Recently I posted two videos demonstrating effective exercises for “thoracic mobility”. If you have yet to view the videos, click below.
Unfortunately, they may not work for everyone. If this is the case, or if you are simply looking for another tool to add to your arsenal, take a shot at performing the “Wall Slide”. This is one of those exercises that aims to improve both your thoracic posture and scapular positioning. It’s not an easy exercise…but it sure is effective.
Performing the following exercise:
- The individual starts in a seated position on the floor with the buttocks and back flush against a wall.
- The knees and hips are flexed as much as possible, paying attention that the buttocks do not round away from the wall.
- The neck is in a neutral position
- The shoulders and elbows are in a 90 / 90 position with the elbows and hands in constant contact with the wall at all times.
- The individual is asked to press his/ her lower back as close to the wall as possible to “lock out” the lumbar spine and minimize arching throughout the movement. This is especially important when one reaches the top of the exercise.
- The individual is asked to slide his / her arms up the wall, ensuring that they are not shrugging their shoulders.
- Upon reaching the top of the movement (this is where they feel that they cannot go any further), they are asked to take one diaphragmatic breath, both inhaling and exhaling with minimal tension. Note: this breath was not included in the video below but is highly recommended.
- The arms are brought back down following the full breath and the movement is repeated.
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Jeff,
This is one of my all time favorites. I had our mutal friend Dr. Cupido perform these during her training session which sparked a discussion about the optimal height that we should be aiming for with our clients.
I will get her to chime in with her thoughts but is there a height that we shouldn’t go above?
Thanks,
Graeme Lehman
Hello Men (Jeff & Graeme),
I love the breath; I have never used that with patients before, but I will from now on.
As for the height of the arms, I was taught in school that the shoulders only need to come up to 90 degrees. Therefore, the starting position places the elbows as close to the thorax as possible, while still maintaining dorsal hand contact with the wall. However, if primary impingement is not an issue and the patient has decent neuro-motor control, I would say that higher could be ok / beneficial.
I’m most often giving this to patients with scapular instability and dyskinesis and am therefore mindful of movements that place them in an overhead position to avoid impingement issues until they have enough mobility &/or stability to get into the higher ranges efficiently / safely.
What do you do Jeff?
Thanks again for the workout Graeme; it was great!
Thanks guys,
Carla
Graeme and Carla.
I think we would be hard-pressed to find a study or two that would outline the optimal height. That said, I do think it is variable.
I think the ideal height is dependent on what they are able to achieve. Those that can fully abduct their shoulders with relative ease and optimal mechanics, likely do not need this exercise for corrective purposes. Those that DO need it, will demonstrate a restricted ROM.
So personally, my goal is to get them to abduct until they reach their limit (minimal lumbar lordosis, minimal shoulder shrugging, full contact between the elbows and dorsal aspect of hands with the wall), then incorporate their breath for control. In doing so, I have found (again no research to back this up, only clinical evidence) that this facilitates improvement with constant practice.
Hope you both are well!
I love it:) I haven’t used this for T/S mobility before, but now will! Thanks Doc:)
If someone has a hard time getting their upper arm to externally rotate in that position (which appears to be quite common), check their active INTERNAL rotation of their OPPOSITE femur. In my experience, it is normally lacking. Have them fix that (a few active mobility drills with it) and then have them retest opposite external rotation. I normally find I can get 10-30 degrees more in just a few minutes.
Let me know what you find as I would be curious.
Rock on
Mike T Nelson PhD(c)
I’ll try this myself. I could use improvement in my own performance. Thanks!