Exercise6 min read
Exercise in thoracic disc herniation: breathing, mobility and endurance
Exercise for the thoracic region differs markedly from lumbar and cervical programmes in one respect: the rib cage and breathing. Shallow breathing adopted because of pain leaves the rib joints immobile and reinforces stiffness.
Breathing work
Lateral rib breathing is taught. With hands placed on the sides of the ribs, the aim is to push the hands outward on the in-breath.
The painful side usually expands less. Directed breathing reduces that asymmetry and moves the rib joints with every breath.
The work is short and done several times a day. Sets of five to ten breaths are better tolerated than long, forceful sessions.
Mobility work
Thoracic rotation in four-point kneeling is the safest mobility work here. The lower back stays still; movement comes only from the upper back.
Extension over a foam roller placed crosswise opens stiffened segments. It is applied briefly and without producing pain.
Seated side bending opens the spaces between the ribs and supports the breathing work. Movement stays within the pain-free range.
What to avoid
Loaded trunk rotation is the riskiest movement pattern here. Weighted rotation is postponed until symptoms recede.
Lifting with a deep forward bend increases pressure on the disc. Lifting technique is retaught to begin at the hip.
Straining while holding the breath raises intrathoracic pressure and can trigger pain. Free breathing is taught during strength work.
Key points
- Breathing is the distinguishing component of exercise here.
- The painful side usually expands less; directed breathing reduces that.
- Rotation in four-point kneeling is the safest mobility work.
- Loaded trunk rotation is the riskiest movement pattern.
- Straining with a held breath raises intrathoracic pressure.
Frequently asked questions
Is swimming suitable?
It is suitable once symptoms recede and supports respiratory capacity. Demanding strokes such as butterfly are postponed in the acute phase; backstroke and freestyle are better tolerated.
Breathing hurts during exercise — what should I do?
Reduce the depth of the breath but do not abandon the breathing work. Continue at a pain-free depth in shorter sets, increasing depth gradually over days.
How long until results?
A reduction in stiffness is usually noticed within two to three weeks. A clear fall in pain and gains in endurance take six to twelve weeks.
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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.