Unveiling the Connection Between Thoracic Spine Stiffness and Shoulder Pain

If you're a swimmer, cricket, AFL or rugby player (league or union), or someone engaged in employment in heavy industries or construction, you're likely no stranger to shoulder pain. 

This persistent discomfort can hinder your performance and daily activities at home, work and during sporting endeavors. However, what you may not realize is that the biomechanical driver of your shoulder pain could be related to the stiffness in your thoracic spine. In this article, we'll delve into the relationship between thoracic spine stiffness and shoulder pain, shedding light on how addressing one can alleviate the other.

Understanding the Thoracic Spine
The thoracic spine, comprising the twelve vertebrae in the middle part of your back, serves as a crucial link between your upper body and lower back. Its role extends beyond providing stability; it also facilitates optimal movement of the arms, shoulders, and chest. However, prolonged repetitive movements, poor posture, or heavy workloads can lead to thoracic spine stiffness, resulting in shoulder pain.

The Impact of Thoracic Spine Stiffness
When the thoracic spine loses its mobility due to stiffness, it can have significant repercussions on the shoulders. Here's how thoracic spine stiffness can contribute to shoulder pain:

1. Restricted Range of Motion: Stiffness in the thoracic spine limits the shoulders ability to move into end of range flexion (arms moving in front of the body above head) and abduction (arms moving out from the side of the body above the head). Consequently, your shoulder joints suffer a reduced range of motion in these directions (flexion and abduction) leading to stiffness and impaired muscle activation patterns around the scapula and shoulder joint.
   
2. Compromised Shoulder Mechanics: A stiff thoracic spine alters the normal movement patterns of the shoulders. This disruption can cause muscle imbalances and poor biomechanics, leading to shoulder impingement, tendonitis, or rotator cuff issues.
   
3. Postural Imbalances: Thoracic spine stiffness often leads to a rounded shoulder posture, where the shoulders roll forward and the chest collapses. This postural imbalance places excessive stress on the shoulder joint, leading to pain, instability, and decreased athletic performance.

Addressing Thoracic Spine Stiffness to Relieve Shoulder Pain
To alleviate shoulder pain caused by thoracic spine stiffness, it's essential to adopt a multifaceted approach that focuses on improving thoracic mobility and optimizing shoulder mechanics. Consider the following strategies:

1. Thoracic Mobility Exercises: Incorporate exercises that promote thoracic spine mobility, such as thoracic extensions, foam rolling, and cat-cow stretches. These exercises can enhance flexibility and reduce stiffness in the thoracic region.
   
2. Corrective Posture Techniques: Pay attention to your posture, both during activities and throughout the day. Avoid slouching or rounding your shoulders forward, and strive to maintain an upright posture. Ergonomic adjustments in your workplace can also play a significant role in supporting proper posture.
   
3. Strengthening and Stability Exercises: Engage in exercises that target the muscles supporting the thoracic spine and shoulders, such as rows, scapular retractions, and push ups. Strengthening muscles that perform these movements can help maintain stability, improve shoulder mechanics, and alleviate pain.
   
4. Activity Modification and Rest: If your shoulder pain is aggravated by specific activities or sports, consider modifying your technique (in consultation with your physiotherapist and coach) or taking rest periods to allow for proper recovery. Overuse and repetitive motions can exacerbate shoulder pain, so it's crucial to give your shoulders adequate rest when needed.

In a lot of cases, manual therapy is needed to help address thoracic spine stiffness so it is always beneficial to seek the help of a physiotherapist to provide treatment to this area. We do often find that unlocking the stiffness in the thoracic spine assists greatly in the management of shoulder pain conditions. Often across a few visits, we are then able to progress to self-managed exercises at home or the gym to keep your pain and stiffness away.

Yours in health
Chris and the team at Out of the Box Physiotherapy