Often I see clients who have difficulty reaching overhead or who have shoulder or upper back pain. In many if not most of these clients I see a forward flexed upper back , a sort of “upper back slump” that looks kind of sloppy, stressful and certainly prevents achieving full overhead shoulder position. Try it yourself, slump in your chair right now and see how high you can raise your arm overhead. Now compare that with reaching overhead with a tall chest and extended (flatter) upper back. Chances are you achieved a higher overhead reach in the non slouched position.
There is, however, an exception to this rule. There is a subgroup of people who have an excessively straightened upper back. I call these folks the military posture exception. While the forward flexed upper back is the more common upper back posture dysfunction that I see, a minority of people present with this exception. These folks are ramrod straight through their upper back and look like they are standing to attention in a military lineup. I also sometimes see this type of posture amongst ballet dancers, ballroom dancers, powerlifters and yoga teachers. In these disciplines an overextended, rather than flexed spine is sometimes adopted in an effort to achieve better posture. Unfortunately the effort in these cases goes too far and pain results from joint compression and chronic muscular overexertion. Neck pain and stiffness can also result. No good. By the way I’ve certainly been guilty of this myself. Check out this picture of me accepting a ballroom dance certificate, see how I look a bit awkward and uncomfortable? That’s because I am. Chill out James!
If this situation sounds like it might apply to you, the trick is to reintroduce normal neutral spine positions, which do include some flexion curve! It’s all about that happy medium between slouched and sloppy, and ramrod straight. Thankfully there are a few great exercises for you to try as you work to assume a more relaxed posture through your upper back! In the video here I describe two such exercises. Check these out. Also have a look at this great blog post by US physical therapist Dr. Quinn Henoch. He’s outlined a number of great exercises and described the nature of the problem in good detail. You can check out his blog post here http://www.jtsstrength.com/articles/2014/05/01/the-scapula-and-thoracic-spine-a-classic-love-story-to-improve-your-overhead-position/
The Breathe over a Roll: In this exercise you’ll take a rolled bath towel and place it in your lap while seated in a chair. Your job is to “wrap” your body around that rolled towel by rounding your upper back over it. You may also consider hugging your legs to create this effect. Once you have achieved the desired position take in 10 slow and deep breaths. Feel your ribcage expanding and falling as you breathe. Notice the sensation of stretch and mobilisation that occurs in your upper and mid back and you execute the breathing. This sensation may be especially pronounced at middle of your back where the the junction between your lumbar and thoracic spine (upper and lower back) sits. Perform this exercise 3-5 times per day.
Reach overhead with a slight slouch: In this exercise you will practice that overhead reach that we described earlier as a painful one for people with extension syndrome. Stand in front of a wall and start to slide your hands up the wall into overhead position. All things being equal. This action will start to produce discomfort as you achieve greater levels of overhead position. This time however, start by bending forward slightly at your upper back. You may find this bend easier to achieve by drawing your chin toward your chest somewhat (the neck bend will automatically induce the upper back bend). From this position you should find the overhead reach much less painful. Perform 15 overhead reaches 3-5 times/day. Impress your work colleagues with this one! For a visual description see the attached video.
These exercises will help those with the less common military type flat back posture to reduce pain and increase mobility. Have fun trying these out and let me know how it goes!
Further reading (If you really want to impress your friends):
Sahrmann, S. (2011). Movement System Impairment Syndromes of the extremities, Cervical and Thoracic spines (pp. 138-139). Elsevier Health Sciences.
Starrett, K. (2016). Deskbound: Standing up to a sitting world. Victory belt.
Henoch, Quinn. The Scapula and Thoracic Spine: A Classic Love story to Improve Overhead Position, Retrieved from http://www.jtsstrength.com/
