A Chest Lift® is when your lower trapezius muscles slide your shoulder blades down the rib cage and your T2-T4 spinal segments extend to stack your upper back and your head gets pulled back on top of the rib cage.  You do not get into a chest lift by pinching your shoulder blades together; you slides your shoulder blades down the rib cage until your sternum lifts slightly.  A Chest Lift® is one of the 4 Principles of Neutral Spine Alignment within the Healthy Posture System™.  It is the most important principle of neutral spine alignment as without it the other 3 principles are not accessible.

The muscles that stack the upper back into chest lift posture are predominately the lower trapezius. You know you are in an inward spiral when the lower part of your sternum is more anterior than the top portion.

Why is it Important?

A Chest Lift® is important because it is the only way to unlock the neck and low back.  Technology has us spending too much time in collapsed posture.  When the upper back collapses, the neck and low back have to extend to counteract this collapse otherwise we would fall forward.  The consequences of excessive extension in the neck and low back is uneven distribution of load and accelerated joint breakdown.  To gain a better understanding of the importance of Chest Lift® posture it is important to understand it’s opposing posture, collapsed upper back posture.

Consequences of Collapsed Upper Back Posture:

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Cervical Spine (neck): Forward head posture reduces the amount of vertebrae supporting in the cervical spine are contributing to supporting and mobility; the other 4 are on vacation.

• Forward Head Posture. When the skull sits anteriorly (forward) on C1 a significant amount of compressive forces are placed on the cervical spine. Forward head posture can cause any of the following symptoms.
• Head Tilt Posture. The head can only sit in front of the upper back for so long before forward head posture progresses into head tilt posture. Head tilt posture is when the head tilts to one side, it is usually a result of a vertebral misalignment.

Common Symptoms: headaches, muscle strain, radicular symptoms down the arm, dizziness, brain fog and altered cardiovascular performance.

Potential Diagnosis’s: cervical sprain/strain, degenerative disc disease, spinal osteoarthritis, cervical radiculopathy, spinal stenosis, spondylolisthesis, whiplash, CCI, cervical instability, sub-occipital neuralgia, herniated or building disc.

Shoulders: When the upper back is collapsed, the shoulder blades (scapulae) are forced off their neutral position on the rib cage.  This results in rounded shoulder posture which places the weight of the shoulder blades onto the muscles that turn the head now that they are no longer resting against the rib cage.  This puts you at risk for headaches, thoracic outlet syndrome and muscle strain-oriented pain in in the upper back.

The shoulder functions optimally when the scapulae are in their neutral position on the rib cage at a very precise angle (35°-40▪ anteriorly).  Collapsed upper back posture causes your scapulae to migrate forward and off their neutral position.  The shoulder blades house the socket of the shoulder (glenoid fossa) and the anterior displacement as a result of collapsed upper back posture put stress on the shoulder joint.  Putting you at risk for shoulder impingement, rotator cuff tendonitis and biceps tendonitis.

Thoracic Spine: The thoracic spine is much more complicated in its architecture than the cervical and lumbar spine.  Each thoracic spine vertebrae has two ribs attachments posterior which are connected anteriorly to the sternum (except the last 2).  That’s 12 articulations per segment!  So, when the upper thoracic spine collapses, it takes more than a few vertebrae with it.

This is why it takes 4 to 6 weeks to improve your posture.  We have to mobilize more than T2-4 into extension; we have to mobilize these segments and their rib attachments in all three plane of thoracic spine mobility.  We have to change sitting posture and workstation ergonomics and revisit them every 4 weeks to accommodate your improved access to neutral spine alignment.  We often have to replace a standard chair (no matter how ergonomically optimized with an adjustable stool to promote the goal of upright sitting posture without back support.

Common Thoracic Spine Joint Misalignments.

• Elevated 1st Rib. Collapsed upper back posture places a significant amount of stress on 1st rib. Any asymmetry in scapula positioning puts the muscles that attach to the first rib in high alert. Overtime the tension of the scalenes and serratus anterior can pull the 1st rib superiorly. This is problematic because the nerves off the brachial plexus the supply the arm run over the 1st rib**.**
• Rib Torsions. Collapsed upper back posture over a prolonged period of time can cause hypermobility in the ribs anteriorly and results in instability. Especially when there is a winged scapulae or head tilt posture involved.

Joint Clearing Techniques: (Xylophone): We teach the 1st rib self-correction  technique at level 9 of the HPS when a client reports symptoms consistent  with an elevated 1st rib or when a client is unable to perform an overhead  press without hiking up their scapulae.   Techniques to safely mobilize the upper back in extension are taught  as early as week 2 of the HPS.

Lumbar Spine (low back): Collapsed upper back posture and results in collapsed pelvis posture.  Instead of all 5 vertebrae playing a role in load transfer and support, 2 segments take up a brunt of the load.  The L5/S1 spinal segment takes up a majority of the load of the upper body when the upper back is collapsed putting you at risk for a herniated disc, spinal stenosis and sciatica/piriformis syndrome.

• Collapsed Pelvis Posture. Similar to how forward head posture eventually progresses into head tilt posture in the neck; collapsed pelvis posture progresses into rotated pelvis posture. This is when one pelvis collapsed more forward than the other.

Common Symptoms: muscle strain, chronically tight QL, tight hamstring, pain down the legs.

Potential Diagnosis’s: lumbar sprain/strain, degenerative disc disease, spinal osteoarthritis, spinal stenosis, cervical radiculopathy, spondylolisthesis, herniated or building disc, sciatica, piriformis syndrome.

Summary:

Your posture is a key aspect to longer term injury prevention and healthy aging.  A complete posture restoration program must pull you out of collapsed upper back and forward head posture and condition you to function from that posture throughout a majority of your day.  Any rehabilitation program for neck pain, shoulder pain or back pain that does not restore access to neutral spine alignment before prescribing strengthening exercises may reinforce the faulty loading patterns that are causing the joint misalignments that are causing your pain.

The Healthy Posture System™ is a system of neutral based functional fitness exercises that condition you to apply the 4 principles of neutral spine alignment in every daily activity, exercise, sport and recreational activity to reduce your risk of injury.  Proprietary joint clearing techniques are built into each workout to ensure you strengthen the right muscles every workout for long-term injury prevention.

“You cannot unload the neck and low back until you stack your upper back.”

Video Resources

• The Science of a Chest Lift° ǀ Why Collapsed Upper Posture is Such a Problem