Clinical Pilates in Practice: Is T9-T12 the Thoracolumbar Transition Zone? (April 2021)
Apr 01, 2021
The authors of this retrospective review study hypothesised that the true thoracolumbar junction is T10-11.
Murphy, J. et al. “Is T9-11 the true thoracolumbar transition zone?” Journal of clinical orthopaedics and trauma 11 5 (2020): 891-895.
- For clinical purposes, the thoracolumbar transition zone is considered to be T11-L2 for due to the variation in the location of the caudal end of the cord, as well as the biomechanical weakness of false ribs at T11.
The point of transition from floating to false ribs resulting in increased mobility at T10-11.
- Articulation between thoracic vertebrae and ribs plays an active role in stability and load-bearing of the thoracic spine, along with the ligaments and facet joint capsules.
- The lumbar spine is relatively more mobile.
- Mean age in the patient cohort was 25.3 years; 300 MRIs were reviewed.
- Disc degeneration was most frequent and most severe at T8-9 and T9-10, followed by T10-11.
- T9-11 demonstrated the highest mean load gradient across two discs, in flexion, sitting, and standing.
- The authors conclude that imaging and assessment for low back pain needs to include higher spinal segments into the low thoracic spine, up to and including T8-9.
CLINICAL PILATES IN PRACTICE
- A relatively immobile upper thoracic spine will download forces and load to lower thoracic segments, therefore work to maintain and improve upper- and mid-thoracic mobility.
- Prone Pulling Straps on the long box.
- Eagle prone on the Cadillac.
- Oblique Curl Ups at the Tower.
- Seated Chest Curls at the Wunda Chair.
- Build strength through the lower thoracic spine through upper transverse, oblique, and mid multifidus training.
- Assisted Roll Ups on the Cadillac.
- Side Bend.
- Down Stretch on the Reformer.
- Rotated Swan on the Wunda Chair.
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