Do you know what shoulder and neck pain often have in common…?

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The thoracic spine is often overlooked as a link in the origin of shoulder pain and/or neck pain. It shouldn’t be that hard to imagine once you think about the anatomy. The thoracic spine consists of 12 vertebrae stacked on top of each other from the base of the neck to the mid-back. A notable feature of the thoracic spine is that each vertebra is connected to a rib. The “ribcage” is comprised of 12 ribs that attach in the back (posterior) to a vertebra (T1 – T12).

The thoracic spine sits just below the seven cervical vertebrae which make up the neck. However, the cervical vertebrae in conjunction with the top 4 thoracic vertebrae contribute to complete cervical rotation. When you look over your shoulder to check your blind spot, it requires movement starting from the first cervical vertebrae to the fourth thoracic vertebra. This is where the inherent problem lies…

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If someone has a stiff (hypermobile) thoracic spine, it leads to increased movement of the cervical spine (the neck) to make up the lack of thoracic spine motion. Excessive motion is one of the causes of wear & tear in the body and correlates with development of osteoarthritis.

The shoulder is linked together by the scapula (shoulder blade). The shoulder blade attaches to the humerus and the clavicle, which make up the shoulder girdle. The scapula lies on the back of the ribcage. Therefore the position of the thoracic spine determines the resting position of the scapula. A common problem affecting patients with shoulder pain is thoracic hyper-kyphosis: an abnormally increased amount of thoracic forward movement. This leads to stiffness of the spine, decreasing the spine’s ability to move in the backward (posterior) directions. If the spine has difficulty moving posteriorly, then so does the scapula. This is the inherent problem associated with the development of shoulder impingement and shoulder dysfunctions.


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