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Mechanism of Spine Injuries (Part 4): Mid Back Restoring and Strengthening


Thoracic or mid back region can be difficult to identify. However, some of the important muscle groups that sits in thoracic region that you may be familiar with is latissimus dorsi (or lats), trapezius and rhomboids. These three are commonly spoke by trainers and therapists because they are major muscle groups in thoracic region and mainly support the movement of the scapula or shoulder blades relative to the spine.


Other muscles that are not too commonly spoke of are erector spinae muscles which runs along the spine from the top of thoracic region T1, right below the big bone at the base of the neck, and extend all the way to T12, which is right above the waistline. This muscles are responsible for keeping the vertebrae extended. If these muscles are weak, it is very hard to keep the posture upright.


Mobility of Thoracic Region

When working on thoracic region, first thing need to be happening is flexion and extension of the spine. Just like lower back or lumbar region, spine without proper functioning can cause issues with the posture and ended up slouching in the process. Slouching, especially in thoracic region can lead to multiple complication, starting from breathing, balance, neck pain and even affect in lower back health.


To improve the mobility of the thoracic region, there are 2 mobility exercises that we can practice.

Cat and Camel Exercise (Video 1)

First one is cat and camel exercise, which will be working on flexion and extension of the spine. If you have done basic yoga, you may have done this exercise. As the video shows, you will be on your fours and mobilize your spine by pushing the thoracic up and down. Key movement is in the hip. When you are in cat pose where you thoracic is pushed upwards, you want to tuck the hip forward. While you are in camel pose you want to work on pushing the hip backwards. These movement will help elongate the spine even further. Go through this movement 10-15 reps.


Thoracic Twists (Video 2)

Second exercise is working on rotation of the thoracic region. You will start by getting in to your fours like you've done with Cat and Camel. Then you will reach the right arm under your body an reach towards the left side. See if you can bring your right shoulder directly under the left shoulder. Hold the position accompanied by deep breathing for 20-30 seconds.


Strengthening of Thoracic Region

Now let's discuss about the strengthening of the thoracic region. When talking about strength, majority of times people will assume that you will be needing to lift heavy. However, most important thing for any exercise is to be able to utilize the muscles fully. Not being able to utilize the muscles properly is like you have fancy cellphone but you don't know how to turn it on.


In videos, exercises are performed in shirtless format to provide a proper understanding of how the muscles should be moved. Initially, though, this may not happen because of tight muscles or simply the muscle is too weak. It is important to understand that it does take some time to properly engage the muscles. You should worry about increasing the weight after you are able to use the muscle properly.

Lat Pulldown (Video 3)

Lat Pulldown is categorized as vertical pull, where you are pulling object from above to the bottom. Major muscle group that lat pulldown is working on is the latissimus dorsi. The main functions of the lat is depression of shoulder blades, adduction (moving close in to the body) of the arm, and external rotation of the arm. When you look at the video, you should be able to see that the shoulder blades are moving downwards. It is somewhat hard to see, however, you may be able to see the elbow is moving back and bar is pulled towards the chest. These movement are both from adduction and external rotation of the arm. You can perform same movement without any tools. All you need to do is to raise your arm and pull the elbows and back and squeeze the shoulder blades tight at the bottom.


Cable Row Mid Height (Video 4)

Cable Row can performed in so many variations mainly with height of where the cable is being pulled. Main focus of this exercise is to pull the shoulder blades together by utilizing trapezius and rhomboids. When hearing trapezius or traps, people assume it is the muscles right next to the neck where bodybuilders have huge hump. However, trapezius is a lot more larger in surface area. It originated from the bottom of the skull to T12, and attached to the shoulder blades. In video, you should be able to see the shoulder blades moving towards the spine and away. Another thing you should be able to see, is shoulder blades are not elevated while performing this exercise. By doing so, you are not only utilizing trapezius and rhomboids but also lats as well.


Face Pull (Video 5)

Face Pull is one of the most important exercise to improve the shoulder health. The exercise involves trapezius and also rotator cuffs. Although it is important, it is also somewhat complicated and need to know how to set up right in order to maximize the exercise. First, you will need to set the cable or band higher than your head. Second, grab the cable or band with thumbs facing you. Third, keep the elbow and hand high and pull the cable or towards your nose. Ideally, the hand should surpass the elbow.


What about erector spinae?

If you have been reading along, you may see I have spoken about erector spinae but not included yet. However, by doing these 5 exercises you are already training the muscle. Function of erector spinae is spinal extension. So as long as you are working on extending your spine as you perform the exercises, you are utilizing erector spinae. In other words, if your not keeping your posture upright, you are not utilizing erector spinae which also may means that you are not maximizing the use of lats, traps, and rhomboids.


However, you may not be able to perfectly execute the exercises. Yet, by practicing and keep mindful of what needs to be done in each exercises, you will eventually, learn you utilize the muscles efficiently. Take your time and keep working!


Kota Shimada

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