Lets go through three different exercises you can do at home to:

1. Keep your upper & mid-back mobile
2. Keep your upper & mid-back strong
3. Help prevent issues occurring in these areas.

1. Mobility Exercise (to get the spine moving!)

a) Sit up tall with your legs crossed or knees bent up in front of you hip distance apart.

b) Place the back of your right hand against the outside of your left leg. Place your left hand on the floor behind you.

c) Breathe in as you grow tall through your trunk, breathe out as you twist your body to the left.

d) See can you go further, using your breathing (as above) to help.

e) Do this for 20 seconds and then repeat to the opposite side.

2. Strengthening Exercise (to keep the muscles able to do everyday activities!)

a) Lie face down with your arms by your side and your tailbone tucked underneath you.

b) Gently engage your core like you were ever so slightly tightening a belt.

c) Lift your arms up and reach towards your toes. Hold this for the count of 10. You should feel your arms and the middle of your back working.

d) Lower the arms.

e) Repeat 5 times.

*Members of JennyPhysioPilates click here to see a detailed video on how to do the exercise correctly & how to make adjustments for certain injuries or issues.*

3. Stretching Exercise (to keep the muscles mobile & flexible!)

a) Start on your hands and knees. Sit your hips back towards your heels.

b) Lift your left hand off the floor and loop it underneath your right armpit, twisting your body as you do so.

c) Lower your left shoulder as close to the floor as you can. Keep reaching with your left arm.

d) Keep breathing as you hold this for 20 seconds. Each time you exhale see can you reach a little further.

e) Repeat going to the opposite side.

*Members of JennyPhysioPilates click here to see a detailed video on how to do the exercise correctly & how to make adjustments for certain injuries or issues.*

Note: You should not feel any pain doing these exercises. You may feel the area working or stretching but it should not be painful - please stop the exercise immediately if pain occurs.

The upper and mid-back are collectively known as the Thoracic Spine. It spans the area from the base of the neck down to just above where the back starts to arch or hollow.

What is it made up of?

The Thoracic Spine consists of 12 vertebrae (spinal bones) stacked on top of each other and separated by intervertebral discs. These discs absorb shock and provide cushioning between the vertebrae. Each of the 12 vertebrae have attachments to the ribs, of which there are also 12! Many muscles (big and small!) span this area, alongside some nerve fibers too.

What shape is it?

The Thoracic Spine is naturally more rounded (kyphotic) compared to the neck and lower back, which tend to hollow or arch.

*[To visualize it: Think of your spine running from the top of your neck down to your tailbone as being a slight ‘S’ shape.]*

What does the Thoracic Spine do?

1. Protects the spinal cord
2. Acts as an anchor for the rib cage
3. Allows us to move our trunk in different ways

What movements does the Thoracic Spine do?

The Thoracic Spine typically offers more stability than it does mobility, compared to the neck and lower back. It does move in all different directions:

• Bending forwards and backwards
• Leaning to the side
• But most of all: TWISTING movements.

Did you know: The action of lifting your arm overhead requires a certain amount of movement to happen in the upper back. Without this we would be restricted in how high we can lift the arm!

What causes pain in this area?

Most commonly pain arises due to muscle or joint issues. It is extremely rare that a disc causes pain in this area.

Specific causes of pain include:

• Osteoporosis
• Osteoarthritis
• Shingles
• Trauma (e.g. a fall)
• Scoliosis
• Excessive rounding or kyphosis
• Other medical causes

Is it related to neck or low back pain?

It can be, yes. Commonly in clinical practice we see the Thoracic Spine contributing to neck or low back pain. Usually this presents as stiffness or a lack of movement in the Thoracic Spine which places increased demands on the neck and low back. By keeping the upper and mid-back as mobile as we can, helps to reduce the likelihood of this. By also keeping the muscles in the area strong you can reduce excessive curvature of the spine and help prevent shoulder, back and neck issues.

JennyPhysioPilates members click here to see videos on how to keep your upper & mid-back mobile.

What is it?

Whiplash results from the head being suddenly jerked backwards and forwards. It can result in injury to bones or soft tissues in the upper body which are collectively referred to as Whiplash-Associated Disorders.

How does this happen?

Whiplash-Associated Disorders most commonly occur after a road traffic accident where the car you are travelling in is rear-ended. They can also occur from sports, diving and other activities.

What are the symptoms?

Other symptoms which can also occur include:

• Restricted movement of the neck
• Stiffness in the upper body
• Pain around your jaw
• Fatigue
• Tingling, pins and needles or numbness in the arm
• Muscle spasms

 

How is it diagnosed?

Whiplash-Associated Disorders are diagnosed by an assessment from a healthcare provider (e.g. Doctor, Registered Physiotherapist etc). This assessment typically starts with some questions about how this injury occurred, your symptoms and your past medical history. You may be asked to fill out a questionnaire to give your healthcare provider further insight into how this injury is affecting different areas of your life. 

 

A physical exam will then be carried out during which you will be asked to perform simple movements like looking to the left/right. Your healthcare provider will carry out certain tests to check what structures are involved. You may be sent for an x-ray to rule out bony injury. It is rare that a MRI or CT scan will be required. 

 

After all of this your injury will be classified depending on the severity of it and the structures involved. Whiplash-Associated Disorders are graded from 0 - IV, with 0 being the least severe and IV being the most severe. Typically in clinical practice we mostly see grade I - II. 

 

What treatment will I need & how long will it take to recover?

Research shows that the earlier you attend a healthcare provider after your injury and the earlier you start a treatment programme the better your recovery will be.

Initial treatment may involve medication to help reduce pain levels.

Evidence-based guidelines recommend starting gentle movement exercises as soon as possible which will help reduce pain and improve your function.

The video "Neck Pain" in the Masterclass Section will take you through tips and strategies on managing neck discomfort, while keeping yourself moving. The "Neck Stretching" video goes through some gentle movement exercises.

 

 

Treatment for the majority of people will consist of exercise. Studies have shown that Whiplash-Associated Disorders respond best to:

• Movement or mobility exercises for the neck, upper back and shoulders.
• Strengthening of the upper back, mid-back and neck.

The Niggly Neck Rehab Series is a progressive series of classes which includes all of these exercises. It is suitable for Whiplash-Associated Disorders (> 6 months previous).

 

 

The most important piece of advice for a quick recovery is to keep moving!!! Research shows that if we move as normal and go about our daily lives as normal (within pain limits) that it aids a speedy recovery. 

 

Recovery time frames vary as there are many factors involved. Approximately 50% of people recover within one year. For a more severe injury it can take up to three years to see full resolution.

 

TAKE HOME MESSAGE:

Keep moving, stay active and return to work as soon as possible to promote a smooth and swift recovery!

 

Information sourced from:

Pastakia, K., & Kumar, S. (2011). Acute whiplash associated disorders (WAD). Open access emergency medicine : OAEM, 3, 29–32. 

National Institute for Health and Care Excellence (NICE) (2018). Neck Pain - Whiplash Injury.