Everyone knows that athletes, particularly overhead athletes, require the body to withstand tremendous demands. Most people think of overhead athletics and think of solely taking care of the arm. Getting deeper, thinking of the shoulder and the elbow. This ties into my favorite line, “Arm Care is more than just the arm”. Today I’m sharing about the role of the spine in overhead athletes. Let’s dive deeper.
This article does a great job at pointing out the job of the thoracic spine (Ruiz, 2020). It dove into one area that I thought was a great point to highlight. If the thoracic spine/upper back is tight, we see more injuries in the shoulder and in the low back. The body is wonderful at compensating, and these are two areas that take the brunt of the force if the upper back can’t move properly.
Let’s take a step back – what does the thoracic spine/upper back do?
The thoracic spine is the part of the spine that has the ribs attached to it, and it is the part of the spine that connects the low back and the neck. Sometimes, it is the guy that is stuck in the middle. The job of the thoracic spine is primarily rotation. However, it is responsible for a fair amount of extension, aiding in rib movement, and is a crucial part of the kinematic sequence to be able to throw/hit harder.
How do these deviations cause us to have injuries?
Let’s go into a few of the most common ones:
Limited in Extension:
If we are limited in extension, it will limit our cervical extension which will impact overhead athletes. However, the most crucial thing that it impacts is the ability to move the arm way overhead, and tilt our shoulder blade backwards to get to a proper layback position when we go to throw, hit, etc. This will eventually lead to pinching of the shoulder and could lead to a more serious shoulder injury. They also found, if we are stuck in a forward head/rounded shoulders posture, it limits the amount of external rotation strength in the shoulder, which predisposes the shoulder to an injury. Also, if the thoracic spine is limited in extension, the back has to try to make up for the mobility in the low back, leading to an injury or further stiffness in the low back.
Limited in Rotation:
Studies found that those who had limited thoracic rotation to their throwing/hitting side, ended up having more shoulder and elbow injuries throughout the year. The athlete is unable to get a proper turn to retract the shoulder blade, and cock the shoulder getting ready for the forward movement. Again, this will lead to a pinch and more stress going through the shoulder/arm, predisposing an injury.
Limited Rib Mobility:
Last, but not least. If the thoracic spine is stiff, this is going to limit our rib movement. Our ribs have two primary motions that occur when we breathe. The upper ribs move as a water pump handle – as we inhale, the ribs go up, exhale, the ribs go down. The lower ribs move like a handle on a bucket. Inhale, ribs swing out, exhale, ribs swing back. If our thoracic spine is really stiff, the ribs can’t have their normal movement that is needed. This will make it difficult for the accessory inspiratory muscles to kick in – in severe cases, it may be difficult for those individuals to properly diaphragmatic breathe.
Bottom line:
If we are going to take proper care of our arms, the thoracic spine has to be a primary area to assess and care for in the process to help avoid injuries. If you’re looking to strengthen your thoracic spine or work with an overhead athlete specialist like myself, request an appointment here!
Sources:
Ruiz, Jeffrey PT, DPT, OCS, SCS; Feigenbaum, Luis PT, DPT, ATC; Best, Thomas M. MD, PhD, FACSM. The Thoracic Spine in the Overhead Athlete. Current Sports Medicine Reports 19(1):p 11-16, January 2020. | DOI: 10.1249/JSR.0000000000000671
