This year, I’ve had the pleasure to meet and work with dancers from around the country — From different studios, age groups and genres.
A common trend I noticed in the bodies of young dancers… back pain. An interesting thing about it is the amount of mid-to-low back pain, at the Thoraco-Lumbar region (the space where the back of the rib cage ends, and the lumbar region begins).
Photo Credit: Juli Kosolapova (unsplash.com) with my edits
It got me thinking… why?
“Back pain” is typically low in most populations. Why is this area so problematic in dancers?
There are some key things to consider with this area:
- This is the bottom of the rib cage.
- This is the transition area from thoracic spine to lumbar spine.
- There are a lot of big muscles that cross through here, forming the Thoraco-Lumbar fascia
Back, Lower Ribcage
The back and lower ribcage are an area prone to decreased lung filling. This keeps the area more closed, less mobile, and more tense. This is exactly what I saw reflected in the dancers I met. You can see it a little in the image of the dancer above… that sunken concavity on her right side.
Look at the back view of the lungs here (below). The regions called “Costodiaphragmatic Recess of the Pleural Cavity” rests right under this common area of pain/tightness. The lungs and pleura provide structural support for our ribs. This specific area is only filled when full (non-compensational) inhales occur. This type of filling requires some specific details and intention (see recommendations at end of this post). Lack of full inhalation to this space means a lack of support to those ribs (aka, sunken in and tight).
Photo Credit: www. internalartsinternational.com
Transition from Thoracic to Lumbar Spine
Another reason this area gets compressed and tight is a dysfunction in segmental flexion & extension of the thoracic and lumbar spines, the transition from flexion to extension of our torso should occur mostly at the T8 thoracic segment. What often happens in dancers is an over-extension (lordosis) of the lumbar segments and a decreased ability to extend higher up at T8. This leads to a habit of using the area circled above as the main area used to extend upright & beyond.
Photo Credit: www.healthy.com with my edits
This combination of depressed, tight back lower ribs and increased lordosis (extension) at the lumbar-thoracic spine causes compression of the bones of the spine. It is more common to experience this kind of compression in the lumbar spine, but studies (and my observations) suggest that it is more common a little higher up in dancers. One study of 29 dancers with back pain showed 25 of them showed apophysitis (joint inflammation) of the thoracolumbar & upper lumbar spine and only 3 with it lower down at L4-S1. https://journals.eco-vector.com/0869-8678/article/view/47894
Example of “Apophysitis” or inflammation of the apophyseal/facet joints
Photo Credit – www.epainassist.com (edited)
Look at this fascia! It covers nearly the entire area of the low back. Thoraco-Lumbar Fascia has been studied in depth and has become a more regularly known cause of back pain. The fascia is embedded with nerve endings that transmit pain signals to the brain (nociceptive). Some studies found the nerve endings of the Thoraco-Lumbar Fascia actually change properties & become overly sensitive in response to overuse, microtrauma or inflammation. Read more here.
Photo Credit: www.insyncphysio.com (edited)
This fascia also seems to be more sensitive than the muscles themselves. This study found that “electrical irritation of fascial low back tissue leads to stronger pain reactions than the stimulation of the lumbar muscles”.
In addition, a lack of pliability in the Thoraco-Lumbar Fascia has been linked to low back pain. This study of 71 humans with chronic low back pain “exhibited a significant reduction in shear-strain of about 20%” compared to 50 without pain.
What does this mean for a dancer?
It means excessive lordosis and front rib cage breathing habits likely cause much of your back pain!
Here’s how to stay ahead of it:
- Learn to extend at the right place (T8 Ext) – Supine T8 Extension or Swiss Ball Roll-Outs
- Maintain good opening at lower back ribs – Swiss Ball Thoracic Breathing or Deep Squat
- Release Thoraco-Lumbar Fascia – Press Down with abdominals or Standing Wall Stretch
Choose 1 from each category to add to your daily routine, warm-up, or cool-down.
BONUS: Place some Fascial Cups along the thoraco-lumbar fascia and where the back caves in below the ribcage. Keep them in place as you do the exercises 🔥
No cups? No worries. You can Buy Cups Here.
Example placement of cups:
Photo Credit: Engin Akyurt, unsplash.com (edited)