Thoracic (Mid-Back) Pain or Disc? Absolute Best Self-Treatment - McKenzie Method

Bob and Brad the two most famous

physical therapist on the Internet

hi folks I'm Bob Shrum physical


Brad heinie physical therapy together we

on the most famous physical therapist on

the internet you know pin and of course

rad today we're going to talk about the

absolute best treatment in our opinion

mm-hmm that one could do for thoracic

pain or a thoracic disc problem through

a secured needed disc pro right yeah

we've been getting a number of comments

people asking which we like by the way I

like requests which yeah so we're going

to satisfy our viewers and show them

this videos now I think we can safely

say Brad that thoracic pain is not that

rare I mean we see a lot of that sure

but a thoracic disc problem is fairly

rare yeah the majority of herniated this

are going to happen at the lumbar spine

or up in the neck so lumbar is the lower

back and thoracic is pretty much every

level where there's a rib attached sure

right right there so there's 12 and of

course the neck and if you look at the

mechanics of it the reason why there are

not so many disc problems from here to

here is kind of self-explanatory once

you think about it you look at this or

the the vertebra here or the back here

it is supporting the whole trunk the

arms in the head you know there's a lot

of stress particularly with bending or

with seated posture and it's all

focusing right down in here usually at

the lower lumbar and that's about where

your body hinges - exactly

so I hinge here and that's where you're

going to feel the pain that is in there

because that's where all the stress is

it's a physics thing there's a

mechanical pressure and leverage here

too here you have the support of the rib

cage and a lot of connective tissue a

lot of muscles that really take this

section of the spine and support it's

like a major backbone you know and you

put a back belt or your muscles here and

talk about core strength well you don't

need it here because you have the ribs

doing all this for you so that's why

there's not so many herniated discs in

the thoracic spine but it does happen

and I've the ones where I see Dan Brad

or the ones where I see with thoracic


a lot of times when they have the habit

of like that when they're bending

something like they bend more from the

mid-back yeah and that you can see

that's where it hinges is right here and

then go back and set it down here right

so they're they're like working they do

a job where they're working at a table

and like this all day long and it's

right you can see where the stress of

the point is going to be I think a good

example if you're working we have a bend

where you have to reach over and down

yeah to get some product out of on a

repetitive baby that's that's funny

because that's exactly one of the people

I treated they had to reach into a bin

and I I could tell right away that's why

it end up being through exactly but

we're so we're going to talk about and

how to address pain and stress I'll

bring one more time Bob sure come on

back now one thing I did want to mention

is something that therapists refer to as

radicular pain or where the pain can

refer to sure okay good point in the

back the nerves in the back actually the

you know from the spinal cord the nerves

come out and exit and they go around

actually they pretty much follow the

ribs to the front of the body so if

there's pain here it's not uncommon for

someone to say plates wrapping all the

way around here and sometimes we might

be numbness or tingling up around the

ribcage and up into the front and when

we hear those symptoms yeah that we're

thinking thoracic yeah we refer astok

we're thinking a pinched nerve somewhere

in this jurassic midnight dress yeah

sometimes trouble breathing too when

they agree I feel it because you know

the ribs are all attached to those

nerves and so the other thing I would

talk about is what other things can

cause pain in this area that are not

related to that disc you know so you're

not getting all concerned about it

number one the muscles can be getting

spasms and tighting from poor posture

right okay and once these muscles don't

you turn around Bob you know these

muscles between here they got the round

blades and when they can tighten up and

up in the upper traps they can tighten

over into the pain can spread up and

down and a lot of that I think is due to

posture which is right right and so

these exercises will help that too

exactly these are good too no matter

which issue you're dealing with exactly

so the other thing is facet joints that

could cause a bottom

and we're not going to get into the

detail that but there's two facet joints

at each vertebral level so you got 12

vertebra you got 24 foot set joints a

lot of joints I can give you trouble

exactly oh all right of all the gin

joints and all the okay all right let's

should we start with the first exercise

Brad yeah so oftentimes we're thinking

you know we have on the title we have a

Mackenzie reference right and so we're

going to go right to that once you move

Bob please you're gonna start yeah why


obviously I would I would try if you're

having pain in the thoracic spine it's

just laying down and if this feels

better than standing up that's a good

sign right okay you might lay there for

a minute or two and then you're just

going to do a simple press up like this

and if the first time you press up whoa

what kind of hurt are you keeping this

pelvis down yep and if you do these the

first time maybe it hurts a little bit

more and then you go down it feels


well then test it again and if you find

that with repetition it starts to feel

better then you're going to keep working

it you're going to go a little higher if

you can and just listen to your body and

I wouldn't do more than 15 of them for

sure usually it's ten and give it a rest

the other thing you're looking for like

Brad said is if it's spreading out more

if it's spreading around that ribcage

when you're doing these stop exactly

you're looking forward to narrow up and

even to concentrate more exactly if it's

starting to spread out that's not what

you're looking for we're looking for the

opposite we're looking for it to

centralize right and that again relates

to the directly to the Mackenzie system

right okay now the other thing you can

do let's get a chair Oh Bob you need the

ball right away not right away but we

will get a chair that does not go too

high if it goes to your neck level then

you definitely need to use the ball but

typically a chair that goes right around

the bottom of your shoulder blades

scapula's okay and you're just going to

arch and extend over that you can put

your hands like this and you're going to

work it or you can go up like this and

the same thing you're going to look for

if the pain comes to the center

and decreases and all that in happening

you can maybe get a little more range of

motion with repetition so if I do it

once like this and it kind of hurts a

little bit nothing well it wasn't real

bad but then you do it again and again

and it starts certain more towards the

center of the back and feels a little

bit better by the fourth and fifth one

then go up to ten by the tenth one if it

feels better pain is more towards the

center of the back then you're going to

use that exercise every hour as long as

you get the same response

most patients I see Brad if it if it's


you can tell just by the look on their

face like well this is it's a little

better right I mean they can they can

sense that it's the right thing to do

back it's not getting worse or it's

doesn't feel right yep so just listen to

your body right now this is a neat trick

yeah this is a nice little thing it's

the same concept of what we did but you

can kind of take the force and go to a

certain spot in your back little easier

it is comfortable to get a ball that's a

little soft not a not one that's

available a couple bucks said Wally

martyrs right all right sometimes you

get those really cheap ones and they're

too hard so you got to get them a little

bit soft or throw them on your freezer

or something of that nature but the kick

balls are really nice can you know I

usually have to hold that they're going

to go right there and then you're going

to kind of experiments to move it up and

down different spots exactly a lot of

times you'll find one spot where it

feels better you can get more stretch

with less pain and that's a spot where

you're going to go then you're going to

hit and stretch pass is a great idea by

the way this is just really a nice

little technique to help get you that

extension in a comfortable manner I wish

I could say I thought of it but then one

of our PTAs Mike did we should not have

to give him the credit and actually what

he was doing with it with one of his

patients was Bob can you grab my

shoulders sure and just pull back just

give me a stretch back and with this

particular patient she just felt much

better it was a really comfortable

stretch a very happy to have someone do

this to help her back pain out yeah I

got it this is a little bit of genius

here yeah this is a compressed I'll give

my kudos when you're right it's time all

right now we better go on to the next


rotation now this is a tricky one this

is something that it takes a little

practice sometimes it or you maybe like

insert right away sit down not in a bed

but a firm surface so that you're

scooted back a little bit and your

pelvis is down to the table would you

say you're doing this if this didn't

work right okay so now I use those for

these if these take away your pain you

don't need to do this one right exactly

good okay but if it's if you're still

kind of stuck or it's it's not going to

be further then let's go to this one

right good point Bob this is why we got

to work together because only 1/2 my

brain is working he picks up the other

hand I got the other half yeah okay so

those don't work you're going to do this

a rotational technique and first you're

going to go rotate to the right you're

going to rotate a really important that

you have excellent posture yes you want

to sit up as straight as possible maybe

even exaggerate a little bit the pain

might might limit you and you that

you're working with but do what you can

now if you go to the right it goes not

too bad you go to the left and it locks

up Wow then what you're going to do is

work to the right do ten rotations to

the right as far as you can comfortably

and then go back to the left now if

after doing 10 to the right going to the


feels better then you're going to work

more to the right yeah you want to go

move in a direction that it allows you

to you don't want pain sometimes I put

my hands here to breath that's a good

way to do it too I mean because then you

really know what you're doing here

you're not just kind of it just gives

you a pure rotation yeah that's a good

point it locks up the upper yeah the

upper trunk so again so I feel good this

way I'm going to work this way if it

feels good this way I'm going to work

this way I'm not going to push into an

area that hurts then you know this is

where it can get tricky Bob I think

sometimes it if you go into the

direction it hurts and you go two or

three times and it starts to feel better

right and the pain starts to go towards

the center back then then you can go

ahead and go that direction so this gets

a little tricky experiment this is where

a therapist that has some experience

really helps you out but we're going to

you know show you what how the way we

think okay so you do the rotate

and hopefully that's going to help

solidify things and get things feeling

better and you and you'll be in good

shape right this really works into that

problem that we've been working on again

Bob that broken heart that's right I'm

thinking maybe this could kind of

translate yeah they fix this we fixed

the heart right it's all in the trunk

right in the core Elmo genius alright

thanks for watching