When being evaluated for shoulder pain, a few things that a Doctor of Physical Therapy usually always looks at is your thoracic spine, shoulder and head position! This is because a forward head, rounded shoulders, and limited thoracic spine mobility may contribute to a common condition called shoulder impingement syndrome. 

A study published this April in the Physical Therapy Journal states that individuals with shoulder impingement syndrome exhibited a greater thoracic kyphosis and decreased thoracic extension range of motion when compared to those without SIS in the same age and gender population. Another study published in the Journal of Electromyography and Kinesiology reported a significant association with altered shoulder mechanics in individuals with forward head position and rounded shoulders. 

Let’s break this down! Shoulder impingement syndrome is essentially a diagnosis of anterior shoulder pain that occurs when the rotator cuff muscles and soft tissues that run under the acromion, the front of your shoulder, become pinched with overhead shoulder movement. These movements can include reaching for a glass in the cabinet, brushing your hair, or putting your shirt on. Thoracic refers to the upper part of your back/spine, just below your neck and just above your low back. Kyphosis is natural rounding of the thoracic spine; however, it can sometimes be increased or excessive, giving an individual the appearance of a “hump” or rounded shoulders. Thoracic extension refers to the ability to lean backwards through the thoracic spine.  

So, while shoulder pain and limitation can be caused by several factors, a good place to start is by looking in the mirror! 

If you are experiencing shoulder pain, head into Performance Plus PT for a free Discovery Visit to see of your appropriate for Physical Therapy and let us help you reach for that glass in the cabinet without pain! 

1. Donald J Hunter, Darren A Rivett, Sharmain McKeirnan, Lyn Smith, Suzanne J Snodgrass, Relationship Between Shoulder Impingement Syndrome and Thoracic Posture, Physical Therapy, Volume 100, Issue 4, April 2020, Pages 677–686. 

2. Charles A. Thigpen, Darin A. Padua Lori, A. Michener, Kevin Guskiewicz, Carol Giuliani, Jay D. Keener, Nicholas Stergiou. Head and Shoulder Posture Affect Scapular Mechanics and Muscle Activity in Overhead Tasks, Journal of Electromyography and Kinesiology, Volume 20, Issue 4, August 2010, Pages 701-709.

By Jacqueline Dagostino PT, DPT, Cert VRS