• Brian LeRiche

Gain VS Sustain: Thoracic Abduction

The importance of thoracic abduction was introduced to me by James Anderson of the Postural Restoration Institute (PRI). I quickly realized that too often PRI practitioners place too much emphasis on a left zone of apposition (ZOA), and over-look the right ZOA. Over emphasis of the left allows us to lose awareness, position, and contraction of the right. We tend to think that we do not desire a right ZOA, which is not necessarily true. We still need the right, but seek to bias the left due to the over-use of the right as a whole. If the right ZOA is lost, you may end up “locking” your patient or athlete into a PEC pattern with an inhibited bilateral ZOA. As a goal, we must sustain a right ZOA and gain a left ZOA through thoracic abduction.

The exercise below can be useful in teaching patients or athletes the correct position of this gaining and sustaining phenomenon. It exhibits a passive long thorax on the right in combination with a passive elevated pelvis on the left. In doing so, concentration can be shifted to the active thoracic abduction goal while minimizing the total amount of steps actively executed.

Besides the above mentioned goals of the exercise, we also need to consider optimal breathing techniques. Through personal experience, I have used a 3:1 breathing method. This involves 3 “exhalations” before 1 “inhalation.” Think of this as a continuation of your breath, not necessarily three separate exhalations. As you begin your first breath, exhale the entirety of air out, when you reach the point just before your maximum exhale, let out a second exhale (you should feel an increase in oblique activation). As your second breath of air reaches its maximum capacity, let out a final and third exhalation. All three exhale’s should be smooth and with no question, increase oblique activity. The goal during the exhalation phase is to sustain left pelvic elevation (left oblique contraction) with concomitant right thorax abduction to the left. Think as the thorax abduction as differentiating your hips from your rib cage and shifting the thorax towards your left side. In doing so, you should obtain a long, but sustained right ZOA with a gained left ZOA. Pause after the exhalation phase and initiate an inhalation to feel a right chest wall expansion. Repeat this process for four breaths or until the balloon is maximally inflated.

The advantage to this technique is the minimal thinking involved and sensory awareness. Sometimes we need to give patients or athletes passive reference centers and convert to active when appropriate. Taking away a passive reference center will enforce them to achieve the desired outcome with a more neuromuscular connection. Additionally, the sensory awareness of the oblique’s contracting demonstrates the feeling we wish for them to sense. The newfound oblique’s can then be utilized to sustain the depressed rib cage, take in a larger volume of air during the inhalation, and create a left ZOA.

Key Points:

  • Maintain a right ZOA with a right long thorax.

  • Thoracic abduction creates a shift of the thorax, not hip motion

  • Thoracic Abduction should further activate left oblique’s.

  • Left oblique’s should increase activation from pelvic elevation & thoracic abduction

  • Oblique contraction sustain during inhalation phase

  • Right Chest wall expansion during inhalation

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