Exercise6 min read
Exercise in thoracic facet problems: from the acute phase to prevention
Exercise in facet-related upper back pain serves two different aims in two phases. A demanding programme increases symptoms in the acute phase, while gentle movements are insufficient in the prevention phase. Sequence and dosage are decisive.
Acute phase: preserving movement
Gentle seated trunk rotation is done within the pain-free range at a slow tempo. The aim is not to push the limit but to prevent the joint stiffening.
Shoulder circles reduce tension around the shoulder blade and support circulation. They are usually well tolerated even during painful periods.
Lateral rib breathing is the most valuable work in this phase. It corrects the shallow breathing adopted because of pain and moves the rib joints.
Recovery phase: widening movement
Thoracic rotation in four-point kneeling is the core movement for increasing range. The lower back stays still; movement comes only from the upper back.
Extension over a foam roller placed crosswise opens stiffened segments. The lower back must not arch and the abdomen is held lightly engaged.
Wall slides with the back against the wall work extension and scapular control at once and need no equipment.
Prevention: endurance
Back extensor endurance is the component that most reduces recurrence. It is worked by lifting the trunk slightly while prone.
The scapular stabilisers are strengthened with a resistance band. As scapular control improves, daily load on the upper back falls.
The programme takes five to ten minutes a day and continues after symptoms settle. Work done only during pain does not prevent recurrence.
Key points
- The aim is preserving movement acutely, widening it afterwards.
- Rib breathing is the most valuable work in the acute phase.
- In four-point rotation, movement comes only from the upper back.
- The lower back must not arch during foam roller work.
- Work done only during pain does not prevent recurrence.
Frequently asked questions
Should I exercise while in pain?
Yes, but gently and within the pain-free range. Immobility delays recovery here, while forceful exercise increases protective spasm. A middle course is followed.
Do stretches help?
They temporarily reduce muscle tension and are comfortable. The work that actually restores joint mobility, however, is rotation and extension.
When can I return to weight training?
Return is gradual once full pain-free rotation and extension are achieved. Loaded trunk rotation and heavy overhead lifting are added last.
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This content is for information only and does not replace medical diagnosis or treatment. Response to treatment varies between individuals. Please consult a healthcare professional about your symptoms.