IJABAHTHERAPEUTIC COURSE
ZONE 2 · REGION 01

Mid Back
& Thoracic

Thoracic region contributes to trunk rotation, extension, rib-cage movement and upper-body function. Student belajar menilai movement dan task secara functional tanpa menganggap stiffness bermaksud vertebra atau rib “lari”.

REGIONAL OUTCOMESOrient T1–T12 & rib relationshipAssess thoracic movementConnect movement to functionScreen non-musculoskeletal patterns
T1T6T12THORACIC REGION
A · ANATOMY

Thoracic spine works with the rib cage.

T1–T12

Twelve thoracic vertebrae form the mid-spine and articulate with ribs.

RIBS

Rib articulations link thoracic movement with the chest wall and respiration.

MUSCLES

Spinal, scapular and trunk muscles contribute to posture, movement and load transfer.

FUNCTION

Turning, reaching, lifting and many upper-limb tasks involve thoracic contribution.

B–D · FUNCTION, MOVEMENT & COMPLAINT

Rotation is especially useful to observe.

ROTATION

Turning trunk left/right during reaching, walking and work.

FLEXION

Forward trunk movement.

EXTENSION

Backward/upper-trunk extension within comfortable range.

SIDE BENDING

Lateral trunk movement contributing to multi-planar tasks.

STIFF ≠ OUT OF PLACE

Reduced thoracic movement boleh datang dengan banyak contexts. Describe range, quality, symptom behaviour dan function — jangan claim vertebra/rib displacement tanpa appropriate diagnosis.

E · ASSESSMENT

Movement first, then relevant load.

INTERVIEWonset · trauma · chest/breathing · systemic · neuro
→
ACTIVE ROMrotate · flex · extend · side-bend
→
COMPARErange · quality · familiar symptom
→
FUNCTIONturn · reach · lift
→
SCREENsafe to treat?
F–J · OBJECTIVE & TREATMENT

Example objective: improve comfortable trunk rotation for reaching.

PREPARE

Supported position, comfortable breathing and gentle movement.

MOBILITY

Controlled thoracic rotation/extension exposure matched to the finding.

SOFT TISSUE

Appropriate trained external work if it supports comfort or movement objective.

LOAD

Integrate rotation and trunk control into reaching, pulling or lifting tasks.

COMFORTABLE MOTION→CONTROL→LIGHT LOAD→FUNCTION
K–L · REASSESS & HOME

Repeat the same movement or task.

BASELINERotation / reach

Record range, quality, comfort and functional limitation.

→
RETESTSame task

Better, same or worse? Use response to guide the next dose.

M · THORACIC RED FLAGS

Do not continue routine treatment with major trauma, sudden severe unexplained thoracic pain, chest pain/pressure, severe or unexplained breathlessness, collapse, fever/systemic illness with concerning symptoms, new significant neurological changes, rapidly worsening unexplained presentation or other emergency-pattern findings. Seek appropriate urgent medical assessment when indicated.

APPLYREGIONAL CASE

Client has gradual mid-back stiffness during repeated reaching at work. Safety screen is clear. Right rotation is less comfortable and reproduces the familiar limitation.

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