Thoracic Spine Corrective Exercises

The following exercises will help to increase ROM in the upper body. Other exercises are available and if you find any of these cause unexpected pain then you should seek expert advice.

T-Spine Smash

Extension and rotation are very closely linked in the thoracic spine - you can’t have one without the other. That’s why with this exercise, we focus on creating more optimal thoracic extension as it’s a great route to improved rotation. Extending

over a foam roller or a peanut if the large roller is too difficult, gives a good feeling of release after a long day on the bike or behind a desk.

Instructions:

Adopt a position as if you were about to perform sit-ups and position the foam roller or peanut under your back so that it’s at the base of your ribcage.

Wrap your arms around yourself and actively pull your shoulders forward.
Extend over the roller by arching your back.
Spend time in this position until you feel change.
Come out of extension, keeping your arms wrapped around you, as if you're doing a sit-up.
Allow your backside to move towards your feet, shifting the position of the roller further up your back.
Extend back over the roller and keep working ln this the way up to the base of your neck.
Increase the extension and intensity by using your glutes and pushing your hips up.

Side to Side Smash

If you discover areas that aren’t responsive to the straight extension exercise on the opposite page or you aren’t seeing the improvements you want, try this side-to-side variant.

Instructions:

Set up in the same way as the thoracic spine extension smash.
Rather than extending over the foam roller, roll from side to side, keeping that tension on your upper back with your arms.
Aim for as much rotation as possible.
Work up your spine. If you find one side or area is especially tight, hold on it and roll up and down over it.
Also, try extending over the roller when on your side.
This exercise is all about moving and exploring tight or restricted areas. Don’t be rigid and formulaic - be active and search them out.

Lat Trigger Release

This exercise could be used to improve all of the upper body assessments but we’ll start with it here. The latissimus dorsi - ‘lats’ - has the largest single attachment of any muscle in the body. It’s a key stabiliser not only of the shoulder but also, because of its extensive spinal insertions, of the spine.

It often becomes restricted as, due to its size, the body recruits it to compensate for inactivity or weakness in other muscles. A lat of sufficient length and strength is key to many movements involving spinal rotation and overhead movement.

Instructions:

Lying on a mat, extend one hand above your head.
Insert a trigger point ball in your armpit near the insertion of your lat and rotator cuff.
Roll over to put weight on the ball.
Increase the amount of weight on the ball and move around the area to look for tight or restricted areas.
You can also use a foam roller for this exercise.

Recumbent Kneel Lat Stretch

As the lats are such large muscles, restrictions in them can have negative impacts both on and off the bike. Affecting both shoulder mobility and the spine, they are a vital muscle group for good form in a considerable number of common gym exercises and achieving an excellent aerodynamic position on the bike and a good catch and pull in the swim.

Instructions

Kneel and reach forward with your hands, placing them on the mat in front of you about shoulder-width apart.
Keeping one hand where it is, place the other hand on top of it.
Sit back gently towards your heels, making sure your hands stay in position.
You should feel a stretch develop as you move backwards and, due to the hand position, should feel it on one side more than the other.
Repeat with your hand position reversed.
You can advance the stretch by side-bending away from the lower hand side or elevating your hands on a bench or Swiss ball.

Seated Spinal Rotation

Thoracic rotation is a good indicator of thoracic extension. The latter is difficult to assess but, if rotation is good, in most cases extension will follow suit. Boththoracic rotation and extension are important in being able to achieve good movement patterns, as the thoracic region is effectively the link between the upper and lower body. Restrictions here can pass on unusual loads to other joints, both upwards and downwards, potentially resulting in overloading and breakdown.

Instructions:

From a seated position with your legs extend forward, cross one foot across the opposite knee
Bend the bottom leg to tuck your foot near the opposite hip.

Make sure your weight is evenly dispersed on both sides and, if necessary, use a towel or block to level them.
Sit tall and rotate towards your top leg. Aim to lock your elbow on the outside of the top leg.
Make sure you lead the stretch with your head and shoulders.

Apley Scratch Test Corrective Exercises

Seated Spinal Rotation

The muscles at the front of the upper body often become tighter and more restricted, pulling us into an ever more stooped and rounded posture. We start life curled up in a ball and end up that way in our old age. They often become long, weak and restricted due to this and to the propensity of modern-day life to encourage us to spend significant time seated and hunched forwards. Getting into and releasing these structures can relieve shoulder pain, improve range of motion and enable better all-round posture. Performed regularly and well, this exercise will help you to achieve more internal and external rotation at the shoulder joint and therefore improve your performance in the Apley Scratch for which they are often the first limiting factor.

Instructions:

Place a trigger point ball right above the insertion of your lat near your armpit.
Lay back onto the ball with the arm on that side bent at 90 degrees. Put as much weight onto the ball as you feel comfortable with and adjust its position if necessary.
Slowly rotate your arm forwards and back, aiming to increase the range of movement.

Pec Smash

Pec release work is a real double-edged sword. It’s an amazingly rewarding exercise in terms of the payback and rewards in increased range of movement and decreased dysfunction, but it’s normally incredibly painful. Simply lying on the trigger point ball is a great place to start and then, once you can cope with that, try the arm movements described below.

Instructions:

Lying on your front, position the trigger point ball so that it’s nestled in the soft tissue between your shoulder and breastbone and below your collarbone.
Outstretch the arm on the side of the ball and hold the ball in place with the hand of your other arm.
Put as much weight as you can handle onto the ball.
If you feel you’re able to, move your arm slowly above your head by your side and behind your back
Repeat on the other side.

Wall Tricep and Lat Stretch

This stretch hits a number of structures including the long head of the triceps and the lats. Increasing your flexibility in this area will free up your shoulder in a way that’s directly applicable to the Hands Behind Back assessment.

Instructions:

Stand next to a wall and, with your left arm above your head, place your elbow and triceps against the wall
Lean into the wall and start to develop a stretch in your triceps.
Grab the wrist of your left arm with your right hand and intensify the stretch by pushing your left hand towards your left shoulder.
Repeat on the other side.

You can further advance this exercise by introducing a trigger point ball and band distraction.

Reverse Sleeper Test

A fairly old-school stretch, but effective, and one you can do anytime and anywhere to work on internal shoulder rotation. If you’re struggling with the Apley Scratch Test, this is a stretch you can do at your desk regularly throughout the day and make real progress.

Instructions:

In a seated, kneeling or standing position, put your left hand behind your back with your palm facing outwards.
Reach across your body with your right hand and grab the elbow of your left arm.
Without letting your right shoulder roll forwards or shrug up, pull your left elbow, towards the centre line of your body.
Repeat on the other side.

Banded Shoulder Distraction

The shoulder is an amazing joint that, in combination with the elbow, wrist and fingers, allows for incredible dexterity in the arm. If you compare it with the body’s other ball-and-socket joint, the hip, the difference in range of motions is fourfold. However, this motion comes at a cost, namely stability. It’s very unusual to dislocate a hip but relatively common for shoulders. Even the act of trying to free up your shoulders can put them in potentially vulnerable positions. This is a great exercise as it allows you to work on two key ranges of motion, extension and external rotation, using your body weight but without any risk. It feels great after you’ve done it and encourages the shoulder joint towards the posterior part of the socket. This plays a significant role in correcting the shoulders rolled forwards’ posture that is so commonplace due to modern life.

Instructions:

Attach a band to the waIl/ceíIing or similar at above head height.
Hook your right hand through the band and then rotate your hand with palm up and thumb towards the outside of your body. This creates external rotation.
Place your right hand on top of your left hand and use it to hold the hand in the externally rotated position.
Hinge and lower your torso towards the ground.
Maintain the external rotation, contract and relax, and alter your body and foot position to search out¡ and work through areas of restriction.
Repeat on the other side.