The cervical, thoracic and lower lumbar regions of the body function as an interdependent system. Pain or injury in one part of the spine may cause a referred injury or pain in another. When treating neck, upper back or lower lumbar pain with exercise, physical therapists may prescribe programs for all sections of the spine.
Identification
The cervical vertebrae are located in the neck, the thoracic are in the upper back and the lumbar vertebrae are in the lower back. There are seven cervical vertebrae, 12 thoracic and five lumbar vertebrae. While the spinal segments are connected, suppleness may vary in different parts of the spine. This may be due to injury, faulty habitual movement patterns or posture. The lack of flexibility in specific spinal segments becomes evident in certain exercises. A person may have sufficient lumbar flexibility and abdominal strength, but tight neck and upper back muscles may limit the ability to perform a full situp. The trainer or therapist may have her client warm up by performing head nods to release the neck. She may also put two tennis balls inside a sock, and place this makeshift massage tool under her client's upper back, in order to release upper back tension. The client rests on the sock massage tool, allowing his body weight to sink into the balls.
Function
All of the spinal segments are capable of flexion, extension, side bending and rotation. Head nods, a common exercise for releasing neck tension, is an example of neck flexion. The full situp, which is controlled by the superficial abdominal muscles, is an example of thoracic flexion. Laying on your stomach and arching your back into a cobra position is an example of thoracic extension, which is controlled by the erector spinae muscles. Lumbar flexion occurs during the reverse curl exercise, which lifts the lower pelvis from the floor. The obliques control the hip and ribcage circles usually seen in dance movements, as well as the side-bending movements performed in waist exercises.
Considerations
Cervical, thoracic or lower lumbar back pain may result from excessive muscle weakness or muscle shortening. Before devising an exercise program for these areas, the therapist or trainer must determine the cause of the pain. Tighter muscles are then stretched, and weaker muscles are strengthened. A typical stretch/strengthen series may involve lying supine and drawing your knees toward your chest to stretch your lumbar region, and following the stretch with crunches on a stability ball.
Types
Stretches may either be dynamic, or performed with movement, or static, performed without movement. The cat exercise, performed on the hands and knees, is an example of a dynamic stretch for the lumbar and thoracic regions. Kneel on all fours, tilt your pelvis and round your upper back, and then return to a neutral position. The lateral neck stretch is an example of a static stretch for the cervical region. Begin with your head in a neutral position. Place your right hand on the side of your head, and gently pull your right ear toward your right shoulder. Hold the stretch for 30 seconds, and then switch sides.
Warning
Extreme pain may indicate a more serious injury. While some exercises may alleviate pain, others may exacerbate an injury. Obtain a professional diagnosis before starting an exercise program.
Prevention/Solution
Don't wait until you are injured to start a cervical, thoracic and lumbar exercise program. Be proactive, and incorporate therapeutic exercises into your regular workout.
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