Intermediate Thoracic Spine Nerve Injury Rehabilitation

Thoracic pain ≤3/10 at rest with verbal numerical rating scale,Passive thoracic extension tolerance within 10 degrees without radicular symptom provocation,Costovertebral joint tenderness score decreasing from initial evaluation,Intercostal sensory exam showing stable or improving light touch sensation in affected dermatomes,Ability to maintain neutral thoracic posture for 5 minutes without increased symptoms,Paraspinal muscle spasm level reduced as palpated at T1-T12 levels

→ Advance to: Week 3 Subacute Mobility

Thoracic active range of motion: flexion ≥30°, extension ≥15°, rotation ≥20° bilaterally,Intercostal nerve glide sequence (slider technique) tolerated without symptom reproduction,Rib cage expansion difference ≤1cm between upper and lower thoracic levels on maximal inspiration,Scapular stabilization test: prone shoulder flexion to 90° with thoracic extension maintained for 10 seconds,Thoracic facet joint mobility assessment showing improved segmental mobility at affected level,Tolerance to prone lying for 5 minutes for extension-based exercises

→ Advance to: Week 5 Early Strengthening

Thoracic extension endurance: prone prop on elbows holding 30 seconds without fatigue,Costovertebral rotation strengthening: side-lying thoracic rotation against gravity for 3x10 repetitions,Intercostal muscle activation: ability to isolate and hold deep inspiration against resistance for 5 seconds,Erector spinae functional strength: seated thoracic extension against manual resistance at T7-T12 level graded as 4/5,Thoracic rotation power: prone trunk rotation with light resistance (2kg) achieving 3x15,Neurological screening: dermatome sensation normalized in ≥50% of affected intercostal nerve distributions

→ Advance to: Week 7 Advanced Conditioning

Full thoracic active range of motion: flexion ≥45°, extension ≥25°, rotation ≥30° bilaterally,Thoracic spinal nerve neurodynamic testing: median neurodynamic test negative for symptom provocation at upper thoracic, slump test negative at mid-thoracic,Functional capacity: able to perform overhead reach with thoracic rotation without compensation,Trunk endurance: modified Biering-Sorensen test holding ≥45 seconds in prone position,Sport-specific or occupation-specific movement tolerance without symptom recurrence,Patient-reported outcome measures: global rating of change score ≥4 (moderately better)

→ Advance to: Discharge/Return to Activity