How often have I been teaching an overhead movement and said to a student “maintain your rib and mid back alignment- try not to move into extension or flare your ribs open in the front”. But is it possible for us to achieve overhead movement of our arm (shoulder flexion) without concurrent movements at our mid
back and rib cage?
There is a symbiotic relationship between our mid back (thoracic spine), our ribs and our shoulder function
Take a moment to think about the relationship of the shoulder to the ribs and mid back. We learned last week that the connection between the thin, triangular scapula (aka shoulder blade) and our ribs, mid back and adjacent musculature forms the functional (not a true bony articulation) joint known as the scapulothoracic joint.
The scapula and the underlying bony structures of the ribs and mid back are very interrelated. Especially as we come close to the end ranges of our movement (when I was in PT school, we learned the last 10 degrees of overhead arm motion-shoulder flexion- come from thoracic extension). When you watch a client move who has excessive mid back rounding (also known as kyphosis) they are usually limited in their overhead movement. This is because the last few degrees of overhead movement is actually contributed to by our ribs opening in the front, our mid back moving into extension.
This is a nice research study that looked at overhead movement and motion occurring at the mid back and ribs among overhead athletes: overhead reach and accessory motion
If we limit the motion at our mid back and ribs, we ask the shoulder joints to move excessively- to become hypermobile for us, so that we may achieve our full overhead motion.
Because the shoulder joint is already a joint that is challenged in its stability (most of us have too much motion than we can truly control), creating excessive or hyper mobility in this way can be detrimental if practiced over a long period of time.
In addition, most of our mid backs do not get enough time into extension. Most of our western mid backs, and ribs are craving opening along their anterior aspects- a deep breath, expansion in the front of the chest and softening in the front, middle part of our body.
I do think we movement instructors can use cues judiciously to limit spinal extension at the mid back in certain clients- consider in your mind’s eye what that client might look like. They will likely be young, with excessive lordosis in their low backs. With clients with this type of presentation I would suggest the following attempts:
Instruct this person about neutral spine (they will likely have an exaggerated “S” curve). See if they can maintain neutral with an overhead arm motion.
When excessive low back and/or cervical lordosis is noted, attempt to contain the rib and mid back extension, and encourage the person to limit their movement overhead. Recall, the last 10 degrees or so of overhead movement is composed largely of spinal extension. So give the clients a break about the last 10 or 15 degrees of overhead movement, if you are choosing to contain mid back extension
If your goal is full overhead movement, go ahead and allow the ribs and spine to move. Your
shoulder joint will thank you for it!
Join us next week when we will check out the anatomy and the function of one of the most important structures assisting our healthful shoulder stability- the rotator cuff.