Clinical reasoning framework for thoracic spine exercise prescription in sport: a systematic review and narrative synthesis

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Review written by Dr Travis Pollen

Key Points

  1. As the link between the lumbar and cervical regions, the thoracic spine is a critical component of the kinetic chain during sport. However, it is not well studied in the scientific literature.
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BACKGROUND & OBJECTIVE

The thoracic spine is a critical component of the kinetic chain during sport. It serves as the link between the lumbar and cervical regions as well as the connection to the upper extremity. It also provides the majority of rotational range of motion through the trunk. However, compared to the lumbar and cervical regions, the thoracic spine has received less attention in the scientific literature. A previous study classified spinal exercises based on four intended adaptations: mobility (i.e. range of motion), motor control (i.e. stability), work capacity (i.e. muscular endurance), and strength (i.e. force production capacity) (1). The purpose of this systematic review was to create a compendium of thoracic spine exercises for athletes and categorize the exercises based on the four intended adaptations.

The thoracic spine provides the majority of rotational range of motion through the trunk.
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Proper function of the thoracic spine is likely important for overall spine and upper extremity performance.

METHODS

The authors searched several databases as well as social media for exercises that target the thoracic spine in adult athletes. Search terms included ‘thoracic spine’, ‘t-spine’, ‘mid back’, ‘upper back’, etc. For each exercise that they identified, they categorized it

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