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Feldenkrais Method
Thoracic Kyphosis, Poor Posture

Normal Curves

In a normal upright position the spine should have three neutral balanced curves. The neck is curved inward from back to front (lordotic), the thoracic spine curved outward (kyphotic), and the lumbar spine inward (lordotic). This is what is called a neutral balanced curve, in the front to back dimension. (See Th 1). Each part of the spine can actually reverse into the opposite direction providing us with the ability to configure ourselves for the purpose of getting into small spaces or express our self in dance/gymnastics.

However for most functional activity in the upright position, a neutral balanced spine is what we want for taking the load of our body and whatever we are carrying, directly through solid bony support.


Without the rib cage to restrict it, the neck and low back are fairly free to move. There is generally less movement in the thoracic spine especially into side bending and rotational directions. The easiest movement available in the thoracic spine is flexion or rounding. If we sit without good muscular support acting around the whole spine, gravity causes increased rounding of the thoracic spine.

When back muscles relax into the back of a chair, two things happen 1) the low back tends to round, reversing its normal inward curve 2) the thoracic spine rounds even more than normal. The inward curve of the neck will reverse and follow the thoracic rounding if a person wants to look downwards. However, more often people want to look ahead, so the neck can be over-arched in relation to a rounded thoracic spine. This causes excess lordosis (inward curving) of the cervical spine and with it another set of problems (see neck problems). Thoracic spine pain is talked about less than neck or low back pain. However people can have degenerated thoracic discs, particularly in the T5-6 area, which is the apex of the thoracic curve.

If compressed discs lose their height, the facets joint take weight they are not meant to bear. Under excess load, cartilage on the surfaces of facet joints wears down and become arthritic. (See Th 2, 2.5)

Chronic poor posture of the slumping variety eventually leads to an excess thoracic kyphosis (rounding curve). Over time the curve becomes difficult to return to normal because the discs and vertebrae tend to become wedge shaped by this rounding. (See Th 3) Some might argue that such a person has weak muscles between the shoulder blades and should simply straighten up. The more flexible a person's spine is, the more easily and quickly posture can improve.

However "straightening up" is really about organizing one's skeleton for efficient bony support, upward from any supportive surface. Case in point, there are people who practice throwing their shoulders back, imitating the military posture. This creates a "holding tension" in the back and between the shoulder blades. The tension restricts normal movement of the ribs, reduces breathing and causes fatigue. The thoracic spine should be normally a little rounded. If it is flat, over-tightening of the thoracic muscles is likely. True support from one's skeleton leaves torso muscles free to respond to normal activity, especially full, expansive breathing.

The area between the shoulder blades is frequently an area of fatigue. It is particularly an area of strain and fatigue for those who use their hands in front of them for work. The weight of the arms in front of the body requires stabilizing support from the shoulder blades and spine. The better you can use your whole spine to spread this load the less local fatigue and strain develops in the middle back.

The Alexander Technique is very helpful in establishing true skeletal support of the whole body. When one's skeleton is organized for support, there is a minimum of muscle tone needed to sustain it. We also have to retrain and develop our slow acting muscle fibers, which support us. Improving posture takes time.

Extinguishing old muscle memory and reinforcing new habits can take 8 months. Remember, good posture is a dynamic activity that allows for shifting movement around the balance core of your spine. It is not about finding the "right position" and rigidly keeping it. No one, even a good Alexander Teacher, can keep perfect posture all day. It is more about losing it and regaining it intermittently and dynamically. Lying on books on the floor (see archives article) gives the spine a refreshing break from gravity.

If you are lucky enough to have a private office or treatment table at work, lying on books is a real pick-me-up at lunch or break time. Even 5 minutes on the books has a profound effect. I teach various exercises to help mobilize the thoracic spine and rib cage. Work on the styra-rollers is like a "masseuse in a can" (products for a purchase source). Deep longstanding fatigue is often felt in the thoracic spine, so heed the caution, you may need to slow down your life and get more rest!

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MovementWise Christine Inserra P.T.
Certified Teacher of the Alexander Technique & Feldenkrais Method
Physical Therapy serving Chicago and the Greater Chicagoland Area