Thoracic Kyphosis
Thoracic - Postural
Excessive thoracic kyphosis is a postural pattern characterized by increased thoracic curvature, often accompanied by rounded shoulders and forward head posture.
Biomechanical Mechanism
Thoracic flexion stiffness, weak thoracic extensors, and tight anterior shoulder structures. Prolonged sitting and poor posture are common contributors.
Clinical Rationale
Excess kyphosis impairs shoulder mechanics and increases cervical load. Improving thoracic extension reduces secondary compensations.
Practical Solution
Prioritize thoracic mobility and extension endurance while reducing prolonged flexed posture.
Common Compensations
- Forward head posture
- Rounded shoulders
- Reduced overhead ROM
Progression
- Level 1: Mobility drills
- Level 2: Isometric extension
- Level 3: Strength endurance
- Level 4: Overhead integration
Regression
- Reduce ROM
- Use supported positions
- Shorten hold times
Red Flags
- Severe pain or deformity
- Neurological symptoms
- History of fracture
Differential Diagnosis
- Scheuermann's disease
- Osteoporotic compression fractures
- Scoliosis
Related Patterns
- rounded shoulders
- forward head posture
- upper crossed syndrome
Related Exercises
- tspine foam roll
- tspine rotation
- wall angels
- ytw series
- wall slide
- thoracic extension foam roller
- cat cow
- thread the needle
- open book
- overhead squat
Related Assessments
- thoracic flexicurve assessment
- thoracic rotation assessment
- postural assessment
Evidence
Level: mixed
Exercise programs can reduce thoracic kyphosis angles, but effect size varies by protocol and population.
Sources:
- systematic review/meta-analysis: Decreasing thoracic hyperkyphosis - Which treatments are most effective? A systematic literature review and meta-analysis. (link)
- systematic review/meta-analysis: Effects of exercise programs on kyphosis and lordosis angle: A systematic review and meta-analysis. (link)
- systematic review: The impact of exercise on spinal posture in adolescents: a systematic review. (link)