I confess that for the past few years I’ve been doing something wrong.

Not wrong in such a way that I’ve been harming anyone, but I certainly wasn’t being as effective as I could have been, and rather than pretend like I’m brilliant 100% of the time, I’d like to use this blog post to rectify my past mistakes.

Namely…

Ohhhh man what was I thinking spending so much time on thoracic spine extension drills??

It was an honest mistake, what with all the talk that “everyone needs more T spine extension, you can never have enough”. That was what I was taught a few years ago, after all, before I learned any different. Can you blame me?

I used to assume that all dancers needed more thoracic spine extension, and that was wrong.

Optimizing thoracic spine function in dancers isn’t just about increasing thoracic extension.

Just because the majority of the human population probably does need more T spine extension from spending most of their waking hours seated, does that mean I should assume the same of the dance population? Nope. Dancers, in fact, spend the majority of their time extending their spines, not sitting flexed, and can get stuck in T spine extension.

To boot, the T spine is supposed to be flexed. Relatively. Too much flexion is detrimental, but a “neutral” T spine sits flexed, slightly kyphotic, like the picture below.

http://i2.wp.com/www.ericcressey.com/wp-content/uploads/2014/01/174px-Gray_111_-_Vertebral_column-coloured.png?resize=147%2C505
To quote physical therapist Eric Schoenberg,

“The sagittal alignment of the thoracic spine is kyphotic: 40 degrees in adults. (Neumann D.A. 2002).  With that said, we are not really talking about the T-spine being “extended”, but instead are talking about the relative amount of flexion that an athlete is in.  With that description, it’s important to appreciate that T-spine extension drills are working to put an athlete into an acceptable amount of flexion!  It is this flexion (or convexity) that provides a surface for the concave, ventral surface of the scapula to “float” on and create the scapulothoracic joint. “

Hear that? Thoracic spine movility drills are actually about optimizing flexion, not necessarily increasing extension.

If you’re familiar with the joint-by-joint approach, we are taught that different segments of the body tend to need either more mobility or stability:

Joint — Primary Need

Ankle — Mobility (sagittal)

Knee — Stability

Hip — Mobility (multi-planar)

Lumbar Spine — Stability

**Thoracic Spine — Mobility**

Scapula — Stability

Gleno-humeral — Mobility

 

This is well and good, but is it not also possible that a joint can become so mobile in one direction that it gets stuck there? In the case of the T spine, if you spend most of life extending it, it might need help getting back to a reasonable degree of flexion.

I don’t have enough T spine flexion. Some of my dance clients also lack T spine flexion. Are you one of us??

It is common for dancers to have a hard time differentiating better lumbar and T spine extension. Before I would assume that it was because they just needed more T spine extension, and the issue would correct itself. I know now that it’s not that simple.

What if your T spine is already so extended that it can’t move any more, and the only option is to get that movement from somewhere else, like the lumbar spine?

So that said, I want to share with you some of the things I’ve changed about how I work with dancers on T-spine function. Now that I probably know what I’m doing. Kindof. Better than 2 years ago anyway.

 Considerations for improving T spine function in dancers:

1. Assess whether it’s actually a T-spine extension limitation, or an anterior core stability issue.

If you’re not assessing, you’re guessing. If it rhymes it must be true.

If you’re just assuming a dancer needs more T spine mobility, worst case you might be hurting them, medium case you’re wasting both of your time, and best case you might have actually helped with something.

That’s 1/3 odds. I’d rather assess.

Most dancers spend life in extension (photo above). Being stuck in extension, with a lengthening of the anterior core can make it difficult to keep them abs engaged when they need to be. A stable core keeps the T spine anchored down, allowing it to extend to it’s max.

To assess this, looks at T spine extension on the floor vs. standing.

If while on the floor, no gravity to fight, T spine extension is fine, but while standing it suffers, then it’s likely to be more related to core stability than an actual lack of T spine extension.

Try this: Perform first a lumbar locked thoracic extension rotation exercise, like below:

Next, perform a standing multisegmental extension, or backbend, like so:

Is her T spine extending? Nope. Check out all that movement at the TL junction though…

If you can extend your t spine on the floor, but not standing up, you might have a core stability issue, not an actual lack of T spine extension.

All the T spine mobility drills in the world won’t help her backbend improve, it might just make things worse, adding mobility where it isn’t needed.

2. Differentiate between a need for thoracic flexion and extension.

These days I’m not doing as many T spine extension drills because dancers are so good at extending through their T spine that they need a little bit of flexion. Yes. Sometimes you need to work on T spine flexion to bring them back to an acceptable neutral.

Remember the core pendulum theory popularized by Charlie Weingroff: A joint functions best when it is centrated, not when it’s stuck in the extreme of one range of motion. If the T spine is stuck off center, in extension, how can you expect it to extend more?

I’m sorry if I’m making posture that much more complicated for you.

Here is one example of a hypokyphotic T spine (needing more flexion):

originally from ericcressey.com

 

In dance the emphasis is always on extending MORE.

Another sign that you might need to get a bit more T spine flexion is the position of the shoulder blades.

The photo below is a client of mine:


Check out that right scapula. Now, she had a few subluxations that she forgot to tell me about, and there are a few other things affecting her scapula position, but lacking T spine  flexion can also create this look. The scapula might be in an ok position, but the T spine may be so extended that the scapula appears to poke out.

It’s easy to confuse this look with hyperkyphosis, but it’s really just the shoulder blade poking out.

TO help correct this, did we do T spine extension drills? Hell no. In conjunction with scapular movement mechanics we also worked on T spine flexion, breathing, and neck alignment. One of the strategies we used was actually coaching her downward dog to get a bit more T spine flexion.

It seemed to help:

Bam. Scapula sitting nicely on the ribcage and T spine.

You can also check out T spine flexion in a standing forward bend. Below you’ll see how her upper back doesn’t flex. Neither does a huge portion of her lower back… A little flexion deficient this one is:


Working on T spine extension drills probably won’t be helpful for her, either.

In many cases, lack of T spine flexion goes hand in hand with poor diaphragm function and rib flare, so working on proper breathing mechanics is hugely helpful.

3. I’m looking more at rotational asymmetries than saggital plane extension.

Most dancers have a strong bias to stand on their left leg and rotate (turn) to the right, in a pirouette or fouette turn for example,  which can lead to range of motion or motor control issues with rotating in one direction.

A dance client I’m working with right now has this issue. She has tons of active T spine rotation in one direction, but in the other probably about 50% as much. Passively, she’s got more than enough in both ways, but the motor control is a bit screwy and asymmetrical.

Rotational stability for dancers is a huge deal and is something you should be looking at due to the nature of the art form. DOn’t limit yourself to looking only at saggital plane extension (forward and back bending)

My preferred way to look at T spine rotation is to look at soft rolling patterns in conjunction with NeuroKinetic Therapy rotation assessments, like this:

It’s magical when you find a quad overworking and screwing up a rotational pattern and then seeing how that can help a dancer improve their balance and turns.

Do I sometimes still do T spine extension drills? For sure, but a lot more rarely than I need to work on core stability, T spine flexion, and asymmetries in rotation and control.

So I guess to sum up what you should take away is to get assessed, don’t just guess that you need more T spine extension, because you might actually need to opposite.