Hello doctor,I am a 52 year old male, very fit. I have rounded shoulders with slight thoracic kyphosis and sit at the desk often but do shoulder, neck, back stretching exercises regularly to combat this. I think that the main problem is coming from weakness in my thoracic spine, causing me to use arms to support myself on the desk. I think the weakness may be coming from my T11/T12 area as it shows up as having a fairly damaged disc compared to others (see attached MRI).Although the whole T3-T10 area seems to have dessicated discs that I have had since my 20s. I have had fairly tight hamstrings all my life and I have tried to stretch them intensely with a number of standard stretches, which works for a short while but they quickly become tight again. I have noticed just recently that using the leg press machine at the gym (see photo attached) is helping a lot to stretch my hamstrings.What I am confused about however is that when I keep the legs loaded, I eventually feel a great stretch and workout on my lower back and then in the T11/T12 area I mentioned, directly around the joint. This seems to be the only way I seem to get to feel a release in the thoracic joints and what feels like strengthening, but it has never been recommended to me. I have done thoracic spine strengthening in isolation (using floor back extensions, as well as tennis balls etc) and as I said hamstring stretching in isolation, but they have limited effect.I am hoping this exercise will do the trick in terms of restoring some flexibility and strength to my thoracic area and take some load off my upper spine and neck from the poor desk posture. I would appreciate any thoughts that you have.
Hello. I read your concern. In my opinion, your posture is the main culprit more than strength and weakness of your thoracic musculature. I wanted to know about your low back posture and pelvic tilt. With your narration, I presume you have weakness in the gluteus muscles which is not supporting your low back thereby causing stiffness in the hamstring and in your thoracic spine. The relief what you get while stretching in leg press machine is not from the mere stretch but your gluteus muscles get activated and started to fire to support your lower body reducing the load placed over the hamstrings. I feel you would have a mild stiffness in your low back while getting up early in the morning. I am not saying pain but kind of stiffness which settles within few minutes once you stretch or start to walk. In my opinion, I suggest you the following: Glute recruitment exercises like bridging, clamshell (10 s hold six each side), side lying and lifting leg up, lying on your stomach and lifting the leg backward, step ups, Swiss ball supported squats and isometric bridge hold (30 s hold). While doing all these exercises, I suggest you exert pressure over the heel. Do not take weight over your toes. These exercises are to be done for 15 reps of three sets twice daily. Stretch your abdomen muscles. Do retraction work if upper back and stretch frequently your pecs. Both pec minor and major lats. Scapular pushups, shoulder retraction help you regain your posture. Support your low back while sitting by keeping a pillow in the low back. Hope this is helpful for you. Kindly revert back in case you need any further clarification in this regard. For more information consult a physiotherapist online -->