Shoulder Pain and the Thoracic Spine

Shoulder Pain and the Thoracic Spine

If it looks like many health conditions have a link to proper spine mechanics and positioning, your perception is correct. The spine has a normal position that best resists gravity and allows for optimum joint and nerve function. In the case of the shoulder, hyperkyphosis of the thoracic spine is the link to shoulder impingement. Hyperkyphosis is the commonly seen posture in our nation’s elderly; slouched, hunched over, shrinking.

Impingement develops when the space between the coracoacromial arch and the head of the humerus narrows. According to researchers, individuals with a shoulder impingement have statistically less thoracic mobility and a more kyphotic thoracic spinal posture than individuals with healthy shoulders. Specifically, three findings are observed with shoulder impingements. First, as stated above, is hyperkyphosis of the thoracic spine. Second, we see decreased thoracic spine intersegmental mobility. Third, we see a tightening of the pectoralis minor musculature causing the scapula to tilt forward.

Here’s the solution: Structural assessment of your thoracic spine for hyperkyphosis and hypomobility, and flexibility assessment of the pectoralis musculature. Here at The Joint Mount Pleasant our focus remains structural. Structure affects function and as you can see in this instance, bad thoracic spine structure leads to bad shoulder joint function.


References:

Crawford, H. Jull, G. The influence of thoracic posture and movement on range of arm elevation. Physiotherapy Theory and Practice, 1993;9:143-148.

Greenfield, B. Catlin, P. Coats, P. et al. Posture in patients with shoulder overuse injuries and healthy individuals. Journal of Orthopedic Sports Physical Therapy, 1995;5:287-295.

Kibler, B. The role of the scapula in athletic shoulder function. The American Journal of Sports Medicine, 1998;26:325-337.