Thoracic spine exercise prescription in

sport: a systematic review

• Biomechanical & kinematic links sporting performance:
– 6.7- 8° arm flexion, 12-15° bilateral arm flexion (Heneghan et al., in prep)
– 80% trunk rotation & to 55% upper limb force generation (Kaczmarek et
al., 2014)

• Clinically:
– UL injury assoc. with low trunk rotation flexibility (Aragon et al., 2012)

– 28% lower risk of shoulder injuries with programme included

thoracic mobility exercises (Andersson et al., 2017)

Aim: To synthesise evidence of thoracic spine exercises

NR Heneghan, Lokhaug S, Tyros I, Rushton A

 Methods
• Systematic review: guidelines & protocol

• Sensitive topic-based strategies 31/1/18

• 2 expert reviewers assessed eligibility

– athletic population
– exercises targeting the thoracic spine
– any empirical study, guideline, video or image
– mobility, motor control, work capacity & strength
(different planes/axes, functional/non functional, intensities)

• Expert-informed spinal classification provided a framework for

synthesis (Spencer et al., 2016)

Results
• 2368 sources, 38 exercises (database n=20, social media n=18)
 Results -
Mobility
Side flexion

Flexion Side Flexion Squat ext/rot

Databases Social media

Tx spine extension on foam roller Tx spine flexion quadruped
with/without roller
Flexion Kneeling Tx spine extension Seated side flexion with/without
stretch rotation
Jefferson curl Side-lying side-flexion over Swiss
ball
Quadruped Tx spine rotation Side-lying Tx spine rotation
Squat with Tx spine extension &
rotation
Extension
Rotation Extension Flexion

(Heneghan et al., in prep)

Results
 Discussion & conclusion
• Exercises++ described on social media
• Relatively little research specifically
investigating thoracic spine exercises
• Quality of current evidence
• Use of classification focused to outcomes will
– Assist clinical reasoning in exercise prescription
– Inform further targeted research

• Outcome focused classification used to inform

rehabilitation in practice and research is now
needed to determine dose-response