Thoracic Manual Therapy for Shoulder Pain

Shoulder impingement syndrome (SIS) is a prevalent problem for sports and office workers alike. It disrupts daily routines, limits mobility, and causes a lot of pain. While strengthening exercises are frequently incorporated in treatment, a lesser-known hero emerges from the realm of manual therapy: Thoracic Manual Therapy (TMT).

The Role of Regional Interdependence Model

Traditional methods to SIS frequently focus only on the shoulder joint. However, the regional interdependence model provides a more detailed picture. This approach, which is validated by studies, argues that seemingly isolated dysfunctions in one area might have a cascade effect, affecting otherwise unrelated parts of the body [1]. In the instance of SIS, the culprit may not be the shoulder itself, but a hidden?evil hiding in the background: the thoracic spine.

The Thoracic Spine and Shoulder Function

Studies have found a compelling correlation between restricted thoracic mobility and limitations in shoulder movements. Webb et al. (2014) explored the contribution of the thoracic spine to functional shoulder mobility in athletes and discovered that decreased thoracic extension and side flexion were associated with reduced range of motion in shoulder flexion and abduction (raising the arm). This restricted mobility can lead to a domino effect. The shoulder blade (scapula) relies on the thoracic spine for proper movement. When the thoracic spine is stiff, the scapula's ability to move freely is hindered, consequently impacting shoulder function (Webb et al, 2014).

The limitations in thoracic mobility don't stop there. Research suggests that the body might resort to compensatory strategies when the thoracic spine can't move freely. This highlights the importance of maintaining good thoracic mobility for shoulder health (Finley et al., 2003).

The good news is that the connection between thoracic mobility and shoulder function is a two-way street. By addressing limitations in the thoracic spine, we can positively impact shoulder health. Research by Hunter et al., (2023) demonstrates that manual therapy techniques targeting the thoracic spine can be effective in improving shoulder pain and function.

In conclusion, the thoracic spine and shoulder function are intricately linked. Restricted thoracic mobility can lead to limitations in shoulder movements, pain, and even dysfunction in other areas of the body. Fortunately, improving thoracic mobility through targeted exercises and manual therapy can significantly benefit shoulder health and promote overall well-being.

TMT: A Targeted Approach to Unleashing Shoulder Power

TMT is a form of manual therapy that focuses on improving mobility and function in the thoracic spine. Through gentle, targeted manipulations by a qualified therapist, TMT addresses the underlying issues in the thoracic spine that contribute to shoulder pain. Here's how TMT empowers you to overcome SIS:

• Enhanced Scapular Mobility: By loosening tight muscles and improving joint mobility in the thoracic spine, TMT allows the scapula to move freely. This restored mobility creates a stable base for the shoulder joint, preventing imbalances and impingement [1].
• Reduced Pain at the Source: Addressing the root cause of pain in the thoracic spine, TMT can significantly decrease the pain associated with SIS, offering a more lasting solution [1].
• Faster Recovery and Improved Function: TMT, when combined with other therapeutic approaches like strengthening exercises and addressing postural imbalances, can accelerate healing and return to normal function after a shoulder injury [2].

Who Can Benefit From This?

If you experience shoulder pain, particularly with overhead activities, and have:

• Rounded shoulders
• Poor posture
• Difficulty moving your upper back

Consulting a physical therapist or healthcare professional can determine if TMT is a suitable option for you. They can create a personalized treatment plan that incorporates TMT alongside other relevant therapies.

A Call to Action: Embrace a Holistic Approach

Shoulder pain doesn't have to be your nemesis. By understanding the regional interdependence model and the power of TMT, you can unlock a path to pain-free movement and reclaim control of your shoulder health. Remember, the body is a complex system, and a holistic approach that addresses the root cause of the problem is often the most effective path to lasting relief [3].

So, embrace TMT, the unsung hero in the fight against SIS. With a combination of TMT and other therapies, you can step back into the light, raise your arms in victory, and reclaim your full potential for movement and action.

References

1.?Hunter DJ, Rivett DA, McKiernan S, Luton R, Snodgrass SJ. Thoracic Manual Therapy Improves Pain and Disability in Individuals With Shoulder Impingement Syndrome Compared With Placebo: a Randomized Controlled Trial With 1-Year Follow-up. Archives of physical medicine and rehabilitation. 2022; 103(8):1533-1543. https://pubmed.ncbi.nlm.nih.gov/35331719/

2. Ferreira ML, Maher CG, Lopes EC, Cordeiro TL, Oliveira GS, Powers CM. Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. Br J Sports Med. 2017;51(18):1340-1348. [https://www.ncbi.nlm.nih.gov/pmc/

3. Finley, M. A., & Lee, R. Y. (2003). Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors.?Archives of physical medicine and rehabilitation,?84(4), 563–568. https://doi.org/10.1053/apmr.2003.50087.

4. Hunter, D. J., Rivett, D. A., McKiernan, S., Luton, R., & Snodgrass, S. J. (2022). Thoracic manual therapy improves pain and disability in individuals with shoulder impingement syndrome compared with placebo: a randomized controlled trial with 1-year follow-up.?Archives of physical medicine and rehabilitation,?103(8), 1533-1543.