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Improving Thoracic Spine Mobility

Issue 2 and Volume 10.

I used the metaphor of systematically searching the fire building for fire and life in my last article. Now we’re taking the time to check the foundation by focusing on movement or mobility of the thoracic spine (T-spine). The T-spine is found in the middle of the back between the lower back (lumbar spine) and the neck (cervical spine). Often it works in tandem with another critical joint, your hips, to assist in movements like ladder raising, equipment lifting, or rescue dragging. Because of this tandem effort and the movements it allows, I’d like to mention that thoracic mobility also plays a role in hip mobility, and vice versa, when it comes to dynamic movements; however, there are times when the T-spine needs to move more independently, as when working from a ladder where your hips are restricted.

Thoracic Tests

Here are two simple tests you can do to feel your own T-spine mobility. Both tests involve simulating working from a ladder.

Test #1: Thoracic Rotation: Stand with the front of your legs a hair’s distance away from a table in front of you with your feet shoulder width apart. With each hand on the opposite shoulder, raise your elbows so that they are parallel to the ground. Rotating only your upper body, turn as far to the right as you can. Now turn to the left. Did you turn less than the full 90 degrees? Did your lower body touch the table? Did you have to push your hips back to move? These would be evidence of lack of T-spine mobility and compensation.

Test #2: Perform test #1 with full turnout gear on.

Yeah, there’s no need to actually do this because I guarantee that everyone reading this would fail. Most of us have some degree of T-spine mobility restrictions, but when you put all our turnout gear on you become less mobile and begin compensating or moving inappropriately to make the test movement happen. Now, if you are someone who has poor T-spine mobility without your gear, this issue gets compounded, and your lack of mobility and compensation increases that much more.

It’s amazing that the time we are expected to move the most becomes the point when we are the most encumbered. The fact is that you have to be able to move adequately without your gear so that you limit the compensation taking place when you put on you gear. And if you have “perfect” mobility (nonexistent), you know the importance of maintenance and would also benefit from a T-spine mobility program.

Engine Joint

Proper T-spine mobility is the ability to move in all directions (front/back, side/side, rotational). For this reason, I classify the T-spine as an “engine joint.” By calling it an engine, I’m focusing on the ability for hoselines to twist, turn, and move uncharged with ease. A hoseline can be stretched into any direction and initiates the fire attack; the T-spine has these same characteristics. Alongside other engine joints, this is the place from which most movement should be initiated. If we are able to move as needed, we immediately increase safety, efficiency, and performance.

Lack of mobility of the T-spine will force other joints to move in ways they weren’t intended. Because of movement limitations in the T-spine when working from a ladder, we tend to rely on our shoulders to do more work that they should, which can lead to overuse injuries. Other joints that get involved because of lack of T-spine mobility are the lower lumbar and cervical spine, which I would classify as “truck joints.” By trucks I’m referring to the ladder’s lack of bendability and the truck’s critical role is supporting the engine’s initial actions. These joints are not intended to move in all directions, as the engine joints are, but act as a type of hinge supporting the engine joint’s movement. When compensations occur, we are telling truck joints to be engine joints.

For instance, the engine is on scene and the crew stretches a 2½-inch line for a small offensive structure fire in a private dwelling. Instead of laying it out properly, they drop the line right at the pump panel in a ball of messy glory and charge the mangled line right there. What was supposed to be a bread-and-butter fire has now turned into an after action review of the engine’s failure because this too-large line was left as a big pile of spaghetti for an intended action.

The truck crew sees that the engine crew messed up their stretch, but the fire still needs to be put out. So what’s their response? They’re going to initiate the fire attack using water extinguishers on their nonwater-equipped truck. The truck now has to stop assisting the engine’s advance that isn’t happening and start initiating fire attack without the proper resources to make up for the ineptness of the engine company.

This is how you should think of those compensations: Your T-spine should be able to move like an engine company by moving in several directions without restriction. But if it can’t, which is often the case, we expect the lower back and neck to make the movement happen. This is a major contributor to acute and chronic lower back pain. In short, make your lower back pain better by improving your T-spine mobility.

Improving Mobility

So how do we improve T-spine mobility? Let’s look back at that engine’s failure. The crew picked too big of a line, laid it out poorly, and charged it. Once that line is charged it’s immobile. How do you rectify that? The crew needs to depressurize, drain, redeploy, and attack the fire. Some of you may know these as inhibition, lengthen, isolation, and integration.

Depressurize: The line is rigid because of the pressurized water that’s running through it. For there to be a change, we need to depressurize it first. The T-spine becomes rigid as a result of overactive muscles that need to be depressurized. A simple means to depressurize these joints is to perform myofascial release. I prefer to do this myself through foam rolling, which will help to release the fascia from this tension by calming it down through massage.

Drain: The second action would be to drain the line by straightening it out. Similarly, this is what you do when you have an overactive muscle. Now that you have released the tension, you need to stretch it out. Stretching will encourage the muscle to come to its intended length so that the joint can begin to work properly.

Redeploy: The engine now gets to start over and do it right. The crew begins to lay out the proper line in the proper position. This is the place where we are able wake up the underactive muscles that aren’t doing their job in helping the T-spine move properly.

Fire Attack: The engine is ready to conduct the attack properly alongside the truck company and all rigs on scene. No fire goes out alone; it requires a well-orchestrated attack. This is where we teach the T-spine to work together with other joints so that they can move cohesively, effectively, and efficiently.

All in all, the process may sound overwhelming but can be done within several minutes.

If you are interested in improving your T-spine mobility, fire ground safety, and performance, check out firefighternation.com to see a brief step-by-step video.