Figure_1_ODR_articleUnderstanding the biomechanics of the thorax is critical for understanding its role in multiple conditions since the thorax is part of many integrated systems including the musculoskeletal, respiratory, cardiac, digestive and urogynecological. The thorax is also an integrated system within itself and an element of the whole body/person. Therefore, understanding the biomechanics of the thorax is fundamental to all forms of treatment for multiple conditions. The interpretation of movement examination findings depends on one’s view of optimal biomechanics and the influential factors.

This article will provide a synopsis of the current state of research evidence as well as observations from clinical experience pertaining to the biomechanics of the thorax in order to help clinicians organise this knowledge and facilitate evidence-based and informed management of the, often complex, patient with or without thoracic pain and impairment. The integrated systems model (ISM) will be introduced as a way to determine when the noted biomechanical findings are relevant to a patient’s clinical presentation.

Keywords: Biomechanics of the thorax, Thorax, Biomechanics, Clinical expertise, Thoracic ring, Integrated Systems Model

The full article can be found on the Journal of Manual & Manipulative Therapy click here


“I so appreciated your recent article in JMMT. It came across as a voice of reason in a world seemingly obsessed with rules and guidelines and the latest ‘tricks’. A perfect balance of the three evidentiary pillars with just a touch of bewilderment that people seemingly refuse to consider two of the three. It was great to see a thoughtful, reasoned defense of the role of biomechanics and to hear about how your integrated model for reasoning continues to evolve. It was also timely in that I had been wondering for a while now where you were now in regards to your original thoracic clinical model. Question answered.

Thank you for standing up for those of us who want to continue to treat patients as individuals and who want to retain the freedom to think through a complicated problem.”

Brett Windsor