My Favorite Wellness Therapy

If I had to choose just one form of wellness therapy to receive on a regular basis to support my health, I would choose to have the middle to upper regions of my spine stretched by a skilled practitioner. This is because I spend many hours reading, writing, and working at my computer each week, so even though I am fully aware of how important it is to maintain good posture, I often find that my shoulders droop forward, causing the muscles in my upper and middle spinal regions to become tight. This is despite the fact that I do many sets of full body weight pull-ups each week to keep my back muscles strong, and spend a few minutes almost every evening doing various yoga stretches for my entire back region.

Over time, developing tight mid and upper back muscles and an accentuated curve in this region can cause numerous health problems, the most common of which are:

• Pain and stiffness throughout the back and shoulder regions
• Tension headaches
• Pain, tingling, and/or numbness in the arms and hands (thoracic outlet syndrome)
• Jaw (chewing) problems
• Increased risk of having the upper spinal region bend forward (hyperkyphosis) if osteoporosis develops

The type of stretching that I love receiving for my mid to upper spinal regions is called passive joint stretching, or passive joint mobilisation. The idea is to relax my body as much as possible and have another person stretch my joints during this relaxed state. The more relaxed my muscles are, the more effectively the joints of my spine can be stretched.

Having my spinal joints stretched in this manner promotes optimal blood circulation to the cartilage that lines the joint surfaces. Passive joint mobilisation also helps to ensure optimal range of motion in those joints, which is to say that it helps your joints stay flexible rather than become stiffer as you age.

Fortunately, it isn't difficult to learn how to apply passive joint mobilisation to another person's spine. With the information in this article and a few practice sessions, you and a partner can easily learn how to stretch each other's spines as effectively as most licensed health practitioners can.

Here is what I do for my patients, family members, and friends (and what my wife does for me):

1. Have the person about to receive the stretching session lie on his or her stomach on a comfortable surface that has a little give to it. A carpeted floor is fine, but a firm mattress or a thick blanket on top of a carpeted floor make for ideal surfaces. The person's head should rest on the ground, looking to the right or left, with arms resting on the ground at his or her sides.




2. Straddle the recipient's bum region. You can rest gently on the recipient's bum to his or her tolerance, but you don't want to sit with your full weight, as most people cannot tolerate having the full weight of an average adult on their pelvic joints for more than a few seconds.




3. Place your hands, palms down, on the recipient's back; your hands should be on either side of the recipient's spine, so that the pads of your thumbs are about half an inch to one inch away from the spine. You can begin in the middle back region, about one full adult hand-width up from the base of the recipient's spine.




4. Your hands should be cupped ever so slightly, so that most of the contact with the recipient occurs with the pads of muscle that line the outside regions of your palms under your thumbs and pinky fingers (your thenar and hypothenar eminences, respectively).




5. Ask the recipient to breathe normally, in through the nose and out through the mouth, and to relax his or her muscles as much as possible.




6. Allow your hands to feel the rhythm of the recipient's breathing for a few cycles of inhalation and exhalation. You want to get a sense of his or her natural breathing pace.




7. As the recipient exhales, apply pressure at an angle that is halfway between going straight down toward the recipient's breast bone (sternum) and up toward the recipient's head (ultimately, you should be applying force in the direction of a line that goes straight from your hands to the front of the recipent's neck).

   Your arms should be close to being straight, but not fully locked at the elbows. Your chest should be directly above your hands. Most of your force should be coming from your upper body weight. Ease off on the pressure as you sense the recipient approaching the end of his or her exhalation, and as he or she begins to inhale, keep your hands in place, but bring your upper body back a bit so that you are not applying any force at all; during inhalation, you just want to maintain gentle contact with your hands. Repeat the same process for another 2 or 3 cycles of inhalation and exhalation.

The reason why you must take care to apply pressure at an upward angle rather than directly down toward the surface that the recipient is lying on is that the joints in this spinal region are angled up at about 45 degrees. If you apply pressure straight down through the spine, you won't be stretching along the natural plane of the spinal joints, and over time, such pressure can actually lead to wear and tear of those joints. By gently pushing the joints along the natural angle of the joint surfaces, you achieve optimal stretching of those joints with little to no wear and tear on the joint surfaces.

8. After applying the stretch to the first region for about 3 breaths, move your hands up about 2-3 inches and repeat the entire process. Stretch the entire spine in this fashion, moving up about 2-3 inches at a time until you reach the upper shoulder area, where you won't be able to apply downward and upward force without putting significant strain on the recipient's face.

Some notes on this procedure:

• Ultimately, the amount of pressure you apply should depend on feedback from the recipient. Apply what you feel is enough force to adequately stretch his or her spine, then ask him or her to tell you if you should increase or decrease the intensity. Remember: for optimal joint mobilisation while the recipient's muscles are fully relaxed, only apply pressure during exhalation.




• If you hear a pop or a crack while you are applying pressure, do not worry. Such noises are called cavitations, and usually represent harmless gas (O2 and CO2) escaping from the fluid that lines the joint surfaces that you are stretching.




• If you receive chiropractic treatments, you may be able to easily picture the procedure described above. Many chiropractors use this method; the only difference is that most chiropractors will add a low-magnitude, high velocity "thrust" when the joints are maximally stretched, which ensures significant movement in the adjusted joints.

  Some chiropractors will do a similar procedure but with the patient lying on his or her back; the chiropractor will put one hand under the patient's back, wedged firmly between the spinal segments that need to be adjusted and the treatment table, have the patient fold his or her arms in front of his or her chest, lean the chiropractor's upper body weight against the patient's folded arms, then thrust down quickly with the chiropractor's upper body weight to adjust the patient's spinal joints over the chiropractor's wedged hand.

  Personally, I am not a fan of this "face-up" technique, as it is very difficult to take into account the angle of the joints in the thoracic (mid) spine. The force applied with this "face-up" technique goes pretty much from back to front, not upward along the natural plane of the joints of the thoracic spine. If this procedure is carried out on a regular basis over an extended period of time, I believe that it has the potential to harm the joint surfaces in the middle to upper spinal column regions and the cartilage that lines those surfaces.

  Please note that a similar "face-up" position can be used to adjust the joints that exist between your ribs and thoracic spine; if a practitioner is highly skilled, this treatment is fine to receive if you are in need of a rib adjustment.




• If you cannot find a partner who can apply this procedure to you, you can experience adequate and similar stretching of your middle and upper spinal regions by lying on your back with a couple of pillows wedged up under your spine. Lying in this position for a few minutes at a time while you breathe regularly can provide an excellent passive stretch to your thoracic region.

  You can accomplish the same stretch by lying back on a plastic exercise ball for a few minutes at a time. Don't forget to maintain steady breathing, and be sure to stretch for only as long as you can comfortably tolerate.




• Before you try the procedure outlined in this article with a partner, it is best to visit a physical therapist, chiropractor, naturopathic doctor, or osteopathic doctor to rule out any underlying health conditions that may make it best to receive this type of therapy from a licensed practitioner.

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