BACK PAIN
Bondi Junction, Eastern suburbs Physiotherapy

The spine is usually described by dividing it into 3 major sections: the cervical spine (the neck), the thoracic spine (the mid or upper back), and the lumbar spine (the lower back). Below the lumbar spine, we can find the pelvis.

This complex structure is an interconnected complex of bones, nerves, muscles, tendons, ligaments and fascia, and all of these can become damaged and cause pain, neurological symptoms or cause a loss of mobility.

Check the links below to find more information about: lower back and lower back pain

You can also find more detailed information regarding disc bulges and sciatica

Or more information about neck pain

​

In this section, we’ll talk about the middle of the back, or the thoracic spine.

​

UPPER BACK PAIN TREATMENT

"Most problems in the middle part of the back are caused by repetitive movements."

Many times it’s a classic example of small things that build up and generate problems over time. Heavy labour or lifting together with a rotation can cause pain or stiffness locally. Sometimes the pain can refer to the side of the chest or to the front, around the sternum or chest bone. Many people confuse rib stiffness with a heart issue. When the joint between the rib and the vertebrae gets stiff, it can cause local and referred pain until the chest, hence the thought of heart problems.

​

At Physio K, we deal with these problems on a weekly basis and most of the time, we can get you up and running within a few sessions.

We first make an accurate diagnosis and based on that, we’ll combine hands on manual treatment with specific home exercises to get your back functioning again asap. Dry needling can be helpful if the deep thoracic muscles are tight or stiff.

​

We made a few interesting videos, 3 of these 4 videos will focus on increasing the mobility of the mid back, as this is often a rigid and stiffer area with many people. The more mobility you have in the mid back, the better for the neck and shoulders. Many shoulder problems occur because of rigidity in this area, so these exercises can help as prevention for shoulder problems as well.

Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you.

Watch them:

​​

​

Middle back mobility exercises

In the above video, Kenny from Physio K runs you through some exercises to improve your thoracic spine mobility, which is the mobility of your mid back. They are good to increase the movement in that area but also to prevent issues in your neck and your shoulders down the track.

1. Cat-cow exercise

Starting on all fours position. You can do this on the floor on a mat. Make sure your hips are above your knees and your hands are under your shoulders. Start with tilting the pelvis. The pelvis is the part that's just below your lower back, so you can tilt this forward and backwards. Focus on the middle back, so when you tilt your pelvis forward, you'll push the middle of your back down and you look up towards the ceiling.Then you’ll change the direction, tilting your pelvis backwards and push the midpoint of your mid back up towards the ceiling and you'll look down. Do this for about a minute: 20 to 30 times and if possible multiple times a day.

2. Threading the needle or thoracic rotations

In the same position as exercise 1, try to rotate your arm as far as you can and look at your hand while you do this, then come back to the beginning position and switch sides. Do this for about a minute: 20 to 30 times and if possible multiple times a day.

Try not to force this exercise. These two exercises are the best ones to increase your thoracic mobility.

Try to do them as much as you can, frequently during the day.

​

​

Thoracic kyphosis exercises: strengthening and mobility for the mid back

In the above video, Kenny from Physio K shows you some exercises to improve thoracic mobility, which is the mobility in the middle of your back. These are especially good if you have a big thoracic kyphosis, which is a big forward bend in the middle of your back, and also if you have stiffness in that area. These exercises will improve your mobility and will also be good for strengthening.

1. Cat cow exercise

On your hands and knees, in all four position, making sure that your hips are above your knees and your hands are underneath your shoulders. Try to tilt your pelvis forward and backwards. We're going to focus on the middle back, so when you tilt your pelvis forward, you'll push the middle of your back down and you look up towards the ceiling.Then you’ll change the direction, tilting your pelvis backwards and push the midpoint of your mid back up towards the ceiling and you'll look down. Do this for about a minute: 20 to 30 times and

if possible multiple times a day.

2. Prone lateral raise

Lay on your tummy and have your arms at 90˚ abduction. Try to lift your arms up and squeeze your shoulder blades together. Hold for about 10 seconds and then go down again and you can rest your arms on the floor. Try to do this for about 20 times and if possible 3 sets. If this is too easy without any weights, you can use small weights in

each hand, you can go from 1 kilo, I wouldn't go too high, we're focusing on endurance. Make sure you focus on squeezing your shoulder blades.

3. Front raise thumbs up

Laying on your tummy on a mat, keep your forehead on a small towel and raise your arms forward. Make sure that your thumbs are up towards the ceiling. Lift up your arms without bending your elbows. Hold that for five seconds and then go down again. This is a tough one. Do this one about 10 to 15 times and if possible 3 sets.

If it would be too easy, you can use some weights as well, about one to three kilograms in each hand.

Mid Back mobility: progression

​In the above video, Anthony from Physio K runs you through a couple of exercises that are great for improving your mid-back mobility.

1. Bow and arrow

Laying on your back, you're going to have both of your arms in front of you and both of your knees bent. Your hands are going to be together out in front of you. Now, just as if you were drawing a bow and arrow, you're going to pull one arm back, bending your elbow all the way across your body. Now the goal of this exercise is to touch the ground. But if you can't get there at the start, don't worry about it, bit by bit as you start to improve you'll notice that you can make it further and further closer towards the ground. For these exercises, we generally recommend that you do 10 each side and you repeat them three times a day.

2. Book opener

In the exact same position as the previous exercise with knees bent and hands together, you're going to open up, keeping your elbow straight this time, opening up all the way, reaching for the roof and coming straight back down again. Like the previous one, the goal is to touch the floor on both sides at the same time. But if you don't get there at the start, don't worry about it. We're going to go for 3 sets of 10 for those exercises.

3. Windmill

In the same starting position, try to reach up above your head, trying to drag your hand all the way across. Try to keep your hand in contact with the ground as you do this. It's important to remember for all of these exercises that your head follows your hand everywhere it goes.

4. Variation of the world's greatest stretch.

For this one, you're going to be up on your hands and knees. The goal for this to start off, is having your hips and your shoulders square with your body then reaching with your right hand, you're going to come underneath your body, going as far as you can, and then opening straight up towards the roof and coming down again. For this one here, we're looking at doing three sets of ten on both sides.

​

Foam rolling for the mid back

In the above video, Kenny from Physio K shows you a few things to increase the mobility of your mid-back, which is your thoracic spine. They will both include a foam roller.

1. Foam rolling your upper back (mid back)

For the first one, try to just lay on your back, with your upper back on a foam roller. Try to cross your arms over your chest, lift up your hips and gently roll up and down on the foam roller. Don't go too fast, you won't have any benefits if you go too fast. Try to do that for about two to three minutes.

2. Breathing on the foam roller

We are laying on the foam roller in a very similar position as exercise 1. Just try and relax your hips down on the floor and then put your arms over your head, and just try to relax in this position and just try to breathe. Take a few deep breaths in and out, and after that, you can try and move a little bit up or down on the foam roller.

These two are really good to increase your mobility in your upper back.