Musculoskeletal pathology of the thoracic spine and ribs is often thought to be self-limiting in nature.1 Recent interest in the thorax from a clinical perspective has been related to the recognition of the thoracic spine and ribs not only as a source of local and referred pain but also the influence of thoracic spine mobility on movement patterns in other regions of the spine and the shoulder girdle. Range of motion (ROM) in the thoracic region is necessary for a number of daily activities and sporting tasks such as golf, throwing sports, tennis, and rowing. Dysfunction of the thoracic spine can also play a role in breathing difficulties and may be linked to postural issues in the later stages of life.
The article recognises the importance of the role of the therapist in treatment, but is primarily concerned with offering a suggestion for self-mobilisation and treatment. The proposal is to use a device to assist mobilisation and the treatment of trigger points. The tool consists of two tennis balls taped together like this:
The article then proposes a series of exercises that can be performed with the tool lying transverse to or parallel to the spine.
Rather like a foam roller, I think it might be useful if used appropriately, and the article certainly supports the need for a client to be taught how to use the device effectively.
The concern I have is for unmonitored use. In other words when people use these sorts of things without any real knowledge of what they are doing and how tissue might respond. It's not that I want to make manual therapy into some sort of mystical art, but having studied through a course I'm so much more aware of what I'm doing and how I stretch and look after my own soft tissue.
It's too easy for people to get into the mindset that if it hurts it must be working. I had a client at an event who stated, "Pain is my friend." While some aspects of manual therapy can be uncomfortable, the pain should always be manageable, a "good hurt" as some have described it.
Anyway, I'll give my new contraption a try and report back. Being a tennis player, tennis balls are in plentiful supply in my house, so making one this morning over breakfast wasn't hard. Perhaps it's a new opportunity to recycle all the old tennis balls!