin to rotate leading with the eyes, head and shoulder as far as possible down towards the hand. Then reverse the motion leading with the eyes, head and shoulder rotating upwards as far as possible.
For second position, change the hand position and place it on the lower back with the palm facing up. Repeat the exercise with the hand in this position.
KB Arm Bar
Lay on your back. Set-up with a light bell in your left hand. Press the left arm to lock out for the entirety of the movement.
Right hand vertically overhead, palm up.
Using your left leg, drive the torso into a roll, using the right leg and right arm as the axis.
Stacking the shoulders and the hips, begin to rotate the torso, leaving the kettlebell in the centre of mass over the base of support.
Begin to straighten out both legs. Your knees should lock and your toes should point.
Tall Kneeling KB turns
Being in the Tall kneeling posture by placing both knees on the ground just wider than your hips, your lower legs remain parallel, and your ankles are plantar flexed. Your pelvis remains in a neutral stacked position with a tall spine, and your shoulder and hips remain squared off.
Begin by holding a kettlebell or sandbag in both hands in front of you. Be sure to maintain the balanced upright posture and perform a series of turns:
Turn the head and shoulders to the right and left in a smooth and controlled manner while moving the KB in that direction (if you can turn far enough you may move the KB to the outside of the hip you are turning over).
The aim is to perform this turns while maintaining “perfect posture” Begin with small turns and slowly add range but do not push into discomfort or increase the range, so you have to compensate in any way.
Bench T spine mobilisation
Get into a quadruped position with the knees on the ground and elbows on an elevated surface, like a bench shoulder width apart.
While holding a dowel, rock your hips back and press your chest towards the ground. As you do this, slowly bring the dowel over your head. Breathe into the stretch, then return back to the starting position.
Performing these exercises consistently will save your shoulder, your lower back, and in many cases your elbow as well. Enjoy unlocking your thoracic spine to move better, feel better and perform at your best.