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1.Thoracic intervertebral joint sprain
The intervertebral joint is the joint that joins the levels of the spine together. Injury to this joint is usually due to a forced movement forward or backward of the thoracic spine. Pain can be felt locally about 2 cm to the side of the spine and may radiate around the chest wall to the front of the chest. Pain is increased with forward or backward movement of the spine.
2.Thoracic muscle rupture
This injury is common in many sports such as throwing sports, football, basketball and boxing. It is also commonly done when lifting heavy objects. Symptoms include deep sharp pain on bending forward and backward as well as rotating. There will also be local tenderness around the area of injury in the back.
3.Costovertebral joint disorders
The costovertebral joint is a joint in the back that joins the rib and the spine. Common problems arise from spraining the joint during forced chest movement or from inflammation due to arthritis. Any irritation in this area will result in tenderness about 5 cm to the side of the spine, with painful, restricted movement of the spine. Pain may also with deep breaths, coughing or sneezing.
This injury is very common in contact sports such as football and rugby. It most commonly occurs as a result of a blow to the ribs. Common symptoms are very harp pain to touch as well as pain and sometimes clicking with a deep breath, coughing or sneezing. This injury commonly remains painful for an unusually long time due to constant movement of the chest wall with breathing.
5.Scheuermann’s disease (Osteochondrisis)
This is the most common cause of pain in the thoracic spine in adolescents, especially boys. It is a hereditary back disease in which the back becomes rounded due to the bodies of the vertebrae becoming wedged shaped. Symptoms include fatigue and tightness in the back after sitting for long periods and a feeling of weakness and pain, usually an ache following exercise or lifting weight.
6.Scoliosis (Curvature of the spine)
This is a curvature of the spine in a sideways direction which causes the spine to be S-shaped. Symptoms with scoliosis are not always present. Symptoms include complications due to muscle weakness and joint ‘looseness’ on the convex side and muscle tightness and spasm with joint tightness on the concave side. The symptoms will vary case to case but will tend to be aggravated by strenuous exercise or prolonged postures such as sitting or standing.
Early Injury Management
For approximately the first 72 hours following an injury, the RICE regime should be followed to ensure control of inflammation and pain relief.
R – Rest
I – Ice
C - Compression
E - Elevation
Rest from aggravating activity.
Ice should be applied in the first 72 hours or when inflammation persists. Ice should be applied for 15 to 20 minutes at a time. Ice should not be applied directly to the skin, but through a wet towel or cloth.
Compression can be achieved with an elastic bandage.
Elevation is used to help swelling to return to the heart through the blood stream.
The injured area should be elevated above the level of the heart.
Strengthening programs should only be commenced when:
Exercises should be 3 sets of 8-12 repetitions.
There are two parts to the pectoral muscle, the sternal and clavicular heads. Therefore, two stretches need to be completed, one with the arm at 90 degees to the body and the other with the arm higher at 120 degrees to the body.
Thoracic Extension Stretch
Using a towel, extension of the thoracic spine can be achieved at specific spinal levels. Thoracic extension is helpful for those with spinal pain resulting from postural problems such as those encountered by people sitting at a desk for long periods
Serratus Anterior Stretch
This stretch helps to lengthen the muscles that pull your shoulders and shoulder baldes forward. These muscles can become tight in those with poor posture related thoracic, neck and shoulder pain.
Latissimus Dorsi Stretch