Improving Thoracic Spine Mobility

Introduction

 Tennis is a sport one can play deep into their older age if they manage to stay healthy. Often times, tennis players plateau in their game due to the inability to recognize the limiting factors that cause the decline in performance. In the game of tennis, if your “symptoms” relates to decreased power production, limited extension/follow through in groundstrokes, and limited rotation during the set up in groundstrokes, then focusing on improving thoracic mobility can be the root to all these problems. 

Thoracic Spine Anatomy

 The thoracic spine consists of 12 vertebrae in the mid point of the spine between the scapulas. The starting point of the thoracic spine is at the end of the cervical spine (C7) and end right before the lumbar spine (L1).(1)  Three main movements are intended for this section. These are rotation, flexion and extension. In the game of tennis, this section is vital during the groundstroke movements for rotational purposes and extension during the serve and overhead. A large number of lower back injuries stem from the rotational incapability of the thoracic spine, which the lumbar spine compensates for. If the given athlete has a lack of mobility at the thoracic spine, it forces the individual vertebrae and joint capsules to do excessive work they are not physiologically responsible for. The cervical spine has 45-50 degrees of rotation, thoracic has 25-35 degrees and the lumbar spine has 5 degrees  of rotation.(2)  A high percentage of tennis players experience lower back pain in all given levels of play. Statistics have been shown that 38% of professional, 47% of elite junior female, and 31% of elite junior male tennis players miss tournaments due to back pain.(3) 

The Thoracic Spine in Shoulder Mechanics

 As stated previously, one of the responsibilities for the thoracic spine is extension. During this movement pattern, it is essential to also think of the scapular positioning during vertical extension in the serve and horizontal extension in the groundstrokes. To perform these repetitive motions without injury requires the scapula to have scapular-humeral rhythm or functional scapular positioning.(4)  Scapular-humeral rhythm is sufficient rotation to clear the acromion from the rotator cuff to decrease impingement and coracoacromial arch compression.(5)  If this space is narrowed then impingement develops which then contributes to faulty scapular positioning. The scapula must retract and tilt posteriorly, which with increased mobility from the thoracic spine, can aid in functional scapula positioning. The serve requires the athlete to reach as high as they can in extension and in some cases some athletes need to work on a longer follow through after their groundstrokes. Increased mobility in the thoracic spine will maintain the proper shoulder alignment without causing any injuries or impingement. 

Increased Power in Groundstrokes

 With increased thoracic mobility, the range of rotation through this section increases which profoundly increases power production in the groundstrokes. Improved force output in the forehand and backhand strokes is due to the kinetic linkage of the proximal and distal sequence of the stroke. For example, the transfer of the hips to the distal joints of the shoulder and then the forearm is crucial for improved performance. If there is an area that cannot transfer force output due to lack of mobility in a given area, then the force output is decreased. One area that contributes to a high percentage of restricted mobility in the kinetic chain is the thoracic spine as previously mentioned. Therefore it is critical to focus on the mobility of the thoracic spine to aid in adequate rotational range of motion that plays a significant role in power production of the forehand and backhand groundstrokes. 

How to Increase Thoracic Mobility? 

 There are several ways to increase the mobility of the thoracic spine. I have used a regimen that has proved to work throughout my experience as strength and conditioning coach. Incorporating an effective protocol is needed in order for the muscle to stick to its new environment, which is increased mobility. Often times you hear clients say, “Well I completed all my stretches but I am still tight and feel pain.” Most cases, the client is not completing all the steps needed to ensure the muscle fully releases. The three most important steps to complete in order to ensure full range of motion in the thoracic spine, along with any muscle, is self- myofascial release, stretching/ breathing, and strengthening exercises.

Self-Examined Test 

 A self-monitoring test to evaluate thoracic spine mobility is the seated rotation test from Gray Cook’s self-mobility screen. This test requires using a pic pipe, a dowel or you can use a broomstick as well. This test will begin sitting cross-legged as close as you can to the door jam with the pvc pipe across the front of the shoulders holding it with your hands. From here, you will access how far you can rotate to one direction, were you able to touch the dowel to the wall? Was there an asymmetry from one direction to the other? If you answered yes to both of these questions, then improving thoracic range of motion is a must before you tackle anything else.(6) 

Figure 1- Image by Annette Lang

Figure 1- Image by Annette Lang

Self- Myofascial Release Techniques

 There are a variety of apparatuses used to release the given muscle. However, I prefer to use a foam roller, tennis/lacrosse ball due to the fact that you are rolling into the smaller muscles groups. For travelling purposes as well, it is more convenient to pack as they can fit into many sports bags or luggage. 

 I begin using a foam roller to warm up the superficial layers of the muscle. You want to ease into rolling out the muscle for the first few minutes and gradually end with a tennis or lacrosse ball. It will be too invasive for the muscle if you go too deep too soon, this will actually impede muscle relaxation. For the thoracic spine, I focus on three muscle groups; the entire erector spine, latissimus dorsi, and pectoralis major. These muscle groups are imperative to release and aid to the mobility of the thoracic spine. 

 Begin the foam roller on top of your lower back. Your hips are off the ground and arms are crossed over your chest. From here you will walk you feet out to roll along the entire erector spinae. Around 10-15 rolls is where you want to aim for.

Figure 2

Figure 2

 Begin with the foam roller right at the bottom of your rib cage. From here you will lean into one side of the spine and roll until you get to the top of the scapula. Around 10-15 per side is the goal.

Figure 3

Figure 3

 Begin to lay on your side with the foam roller directly under the armpit. The top leg will be bent over the bottom leg as this top leg will push into the ground to roll along the lattisimus dorsi. From here you want to roll along the side of your rib cage all the way past your armpit.

Figure 4

Figure 4

 Begin in a supine position, with the foam roller on the center of the spine with the head resting on the top of the roller. Keep your hips up by squeezing your glutes and make sure the ribcage is flat on the roller. Bring your arms to 90 degrees and relax the pectoralis major. Keep them here for 1-2 minutes until the pectoralis release focusing on the ribcage down on the roller. 

Figure 5

Figure 5

Lacrosse or Tennis Ball Techniques

 Using a lacrosse or a tennis ball, which can release the deeper layers of the muscle after foam rolling. There are two areas that I concentrate on the thoracic spine, which are the lower trap, and the mid thoracic spine at the end of the ribcage.  

Figure 6

Figure 6

 For the mid-thoracic spine, place the ball on one side of the spine right along the bottom of the rib cage. Lay on your back making sure your shoulders are square to the ceiling. Then place your arms straight out beside you for two seconds and bring them back giving yourself a hug. While holding this position, rock to the left and right putting more pressure on those tissues. This is one rep, the goal is to complete 15 reps and then complete the same thing on the other side of the spine. Inhale as you bring your arms to the side and exhale as you bring your arms in. Then move the ball back to the other side same location and this time the hand that will be moving will be on the side that the ball is on.

Figure 7

Figure 7

 

 For the mid trap, the set up will be the same as the mid thoracic spine just with the ball placed right in between the scapula on the erector spinae. This time the arm on the same side the ball is placed will extend overhead. The hand will start at the hip and end into full extension as far as possible without the ribcage popping off the floor. Ideally you would want to touch the floor with your hand over your head but try to get as close to the ground as possible. There and back is one rep complete 15 reps before switching sides.

Figure 8

Figure 8

Stretching

 Thoracic stretches are done after any myofascial release to hold the new length in place. All static stretches should be done after any physical activity as well. If you are completing myofascial release before activity, make sure to hold these stretches in a dynamic format, if completed after a tennis match for example it is recommended to hold these stretches from 60-90 seconds per side. A crucial side note when completing thoracic stretches is deep breathing. Fully inflating and deflating your lungs will immediately improve rib and thoracic mobility.(7)

 A rib pull will be one example of a thoracic stretch. Begin in supine position on the ground. Roll onto one side of the body with bent knees and leave the top knee at 90 degrees with the bottom hand pinning the knee down. The bottom leg will be aligned completely straight with the head and the upper hand will be tucked under the rib cage. From here, take a breathe in for four seconds and simultaneously as you breath out for four seconds the goal is for the top shoulder to be as close to the ground as possible. This is one rep, complete 8-10 reps per side. 

Figure 9

Figure 9

 Another fantastic thoracic stretch is called the pretzel. Start in a supine position and roll onto one side of the body with knees bent at 90 degrees. Leave the top knee in that position as the bottom leg will be pulling into a quad stretch grabbing onto the ankle or any part of the foot. From here the goal is for the top shoulder to be as close to the ground as possible. Hold this position for 60-90 seconds and complete the same on the other side. Remember to focus on deep breathing. 

Figure 10

Figure 10

Conclusion 

 The thoracic spine plays an important role for a tennis player. Through increased mobility in the thoracic spine, a tennis player can improve the quality of their game by improving their power output in groundstrokes and decrease injury in the lower back and shoulder impingements. Focusing on a regime to continuously improve the range of motion in the thoracic spine should be incorporated into every tennis players off court training program. Along with soft tissue and stretching, strengthening exercises such as pull ups and single arm dumbbell rows are one of my favorite exercises to aid in thoracic mobility. Thoracic mobility is often overlooked in many programs, however when these exercises are frequently repeated the tennis player will notice tremendous results on court. 

References

Andelova,V. (2013). Clinical rehabilitation. Prague: Rehabilitation Prague School

Henoch, D. (2014, May 1). The Scapula and Thoracic Spine: A Classic Love Story To Improve Your Overhead Position - Juggernaut. Retrieved November 12, 2015, from http://www.jtsstrength.com/articles/2014/05/01/the-scapula-and-thoracic-spine-a-classic-love-story-to-improve-your-overhead-position/

 Ivančević, Tijana, Bojan Jovanović, Milorad Đukić, Saša Marković, and Natalia Đukić. "Biomechanical analysis of shots and ball motion in tennis and the analogy with handball throws.” Physical Education and Sport Vol. 6.1 (2008): 51-66. 

McLaughlin, G. (2015, May 5). Developing truck rotation in tennis. Retrieved September 14, 2015.

Ozunlu, N., Tekeli, H., & Baltaci, G. (2011). Lateral scapular slide test and scapular mobility in volleyball players. Journal of Athletic Training, 46(4).

Saraux, A., Y. Guillodo, V. Devauchelle, J. Allain, C. Guedes, and P. Le Goff. "Are Tennis Players at Increased Risk for Low Back Pain and Sciatica." Rev Rhum Engl Ed 66.3 (1999): 143-50. Print

Young, S. (2012). Thoracic spine mobility. Technique, 32(3), 2-6. 

William,M., & Feil, C. (2010). The importance of the thoracic spine in shoulder mechanics. Dynamic Chiropractic, 28(10).