This post is prepared by West 4th Physio associate Marj Belot.
The Thoracic Ring ApproachTM: What is it and how does it work?
In early 2017, I learned The Thoracic Ring ApproachTM. on a four day course. Since then, I’ve had many opportunities to incorporate it in my physiotherapy practice and clients have been reporting some great results. Although courses are taught in many countries, including England, US, Canada and Australia, many people have not heard about this approach, so I’m sharing this brief summary.
The Thoracic Ring ApproachTM. is a physiotherapy model involving assessment and treatment of the thorax (between the neck and lower end of the rib cage) from a different perspective. It was developed by a local physiotherapist, LJ Lee, to try to resolve her own persistent thoracic pain, following a car accident. She observed clients, assessed for changes in her own thorax, and pursued a PhD to better understand how this area of the body works. It’s still an area with much less biomechanical research than the knee, shoulder, or even lumbar spine.
One key element is, that each segment of the thorax looks and acts like a ring (vertebra, rib connected on each side of the vertebra and circling around to the front of the thorax to attach to the sternum). When we are standing or sitting upright the rings should stack nicely, be balanced and have space between them to facilitate movement. LJ noticed that it was easier to assess subtle changes in how the rings aligned with each other and whether they were centred over the feet by feeling along the sides of the rib cage and the front of the upper ribs at rest (e.g. standing), and through movements that are associated with symptoms.
The physiotherapist then applies a manual correction to the ring alignment, and assesses changes in symptoms with the same provocative movement. If the dysfunctional thoracic rings are driving the person’s symptoms, then the symptoms will improve when the rings are corrected. A wide variety of symptoms can be associated with ring dysfunction, including pain, numbness, muscle tension, and weakness in the thoracic region but also, upper or lower body symptoms. The reasons include:
• The large size of the thorax
• Position between upper and lower body
• It provides nerve supply to the abdominal muscles
• It provides attachment for numerous muscles from the neck, shoulders lumbar spine and pelvis.
Treatment involves rebalancing the rings, teaching clients how to assess and manage themselves and progressing their new skills in to day-to-day tasks, exercise and sport. I’m happy to entertain any questions you may have as to whether this approach could be helpful for you. I can be contacted at firstname.lastname@example.org. In most cases, however, it would be difficult to know without providing a hands-on assessment.