Sebastian Brosche · 7 min · 1,342 words
Previously titled: Rib or mid back injury
Hey guys, it's Joel Kreska, Sport Physiotherapist, back again. Today we're going to go over some things you can do to help recover or get back on the mats after a thoracic or rib injury. It was a great request and I appreciate the feedback, thank you very much. So when we're thinking about thoracic or rib injuries, we always have to remember that the most fundamental thing that has to happen is we regain the ability to rotate our thoracic spine.
And when we're thinking about this, we're thinking about either anchored hips and moving shoulders or anchored shoulders and moving hips. Those are movements that happen in yoga, they happen in jujitsu, they happen in life. And again, when you have particularly a rib injury, it gets very guarded and it hurts and it's splinting, it does not want to move that way. So the first thing we want to try and regain is just passive thoracic mobility.
So we're sitting either in a chair or in a cross leg position like this. We're going to use our arms to help over pressure this. And as I rotate to one side, so in this case, I'm going to turn to my left, I want to make sure that I'm using my arms to pull. And on the side that I'm turning to, so if I'm turning again to my left here, I want to use my left mid traps, lower traps to help pull that shoulder back to get full thoracic rotation.
We're sort of searching for about 90 degrees of rotation, again, of my shoulders turning 90 degrees or perpendicular to what my pelvis is doing. And for some people, they're never going to get that range, but that is a good goal to have. The next progression of this that we want to think about is doing the same thing but without using the assistance of our arms. So we're going to set our hands up on our head.
And as we do this motion, you'll notice that I go way, way, way less range of motion. But what I need to try and do here is I'm using my own muscles to turn and I have to really focus on breathing. So as I turn, big breath in, big breath out, and use your muscles to try and rotate. So now I'm only really going to maybe about 70 degrees.
But as I keep doing that motion, I want to try and again work towards that 90 degree range of motion. So as we keep working at this, I want you to understand that this is a very, very simple position. Notice my hips are really only anchored by gravity. And a way that we can progress this kind of things and translate it towards things that are more yoga related or more jiu-jitsu related is we have to get ourselves into the positions that we're going to typically be in and then challenge rotation.
So the next progression of what I want you to work on here, and it's something that I give almost daily at my clinic, is called IR reach back or reach back. And so the IR part is basically an internal rotation of the shoulder and it sits like this. The progression of this is we're going to get it on our head in a second. So where we want to start is we're in a turtle position and it's not the greatest turtle position mind you.
I totally get that. I like playing turtle. But now whether you're up on your toes or whether you're down on the tops of your feet, seal feet as it's been called, we're not worried about sort of doing this kind of position and hiding anything. We're just going to have our forearms at our knees and we want to think about having a neutral back.
So I don't want to be rounded and I don't want to be looking forward with my face. I'm going to be talking to the camera, but normally you're going to have the top or the crown of your head and a straight line coming right to your tailbone. As we go to do this movement, I'm going to be turning towards the camera. I'm going to take my hand and I'm going to set it on my bum.
I'm not going to put it on my low back. People tend to kind of want to do that right away as they do it. But as we talked about in previous videos, as I do this, it dumps my shoulder forward and that creates a lot of difficulties, but it also makes it harder to actually rotate back. Notice if I'm here and my shoulders dump forward, I can't go that far.
I put my hand out here and I can bring my shoulder back using my mid traps and lower traps and I go way farther just by incorporating scapular muscular work. So as we do this, I set my hand on my bum. I'm going to look over my shoulder like a shoulder check and my eyes are actually looking up at the roof. Your eyes drive the movement.
So as I look over my shoulder, I'm looking up to the roof, I'm pulling back on my shoulders and I try and get as far as I can. Big breath in, big breath out and go as far as you can. Now again, I'm pretty flexible this way. I go about 90 degrees.
If I go the other way, which shockingly is the side that I had a rib injury right as COVID sort of started to kick in. Again, I'm here, hand on my butt, look over my shoulder and this is as far as I go. Big breath in, big breath out and I can slowly work my way there, but it's definitely a lot of work and you might even get a cramping feeling happening right between the shoulder blades. So the progression of this once you get better is we want to get the hand on the head and just like when we were sitting and twisting and putting our hands on our head makes it significantly harder, A, because we're putting tension through the ribs and we're elevating everything, but it also again makes it just a more difficult position in general because the elbows are not tucked into the side.
Anytime the elbows are away from the body, it's more hard or difficult to stabilize the shoulder blade and scapula region. So put my hand on my head. Again I'm up on my toes this time just to show you variety, but I'm going to have hand on my head and I'm going to rotate this way and notice I can barely get up here. Big breath in, big breath out and rotate.
Here's the difference if I'm here versus hand here I can rotate way over. So again a really good exercise for me is this one is a good warm up for example and then I want to get my hand on my head and do some repeated motions as I come up and down, up and down. And again if you have a rib injury you're going to feel tension in those areas. Really try to work through that and breathe because your body is in sort of a clamp down mode.
Often your diaphragm is going to be really tight and anytime we try to twist through the torso one of the worst things you could do is hold your breath because you're locking down that cylinder when we really want to try and encourage movement. And so again you get to that end range of rotation where you feel it tightening, take a deep breath in, encourage that diaphragm to expand and relax and then go a little bit farther. Okay I hope that helps I'll see you on the mat soon. Have a good one.
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