Cervical Ribs and other limitations?

[Tracey Weaver]

Hi Everyone,

 

I am fairly new here.  Here is my back story... haha... skip to the end if you just want to know my question. LOL

 

I am 45 year old gal that has a history of surgeries to my core.  

 

Chronologically...

 

- 1 attempted kidney donation (at 25 years)  (still have both kidneys, but also a 12 inch incision on left trunk)

- microdisctomy L4-L5 (at 32 years)

- 2 cesarean births (at 34 & 36 years)

 

I am pretty sure  years of compensating different movements has made me end up in my current situation.

 

 - Rolled shoulders

- very limited thoracic mobility (bridge is non existent lol) 

- poor ROM overhead  (no arms by ears)

- weak lower core muscles  (hollow is weak)

- poor lower back flexibilty (i don't rock and roll well. haha)

-  anterior pelvic tilt.

 

With all that said... I am a fairly successful athlete for my age.  I am very active.  I am a triathlete and enjoy weight training and am pretty strong for my size.  I would like to stay injury free and strengthen my weaknesses. After all my research, I believe if I could correct my postural issues by developing some raw strength in my back and core, this can be done.

 

Which is why my journey has led me here.  I know the road ahead will require patience and persistence.  I am ok with that and have never shied away from hard work.

 

My question is... a recent X-ray of my neck shows cervical ribs. I was experiencing arm dullness, bicep pain and pinky numbness (symptoms of thoracic outlet syndrome) but have since gotten out of pain/numbness working GB Thoracic stretch series. I would like to move forward to Foundations and Handstand 1.

 

Does anyone know if having cervical ribs will limit my overhead/shoulder mobility or success with the program?  Can I expect full ROM if I am consistent?  Is getting the flexibility back in my lower back after microdisectomy in the lumbar spine even possible???

 

I know you all aren't doctors.   Just wondering if anyone out there is perhaps in my boat or have trained athletes in my situation.  Thanks for reading!! :-) 

 

[Wesley Tan]

Hi Traweaver,

 

In my opinion, the presence of cervical ribs should not limit your degree of shoulder flexion significantly, i.e. you should at least be able to get your arms either side of your head. Movement beyond this may be limited as the clavicles may be blocked mechanically in these ranges. 

 

However, the current state of your spine as whole will do, particularly the position of your neck relative to your thoracic spine ( the AP curves or anteroposterior shape of your spine) and your degree of thoracic mobility and shortening in the front myofascial chains (neck and down through chest and abdomen).

 

As you have always had cervical ribs (you developed them during embryonic life) your nerves and blood vessels in that region have developed alongside them. This means they have grown over and around them and will have sufficient length to not be snagged or compressed against them to cause issues. That is why you haven't had any issues up until now.

 

In Osteopathy, we like to think of the body as having a reservoir of compensation, this is a concept concerning how much insult the body can withstand before serious dysfunction begins. In terms of thoracic outlet, you can think of cervical ribs reducing this conceptual 'reservoir' to a degree but not drying it out completely. 

 

As a triathlete I assume you spend many hours/miles cycling, in a particular posture to cyclists that can be blamed for many mobility deficits and postural adaptations. I have a male client in his late 60's who has been a keen cyclist for decades. He has almost zero side-bend in his neck and very limited rotation and I put his cycling position as the major cause. It encourages rounding of the shoulders and upper thoracic spine, compression through the C/T junction (cervico-thoracic) and an increase in the cervical lordosis.

 

So, how much mobility you can gain is a good question and one only you yourself can answer, over the next few years. Whether you can become more mobile is not a question, this is fact, only the amount is unknown (yet).

 

My personal and professional recommendation would be to give up weight training completely. Each time you pick up a weight it adds extra compression to a spine already suffering without much support form the core. Your priorities, in order to achieve the most gains in spinal and global mobility/health, should be mobility and core work. Together. Basically GST.

 

It's best to think of your spine as a whole and not in terms of lower, mid and neck (although they are of course useful concepts). For your lower back to become more mobile, your thoracic spine needs to change, and for your thoracic spine to change, your neck will need to as well. For they are the same structure!

 

Out of interest, I take it your second child was an elected C-section? What happened the first time round if I may ask?

 

Best wishes and welcome!

 

Wesley

[Tracey Weaver]

Wesley... thank you so much for such a thorough and insightful reply.  I really appreciate it.

 

The second paragraph you wrote depicts me physically... very accurately... and the hours on the bike you mentioned have not helped the condition of my neck and thoracic spine no doubt. (Been biking for the past 5 years).   In addition to cervical ribs, my  X-rays show a cervical bone spur and the lordosis you mentioned.  Some ostoarthritis... but then again I am 45. haha   I do agree that I was built with these extra ribs and only now... like you stated...after years of insult my body is showing dysfunction.  I believe it has given me signs for years...but only now is it becoming crystal clear.

 

I have also been advised to go to voice therapy because I "speak incorrectly", apparently not recruiting the right muscles and project my voice strictly with my chest and not belly breath.  It is insult to my injuries... because I now believe it probably has contributed to the shortening of the front myofacial chain you mentioned.  I balked at the Dr. when he suggested this therapy, but now am reconsidering.

 

You are absolutely right in your suggestions for training. I know the right thing to do would be to dive into GB 100% shelving all of my other training (biking, running, weight training) for 6 months, to a year or maybe more?  But the idea of that makes me very sad.  The reason I want to "fix" myself is so I can become a better weight lifter (lifting more weight with better form) and triathlete (Go longer distances staying pain free).  Perhaps I would find joy in GB alone...but I truly love weight lifting and cross fitting and not sure I can give it up.  It drives me.

 

Is it possible that I could continue to lift weights but with less intensity.  Perhaps not lifting to failure, or working with weights that are maybe 50-70% of my current maxes?  Also reducing the days I lift.  Not lifting everyday... but only 2-3x per week and work the GB program the other days of the week?

 

Thanks again for your valuable input.

 

Tracey :-) 

 

P.S. Labor was induced by my doctors, as I was a five or so days late from the charted delivery date for my first son.  Things did progress with the induction, but perhaps too quickly because my son presented "sunny side up" (facing the ceiling instead of facing the floor) and I was unable to get him down the birth canal.  In hindsight... induction was the wrong way to go.  The Dr. dates were probably off and my son needed a bit more time before he entered the world!!

 

Son two I insisted having a vaginal birth.  We waited (I was a few days over due) and I went into a natural labor.  Unfortunately he also presented sunny side up.  My Dr. had no confidence that I would be able to deliver him and suggested I don't try and go with a c-section.  It was going to be safer for all.  In the chaos of the moment...I agreed and had the c-section.  Uhg.  

 

Silver lining to crappy birth stories... two healthy boys. :-) 

[Mark Collins]

You are not alone with those injuries and I cannot see why you would not make great progress with Foundation, H1 and the strecth series. At 45 you have spent years getting stiff and it will likely take years to reverse the damage you have done. You will see changes week to week and over the course of years you will look back and be amazed at the changes in your body.

I understand that you want to continue triathalons and Crossfit and even though it is not ideal I think it is better you keep doing for your minds sake. You will need to reduce them to fit in the extra work that you will be doing with GST and mobility. If you could make your mobility, F1 and H1 a priority you will improve in the others and will be able to keep training for years to come.

[Wesley Tan]

Hi Traweaver,

 

I think for many the idea of letting go of one way of training in sake of another is hard because of the social aspects that come with the training. I know Crossfit can have a good sense of community around it's boxes and so can understand wanting to continue, but lifting purely for lifting, for a body that is already significantly compromised just doesn't make any sense.

 

Lifting everyday, to failure = madness 

 

Set some goals, and then implement training that will take you toward those. In small, incremental, measurable and testable steps. GB programming has all that. I am not selling it here, I'm just saying, someone has already done all that hard work for you, and others (like myself) have tried it and can say it works.

 

I have quite a few students that have completely given up lifting in order to give GST a try and after 2+ years they haven't looked back or regretted that decision. I never told them they needed to stop lifting but that in order to make BIG changes in mobility it was a good idea. 

 

I don't want to press my beliefs on you, but this is the best advice I can give on knowing how to make the changes with your body you desire. Mobility needs to be a focus, if it is just an add on, and strength training still dominates, very little will change! 

 

Really glad to hear you have 2 very healthy boys. Giving birth has so much tension around it when it comes to the medical establishment and this fear of babies somehow over cooking is ridiculous. It is the same here in the UK with Doctors wanting to induce after the 'due date' with 2 weeks a maximum. 

 

It is my belief that difficulties in labour can of often be traced directly to mobility issues of the lumbar spine, pelvis and hips as well as internally with regards to the pelvic floor musculature. Babies presenting breech (bum first) and other types can often mean the baby never never had the room to manoeuvre. 

 

Best wishes,

 

Wesley

[Tracey Weaver]

Hi Wesley,

Interesting perspective on the birth of my two boys.  Since I went into labor naturally with baby number two, and he also presented OP (sunny side up)... perhaps it wasn't the induction after all but the state of my lumbar and pelvis after the previous surgeries to my back/core? Interesting.  

 

I know you share your opinions and suggestions for my future training from a place of experience and knowledge (not sales!).  Deep down I know the right thing to do would be to stop lifting weights altogether for a while.  I have been doing Crossfit for 3 years.  Last year I left my box because I needed more individualized programming and now WO mainly at home.  Through my new CF programming... via online coaching...I realized the major deficits I spoke about earlier, which has landed me here. 

 

I do drop in a couple times a week at a different area box to train with a couple close friends.  At this new box I am allowed to do my own programming and the ladies (and coaches at this gym) support me.  The not wanting to make the total switch... is me.  I love the heart thumpin, sweat inducing, badass feeling of completing a good metcon.  It is safe to say I am a metcon junkie. haha  But I have come a long way...as the past six months I have incorporated skills and mobility into my routine.  However, I do believe in the added skills and mobility that I am missing steps, not investing enough time, and do not have the proper progressions for me personally to gain the raw strength I desire.  Again...this dilemma has led me here. haha

 

So... last night I decided to commit (YES...prior to reading your post!).  I purchased the other two stretch series and Foundations 1 and Handstand 1.    I have brought a TV into my home gym that I can stream the WO's through and am investing in some stall bars (UHG.... could use some help with that!! Any suggestions that won't break the bank??)

 

I am still trying to make heads or tails of the whole GB system.  I am getting lost in all the abbreviations and am not quite sure how to set up a schedule that will include both courses, plus each of the stretch series weekly... deload weeks, integrated mobility with each move, prerequisite moves? haha I plan to scour these forums for info and create a plan (not sure what the Pro+ is and if that would be something that would be right for me??)  Anyhoo... Once I figure it all out...I will decide where I can toss in 2-3 weekly metocns.  GB programming will take precedent and the weights chosen in my metcons will only amount to 50-60% of my current 1 RM and be 20 minutes or less.  There will be no strength training persay where I am trying to increase muslce mass to increase my 1RM.  That will be put on hold.  

 

Any advice  (or point in the right directions) you can give me on scheduling my current courses into a weekly plan would be great.  I currently WO 6x a week and am flexible on days and times for training.

 

This is pretty exciting and looking forward to starting this journey here.

 

Thanks for all your help!

 

Tracey