Wednesday, September 1, 2010

Exercise and Upper Spine Alignment

Update December 2013: I have a long blog post just on this topic: Improving a Rounded Upper Back

Recently I observed someone at the gym I've advised before on improving his head-forward, rounded upper back posture(thoracic hyper-kyphosis).  My exercise advice was briefly to exercise the upper back and do much less exercise for the front of the torso but to stretch there instead.

What I saw was a commendable emphasis on working the posterior shoulders, but unfortunately always done with the spine rounded forward.  The loads were actually pulling the spine more forward as the arms pulled back, for instance doing a row.  And if I had to choose, for most people I'd say that improving the spinal curvature is more important than improving the shoulder position.

Generally exercise should be done "spine neutral," meaning the spine keeps its slight natural curves but isn't allowed to bend more.  Indeed, the spine musculature's primary role is in preventing movement(which should be in the hips, shoulders, and limbs), although the thoracic spine does contribute to rotation(transverse plane), and maintaining mobility is good for all the joints.  A rigid spine isn't the goal.

As you work out, first try to keep the spine neutral, then if you tend to round forward, extend the upper spine backwards.  This includes the head, which should pull straight back and not jut forward or tilt upward.

Taking It to the Park
These are rows on a suspension device.  Note the good alignment of shoulders and upper back.  This shows how an exercise that focuses on one movement also works the rest of the body to provide stability.
Medicine ball slams are great for shoulders and core, dynamic stretching, and fun.  The start has the shoulders fully retracted and flexed, opening up the chest.


  1. I love exercising in the park, or anywhere outdoors for that matter. Medicine balls are great for so many things too!

  2. It is interesting, even when you instruct clients to keep their chest up and shoulder blades back, when fatigue sets in, their dominant motor patterns take over and they protract their scapulae with each rep! Cueing usually doesn't fix the problem. You may all ready seen and done this, but breaking down the pattern ( making it simpler, lower resistance) is helpful.

  3. Things definitely break down with fatigue, and it's a challenge to keep the client doing the exercise and not just lifting the weight. There's a short term trade off between training for movement and training for strength, even though we know long term they improve each other.