How Posture Can Cause Pain In The Thoracic Spine (mid back) and What You Can Do To Fix It

This blog is the written form of two of our weekly video series, Wellness Wednesdays and Thirsty for Knowledge Thursdays. Our Wellness Wednesdays go over great exercises that can help relieve pain from a specific injury, and our Thirsty for Knowledge Thursdays go over exactly what that injury is and how it happens. Click the "Our YouTube Channel" button on the right side of this page to head over to our YouTube Channel or check out the videos above!



This weeks video topics were on Thoracic Sprains and Strains, Earl and Chris showed some great seated exercises that can help treat the pain and Harry and Anthony talked about Thoracic injuries in more detail and explained how they occur. First, let’s start off with talking about exactly what Thoracic sprains/ strains/ pains are and see how people usually get these kinds of pains.
 
The Thoracic spine is the longest part of the spine and lies between the Cervical spine and the Lumbar spine. The Cervical spine is the neck area and the Lumbar spine is more of the lower back area, so the Thoracic spine would be right in the middle in that mid back area. The Thoracic spine is not necessarily an area of a lot of problems, we normally see more neck and low back problems but it can still be an issue for someone who does not practice good posture on a regular basis. When sitting or standing with proper posture our spines will generally have an inward curve in the Lumbar/ lower back, a more outward curve in the Thoracic spine/ mid back area, and ending with an inward curve at the Cervical spine/ top. When someone is sitting or standing with bad posture, their spines form one big “C” shape which is not its natural position and therefore can cause some pain and discomfort in the Thoracic spine region.
 
When we are in this position it might feel good or comfortable to us in that moment, but sitting in this position often enough or for long periods of time will start to give someone serious problems. We have been seeing these problems more and more in the clinic due to the Covid-19 pandemic causing many people to have to work from home. People are sitting on their couches or beds rather than their normal desks or work spaces resulting in more bending over and less sitting up straight, causing these issues in the Thoracic spine. We usually hear our patients with these issues report having a kind of stabbing pain in the mid back that will be present for one moment and gone the next. What they are probably not realizing is that when they are sitting with correct posture the pains disappear, but those pains always return when they revert back to sitting incorrectly. Even though having good posture is not normally a big area of concern, doing this long enough can lead to pain between the shoulder blades and even low back and neck pain in the future.
 
So the secret to avoiding those pains and strains in the Thoracic spine? Listen to all those times your mother told you to sit up straight and practice good posture! If you are already starting to get those pains though don’t worry, we have some tips and easy exercises you can do to help relieve those pains and get your back, back (pun definitely intended) to it’s natural pain free state. One quick tip we always give patients who have trouble figuring out how they should position themselves to have good posture can be done in three easy steps:
1.First slouch, then over correct your posture by squeezing your shoulder blades together and pushing your chest out
2.Do this movement 10 times
3.On the last one, overcorrect by about 15-20 % less and find where you feel balanced the most, this should be the correct posture for you
Another way to relieve pain and correct the posture some is to put your hands behind your head and stretch out the opposite way. Stretch backwards and make a “C” shape in the opposite direction of when slouching forward, that should help reset your back and posture a little.

​Other than those two tips, there are also some easy exercises that can be done while seated that can help relieve Thoracic pains and strains, here are 6 to start off with.
 
The first exercise is called External Rotation Series and the only equipment you will need for this are some weights. In the video, Earl and Chris used two one pound weights but for someone doing these at home a simple can of corn or soup is a great substitution, or these can be done without any weight if needed. Once you have your weights, you start by raising your arms at a 90 degree angle in front of you, and then lifting your arms straight up towards the ceiling. Bring your arms back down to a 90 degree angle, keep them at that 90 degree angle but now open your arms so that they are in a straight line with your shoulders and then push your arms straight up to the ceiling again. Once you have that movement down, do about 3 sets with 10 to 15 repetitions.
 
The second exercise is called a Swimmers Press. This exercise will also require a one pound weight in each hand (or soup can or nothing if you don’t feel like it). With a weight in each hand you will start off by doing a basic bicep curl, once your hands are positioned close to your body in the bicep curl you twist your wrists so that your palms are facing outward. Now that your palms are facing outward, you push your arms straight up to the ceiling, bring your arms back down to the bicep curl position, twist your wrists back to facing your body and lower your arms back down to your waist. When doing this make sure to not drop your arms after you lifted them up above you, slowly bring them down in the correct movements. Once you got that movement down this can be done for about 3 sets of 10 to 15 repetitions as well.
 
The third exercise is called Seated Middle Trapezius. For this one you have your arms at waist level with your weights in your hands, your palms facing up, and your thumbs pointed out. Next you squeeze your shoulder blades together as you move your arms outward. While you are doing this never let your elbows leave your ribs, your elbows should be touching your ribs even as you squeeze your shoulder blades and move your arms outwards. Once you got this movement down you can do about 3 sets of 10 to 15 repetitions.
 
The next and fourth exercise is called the Kayak. For this exercise you can use a number of different items, Chris is using a towel and Earl is using a stretch out strap, but you can easily use maybe a t shirt or a dog leash or anything of that nature. To start you position you hands about a shoulder length apart from each other on your rope (or rope substitute) and hold it with both of your thumbs out and facing the same direction, one hand should be facing palm up and the other palm down. Once you are holding it correctly you stretch your arms straight out in front of you, and move it up and down diagonally across your body, you should reach up to your head and then back down to your knees all while keeping your arms perfectly straight. When moving you move up in the direction that your thumbs are pointing then when you have done a few sets on that side, switch your hands around the other way so that your thumbs are both pointing in the other direction and repeat the movements for that side. Make sure you are twisting the upper body well and squeezing that core. Once you have the movement down this can be done for 3 sets of 10 to 15 reps.
 
The fifth exercise is called a Seated Dead Bug. For this exercise you won’t need any equipment at all, just you! Start by putting your arms out in front of you and your feet planted firmly on the ground about shoulder width apart. Next you lift one knee up and touch it with your hand that is opposite to the knee you lifted. Continue this motion switching between each side. As you are lifting your knee make sure you are twisting good and strengthening your core, it should look somewhat like a march as you are tapping with the opposite hand. As you are tapping your knee, the hand that is not in use should be lifted in the air and stretched behind you following your twisting body. Once you are good with the movement you can do this for about 3 sets of 10 to 15 reps.
 
The sixth and final exercise is more of an extension, so once you feel pretty good with doing all those exercises, you want to make sure you can move in all directions that your upper back is supposed to move (bending backwards, bending forwards, rotation etc). One way to do an extension is to start by having your arms crossed against your body with your hands on your shoulders and sitting at the end of your seat. Next lean forward a little and then start arching your back and pointing your elbows up to the ceiling while they are still crossed. If this causes some shoulder pain another way it can be done is by uncrossing your arms and putting your hands on your shoulders. Once you’ve done that you can arch your back and lift your elbows up to the ceiling while keeping your arms in front of you, don’t let your arms open up while you are arching your back. Once you have that down you can do that for about 15 repetitions.
 
Those are some different exercises you can do if you do have any Thoracic sprains or strains, we gave a general recommendation of doing around 3 sets of 10 to 15 repetitions for each exercise but that part is definitely up to you and how you are feeling with the exercises. If you are still having problems or if you have any questions for us, give us a call at either of our locations and take advantage of our free consultations so we can help you guys with whatever you need.