Name: Sternocostal Joint Self-administered Mobilization
Uploaded: 2023-04-26T01:00:15.000Z
Duration: 9 min 31 s

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https://stream.mux.com/4WQByZWbIcd8XkGM6YkRcuPLp6jhsRxhZR33hW9Ao54.m3u8

Learn how to properly perform sternocostal joint self-administered mobilization in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert coaching on setup, positioning, alignment, and exercise modifications to improve sternocostal joint mobility and thoracic movement. Enhance rib mobility and chest expansion while supporting optimal breathing mechanics and thoracic spine function with this targeted mobilization technique. Perfect for athletes, fitness enthusiasts, and rehabilitation clients seeking to reduce chest stiffness, improve mobility, and restore optimal movement mechanics while reducing the risk of injury.

Introduction to Sternocostal Mobilizations

Identifying the Need for Mobilization

Understanding the Anatomy and Technique

Executing the Mobilization Technique

Progressions and Variations of the Technique

Importance of Care and Sensitivity in Technique Application

Sternocostal Joint Self-administered Mobilization

This is Brent of the Brookbush Institute bringing you a new self-administered joint mobilization technique. In this video we're going to talk about sternocostal mobilizations, or mobilizations of these tiny little joints that you have just lateral to your sternum where your ribs interface. Some of you guys are thinking to yourself well why would I want to mobilize these tiny little joints. We have to think a little bit bigger picture for the broadest use of this technique, which is those individuals who have problems with thoracic mobility. So your thoracic spine controls your ribcage, and your ribcage attaches to your sternum anteriorly. Now if you've had long-standing thoracic mobility issues, it would actually make sense that we've had some sort of adaptive change in the mobility of these joints. Maybe an increase in stiffness that is preventing us from getting as much results as we could be getting from our thoracic mobility routine. There are some other issues where we may look at using this technique as well, for example those people who get a lot of trigger points through their pectoralis major. I would say it's worth a try to do this technique. I have noted clinically that there seems to be a relationship between sternocostal mobility and pectoralis major trigger points. There are also those individuals who feel like these joints need to pop, that's a potential symptom or a potential sign that this technique is also worth a try. Of course if you guys are dealing with pain, make sure you're either a licensed professional or you refer out to a licensed professional, to determine whether this technique would be appropriate. I'm going to have my friend Melissa come out, she's going to help me demonstrate this technique. Now let's go over our anatomy a little bit, like the practical part of this. You guys all know where your sternum is. Now this is her manubrium, the top of her sternum. I can actually just by putting the pads of my fingers down in the center of her sternum, I can actually feel her sternocostal joints at either side. So if you thought your sternum was that wide you're wrong, your sternum is actually fairly thin. These sternocostal joints are just lateral to the midline, so we're not going to be moving a whole lot when we do these mobilizations. We're going to be staying pretty center, which I know what some of you guys have already been thinking with this technique, is this safe for females to do, is this going to be uncomfortable for females to do, am I going to impinge, or bruise, or compress breast tissue. Chances are no, we're not moving very far and if somebody is really rolling over their chest they're going too far. Or they're using a foam well that's just too wide for their little person, but chances are they're rolling too far and as I show you this technique that'll make more sense. Now what we're going to do is we're going to adapt a manual therapy technique, which would be anterior to posterior mobilizations, where I would take maybe the ulnar border of my hand and put pressure down on those sternocostal joints anterior to posterior. Now obviously I can't do that with a foam roll I guess I could have somebody hug into themselves, but that's not going to work out too well. What we're going to do is we're going to start on the sternum which is essentially the ribs being unloaded, and then roll onto the ribs which is going to be an anterior to posterior force. We're then going to roll back and forth and that's going to create the oscillation that we'd normally use for mobilization. So Melissa's going to go chest down on this foam roll and the trigger point roll tends to work pretty well, being covered in a little bit of foam it definitely helps the sensitive area. She's going to start with her hands and maybe even elbows down to take off some of the weight, especially when she starts because this can be quite tender. If I needed to I could even use a towel underneath, to even further soften that down. We don't want to kill the person. We don't want them in so much pain just trying to do the technique that they're not going to comply, and do this with their home exercise program. Once she's found the center of her sternum I'm going to have her try one side at a time. I just want her to roll over one set of ribs, just barely over those bumps and then back, and then if she can get a little oscillation going, I'd have her do about 15 maybe 30 seconds tops on each side. Good go ahead and switch sides. I'm going to have her get up and go back into Child's Pose. Nice and comfortable and then I go ahead and retest. Be very careful how much of this stuff you guys do, you don't want to take a mobilization from positive to irritating. Now there are several progressions to this mobilization to add force, that was our first progression. You may need to regress to something even softer. When Melissa and I were experimenting before we made this video, we actually used this very soft squishy ball, and honestly that's enough to load and unload the ribs for somebody who might be really really sensitive. Little tougher to roll back and forth but that's okay. Good go ahead and relax. The other thing we talked about is if you guys have any really soft foam rolls lying around, a good reason to keep some of those old beat-up spongy foam rolls, is a long foam roll can actually be less force because now Melissa can shift part of her body weight, onto her inner thigh on the side the she's is going to roll. So now she's getting like more or less the bottom half of her body supported by the length of the foam roll, and then she only has her upper body weighting down her ribs. But as Melissa is pretty tough and we've been working on this a little bit, let's go ahead and show you guys the progression. So those are some of the regressions, how would I progress this exercise, you want the trigger point roll back. So to increase the amount of weight we're using, we could just start by going from elbow and forearm down where we're nice and unweighted, to arms wide and now she can kind of roll back and forth this way. The next progressions we kind of start integrating this into our trapezius activation, or those prone ITY's. She goes on one side just over those sternocostal joints, and she goes down into her Cobra from floor and then pinches your shoulder blades. Not only is she unweighted herself by going from floor and up, floor and up, but her scapula having to retract and posteriorly tip, is also forcing mobilization of her rib cage which is going to have an effect on our sternocostal joints. And of course i can increase that posterior tipping and that retraction by going from Cobra to abduction, abduction with external rotation ideally. So now I'm kind of getting a little bit more bang for my buck if I'm writing out like an integrated warm-up, corrective exercise routine, home exercise program, where I'm trying to get a lot done in a few exercises or a short amount of time. I might be able to use this for trap activation knowing that I'm also getting some sternocostal mobility, if she's had a history of upper-body dysfunction. You can go ahead and relax. It has a tendency to be very tender. As they get off that foam roll I have found that going right into a child's pose helps. Sometimes you even get a little cavitation or mobilization of the thoracic spine going back into that lengthened position and having loosened up all of this tissue. This is once again a sensitive technique, you guys are going to have to use your best judgment. You guys are going to have to modify with towels and softer pieces of equipment and keep some old foam rolls around, but this is one of those techniques if it really is like a clinical gem. If you have that stiff thoracic spine that just doesn't seem to want to respond for you. You have somebody who's several years post sternotomy right, that bone is healed but all these joints are super stiff. Little stuff like this all the sudden might open some doors and get you a little further through your rehabilitation, or a little further into your intervention, or give you a little better mobility for your performance training, so that you can get better results than you've had before. I look forward to hearing how you guys use this technique, when you guys use this technique, and of course what results you get. I look forward to hearing from you.

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Joint Mobilizations: Upper Body (Self-administered)

Self-administered Sternocostal Mobilization: Anterior to Posterior:

Assume a prone position with chest on a foam roll. The foam roll should be parallel to the spine, with one end of the foam along the sternum, extending to just inferior the sternoclavicular joints.

To ensure pressure along the entire sternum (and all sternocostal joints), the head may be lowered toward the floor (thoracic and cervical flexion).

The hands may be placed wider than shoulder-width to aid in moving the torso, and reducing the weight and pressure on the foam roll if necessary.

Start with the foam roll center on the sternum.

To apply an anterior to posterior (AP) force on the ribs and sternocostal joints, roll laterally off the sternum, just past the ridge created by the sternocostal facets and the origin of the 

To offload the facets roll back to the center of the sternum.

To create the oscillation normally associated with joint mobilizations, roll back and forth from sternum to ribs, focusing on one side at a time, until a reduction in discomfort is felt or 30 seconds have passed.

Repeat on other side if indicated by assessment.

Progression 1: The hands can be placed wider to reduce the ability to use the arms to decrease pressure on the foam roll.

Progression 2: This is a relatively large jump in intensity, but a 

 can be performed with the foam roll offset to one side. This ensures constant anterior to posterior force while the scapula posteriorly tip and apply pressure to the ribcage.

Sternocostal Joint Self-administered Mobilization

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