Parkinson’s and Axial Rotation (Part 2, Thoracic Spine)

“It’s not what you do some of the time that counts, it’s what you do all of the time that counts.” Jack LaLanne

“The essence of decay is inactivity.” Jack LaLanne

Background: The function of our spine and all the bones and muscles, and associated tissues connected to this region are crucial for our everyday life. A prevalent injury or pain that many people typically have is usually to some part of the back. This is Part 2 of 3 blog posts dealing with axial mobility, presenting some exercises for Parkinson’s, and exercises to help stretch specific back regions (Part 1 is here). A few other things to consider besides the actual task of exercising, one should also exercise the core region if the back is being targeted. Furthermore, one must consider your response to recovery from injury, quality/quantity of sleep, and the quality of your overall diet plan, especially in the presence of Parkinson’s. Let’s begin with some review about the structure and function of the spine.

“Virtually everything we do in life is a matter of habit. Habits make us who we are. Why not change your habits to better your life?” Jack LaLanne

Regions of the Spine: We typically identify four areas of the spine, including cervical, thoracic, lumbar, and sacral. Each part of the spine has vital physiological functions that protect the body in response to physical stress and obstacles we face every day. See the figure below.

• The cervical region of the spine is the neck region. There are seven vertebrae, which are identified as C1 through C7 from top to bottom. Cervical vertebrae support the skull, protect the brain stem and the spinal cord, and support head movement.
• The spine’s thoracic region begins where the cervical ends, and there are twelve thoracic vertebrae numbered from top to bottom as T1 through T12. Ribs attach to the thoracic vertebrae increasing their strength and offer protection of many essential organs. Thus, due to these structural features, the thoracic range of motion is limited.
• The lumbar region of the spine begins after T12 with five vertebrae identified as L1 through L5. The lumbar region is designed and poised to bear much of the body’s weight. The lumbar vertebrae are more flexible than the thoracic spine region, but they are less flexible than the cervical region.
• The sacral region of the spine is located behind the pelvis, which is numbered S1 through S5. The sacrum is a triangular-shaped region from the fusion of the sacral vertebrae. The coccyx (tailbone) is below the sacrum and is formed from the fusion of five additional bones. Think of the sacrum as a connector between the spinal cord and the pelvis. The sarum and coccyx allow us to sit upright.

“Most people, when they reach a certain age, let down and talk about what they used to do. Well, who gives a damn about what you used to do? It’s what you’re doing now.” Jack LaLanne

The Thoracic Spine: In between the neck and the lower spine sits the thoracic spine. Since it has ribs attached to it, this spine region is not very flexible and offers protection to vital organs. However, as the bridge between two more flexible spine regions, the thoracic spine is an integral part of the entire spine, and it can be damaged during exercise and sports. Furthermore, dysfunction of the thoracic spine region can lead to postural changes if left untreated. In other words, try to keep these regions limber, stretch the thoracic spine regularly, and maintain your posture. As stiffness and range of motion become more prevalent with the progression of Parkinson’s, it is crucial to find some exercises that stretch the spine and do not forget the thoracic spine.

“Better to wear out than rust out.” Jack LaLanne

*Please read the medical disclaimer at the end. And as always, a reminder, I am neither a physician nor a physical therapist, no matter how hard I try, they are the trained experts. Contact them for further details about these and other exercises.

Thoracic-related Exercises: I recommend trying them all first because they are not hard and are relatively straightforward. Pick 4 or 5 of the exercises you like or those that you feel impact your back the most. Work up to 3 sets of 10 reps/exercise routine. Alternatively, do exercises 1-5 in week 1; move to exercises 6-10 in week 2, and then do exercises 11-15 in week 3. Perform these exercises three times during the week (or as needed). Please note that many of these exercises will work or target your core region, which is excellent. Supporting your back and good posture is crucial for your core muscles. Strong core equals good news for your thoracic spine.

1. Bird Dog ( Click Here)
2. Side-Lying Thoracic Extensions (Click Here)
3. Wall Squat (Click Here)
4. Deep Lunge with Thoracic Extension (Click Here)
5. Superman (Click Here)
6. Sitting spine side bend (Click Here)
7. Sitting side flexion (Click Here)
8. Dead Bug (Click Here)
9. Thoracic/ Upper Back C.A.R. (Click Here)
10. Seated Cat/Cow Pose (Click Here)
11. Quadruped Thoracic Extension (Click Here)
12. End range shoulder flexion “lift-offs” in Childs pose position (Click Here)
13. Thoracic Extension over a Foam Roller (Click Here)
14. Thoracic Spine Windmill Mobilization (Click Here)
15. Seated Trunk Rotation with Side Bend (Click Here)

Using the PWR! Moves to Exercise the Thoracic Spine Region:
Start with the tutorial on your Back (Supine) (Click Here)
Here is an actual demonstration by me being exercised by Jennifer at the Pwr! Gym in Tucson, AZ. She’s a much better instructor than I am a student, click here for video.
PWR ! Moves are helpful for many different muscle groups, the two shown here are great for your thoracic spine.

“Your muscles know nothing. It’s your brain. Exercise is something you’ve got to do the rest of your life. It’s a lifestyle. Dying is easy. Living is a pain in the neck. You’ve got to work at it.” Jack LaLanne

Exercise in the Presence of Parkinson’s: One already knows that if Parkinson’s is present in ten different people, the disorder and expression of symptoms will differ in each person. Saying that does not mean that all ten people with Parkinson’s cannot exercise; in contrast, exercise is essential for everyone with Parkinson’s. The degree to which you may need to exercise or what you can handle may differ from one another. Try some of these exercises if your back is stiff, but talk it over first with your neurologist. The short video below is to lend you support. I understand your stiffness, but I do want everyone to exercise regularly.

“The only way you can hurt your body is if you don’t use it” Jack LaLanne

Medical Disclaimer Statement on Performing these Exercises
MEDICAL DISCLAIMER: Always consult your physician before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider.

WHEN TO CONTACT YOUR PHYSICIAN: If you experience any symptoms of weakness, unsteadiness, light-headedness or dizziness, chest pain or pressure, nausea, or shortness of breath. Mild soreness after exercise may be experienced after beginning a new exercise. Contact your physician if the soreness does not improve after 2-3 days.

References:

Heneghan, Nicola R., Svein M. Lokhaug, Isaak Tyros, Sigurd Longvastøl, and Alison Rushton. “Clinical reasoning framework for thoracic spine exercise prescription in sport: a systematic review and narrative synthesis.” BMJ open sport & exercise medicine 6, no. 1 (2020): e000713.

Kisner, Carolyn, Lynn Allen Colby, and John Borstad. Therapeutic exercise: foundations and techniques. Fa Davis, 2017.

Heneghan, Nicola R., Katie Webb, Tom Mahoney, and Alison Rushton. “Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: a systematic review.” Translational Sports Medicine 2, no. 6 (2019): 301-315.

Sabino-Carvalho, Jeann L., James P. Fisher, and Lauro C. Vianna. “Autonomic Function in Patients With Parkinson’s Disease: From Rest to Exercise.” Frontiers in Physiology 12 (2021).

da Costa Daniele, Thiago Medeiros, Pedro Felipe Carvalhedo de Bruin, Robson Salviano de Matos, Gabriela Sales de Bruin, Cauby Maia Chaves Junior, and Veralice Meireles Sales de Bruin. “Exercise effects on brain and behavior in healthy mice, Alzheimer’s disease and Parkinson’s disease model—A systematic review and meta-analysis.” Behavioural brain research 383 (2020): 112488.

Hall, Mary-Frances E., and Frank C. Church. “Exercise for older adults improves the quality of life in Parkinson’s disease and potentially enhances the immune response to COVID-19.” Brain Sciences 10, no. 9 (2020): 612.

Bliss, Rebecca R., and Frank C. Church. “Golf as a Physical Activity to Potentially Reduce the Risk of Falls in Older Adults with Parkinson’s Disease.” Sports 9, no. 6 (2021): 72.

“I do like working out. I feel my best when I work out, but you know, I’m human. I like to ride my bicycle and lift weights and hike. When I am diligently working out, ideally, I like to work out four days a week. If I can do that, I feel good about myself.” Shemar Moore

“You should be proud of what you’re doing, but not conceited. If you can’t be proud of yourself, you’re a failure. And discipline. To do anything in life you have to have discipline. To accomplish anything, you have a goal, challenge yourself, and work until you accomplish that goal. Practice what you preach.” Jack LaLanne

Cover Photo Image by Engin Akyurt from Pixabay