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Part 2, Thoracic Pain That Doesn't Respond to Extension

Published 3 months ago • 1 min read

Hi everyone, here's part 2.

I'm leaving the FAQs in at the bottom for a little while. Glad they're helpful.

RECAP: Patient is a 42-year-old female yoga instructor with the onset of intermittent symmetrical mid-low thoracic pain about one year ago after roughhousing with her young boys. Twisting R is stiff when pain is elevated, but her movement exam did not demonstrate any motion loss. Neural tension + on L. Multiple attempts of thoracic extension had no effect. I sent her out with sustained extension to confirm or rule out a derangement.

UPDATE: She messaged me that her pain was all on the right side, and thoracic rotation right was now continually stiff. I responded to let her know this is a good thing and sent her a new exercise (see below).

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TAKEAWAY: Turns out, her initial history was much more telling than her exam, because she initially stated that rotation right got stiff when pain was high. There were no signs of it on the exam; however, sustained thoracic extension for a week exposed the lateral.

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The video below is what I sent her for HEP.

I still have not seen her for an in-person follow-up yet. She feels completely comfortable communicating via messaging.

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Until next time,

Ryan Tauzell, PT, Cert. MDT

ryan@atlashealth.io

​atlashealth.io​

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