Thoracic Spine Mobility and How It Affects You

Bonus Video Exercises

Woman Stretching Thoracic Spine

You want to be flexible – so you stretch your muscles. But what about your joints? You also need to have good mobility in your joints to allow you to move freely and do the things you love. So then, what areas should you be focusing on to improve joint mobility? It turns out that you lose the most mobility in your mid and upper back – the thoracic spine – throughout your life. This decrease in mobility not only affects your back, but your neck and shoulders, as well.

Here’s how improving mobility in your thoracic spine can maximize function and even increase your strength potential. Plus, I’ll show you a few simple exercises you can do from home…

Thoracic Mobility as You Get Older

You’ve seen the older men and women with the large kyphosis (forward curvature) in their upper backs. Although some people are more pronounced than others, the vast majority of us increase our kyphosis as we age, especially after the age of 40.

In fact, all directions of thoracic mobility have been shown to decrease with age, mostly extension followed by rotation1.

Although the lumbar spine (lower back) has been shown to decrease in mobility with age, the thoracic spine loses an even greater percentage of mobility2. Even by the time you turn 16, your thoracic spine loses as much as 27 degrees of sagittal mobility, 9 degrees in flexion and 16 degrees in extension3.

How crazy is that?

Clearly, thoracic mobility isn’t just something you need to address once you become older.

Sprinkling in a few thoracic mobility exercises in your regular stretching routine can improve your ability to move and can even prevent neck and shoulder problems, too…

Thoracic Mobility and the Neck

Sometimes impairments in one region of your body can lead to dysfunction in another region – a concept known as “Regional Interdependence”4.

Your thoracic spine is directly connected to your cervical spine (neck). Because of the close link between the two, you can see how a lack of joint mobility in the thoracic spine could potentially contribute to disorders in the neck5.

In fact, a direct association has been found between people with decreased mobility in the thoracic spine who also complain of neck pain6.

It’s no surprise, then, that multiple studies have found that manipulation of the thoracic spine can improve neck pain. Interestingly, more Physical Therapists perform thoracic manipulation techniques rather than cervical manipulation techniques in patients with neck pain7.

Clearly, when it comes to the neck, thoracic mobility matters.

Thoracic Mobility and the Shoulder

Similar to how the mobility of your thoracic spine affects your neck, it can affect your shoulder, too.

Studies show that reduced thoracic mobility or an increase in thoracic kyphosis directly contributes to a lack of potential for full range of arm elevation8,9,10.

This increase in kyphosis can also alter the position of the shoulder blade to be further away from the spine (abducted), which can limit the scapula’s ability to rotate, therefore limiting shoulder motion, and increasing the potential for impingement11.

So, how much thoracic motion is needed?

In normal overhead motion of the shoulder, the thoracic spine must side-bend, rotate, and extend12,13. It must extend 15 degrees to achieve full elevation of both shoulders14.

In my eBook, Why You Have Bad Posture and How To Make It Better, I discuss in detail what is termed Upper Crossed Syndrome – a forward head posture leading to stiffness in certain muscles and weakness in others. It has been shown that people presenting with Upper Crossed Syndrome frequently show evidence of an increased thoracic kyphosis15,16.

For exercises specific to improving Upper Crossed Syndrome, check out the eBook here.

Want more evidence?

Multiple studies have demonstrated that thoracic manipulation can significantly decrease shoulder pain and improve function – even showing improvements in shoulder range of motion and strength17,18,19,20,21.

A study by Cleland, et al. showed that short-term Lower Trapezius strength can improve by 14% after manipulation to the thoracic spine – and this is in asymptomatic individuals (people without pain)22.

Although I’m not teaching you how to manipulate your own spine, you can implement some exercise techniques to help improve thoracic mobility. Restoring this mobility can then lead to better shoulder function.

Now, let’s get to the exercises…

Thoracic Mobility Exercises

Here are a few instructional videos of some simple thoracic mobility exercises you can do just about anywhere.

I’d recommend incorporating one or all of them into your exercise or stretch routine on a regular basis.

  1. Thoracic Extensions on a Foam Roll

 

2. Quadruped Thoracic Rotations

 

3. Dynamic Thoracic Extension against a wall

 

Question: What other exercises have you found to improve thoracic mobility? You can leave a comment by clicking here.

  1. O’Gorman H, Jull G. Thoracic Kyphosis and mobility: the effect of age. Physiotherapy Practice. 1987;3:154-162. ↩︎
  2. Twomey L, Taylor J. Sagittal and horizontal plane movement of the human lumbar vertebral column in cadavers and in the living. Rheumatology and Rehabilitation. 1980;19:223-232. ↩︎
  3. Widhe T. Spine: posture, mobility and pain. A longitudinal study from childhood to adolescence. Eur Spine J. 2001;10:118-123. ↩︎
  4. Wainner RS, Whitman JM, Cleland JA, Flynn TW. Regional interdependence: a musculoskeletal examination model whose time has come. J Orthop Sports Phys Ther 2007;37:658–60. ↩︎
  5. Cleland J, et al. Development of a clinical prediction rule for guiding treatment of a subgroup of patients with neck pain: use of thoracic spine manipulation, exercise, and patient education. Phys Ther. 2007;87(1):9-23. ↩︎
  6. Norlander S, Nordgren B. Clinical symptoms related to musculoskeletal neck-shoulder pain and mobility in the cervico-thoracic spine. Scand J Rehabil Med. 1998;30:243-251. ↩︎
  7. Adams G, Sim J. A survey of UK manual therapists’ practice of and attitudes towards manipulation and its complications. Physiother Res Int. 1998;3:206-227. ↩︎
  8. Hollingshead WH, Jenkins DB 1981 Functional anatomy of the limbs and back. WB Saunders, Philadelphia ↩︎
  9. Bowling RW, Rocker PA, Erhard R 1986 Examination of the shoulder complex. Physical Therapy 66: 1866-1877 ↩︎
  10. Chapman L 1986 Manual techniques for the thoracic spine. In: Grieve GP (ed.) Modern manual therapy for the vertebral column. Churchill Livingstone, Edinburgh ↩︎
  11. Bowling RW, Rocker PA, Erhard R 1986 Examination of the shoulder complex. Physical Therapy 66: 1866-1877 ↩︎
  12. Crosbie J, Kilbreath SL, Hollmann L, York S. Scapulohumeral rhythm and associated spinal motion. Clin Biomech 2008;23:184–92. ↩︎
  13. Theodoridis D, Ruston S. The effect of shoulder movements on thoracic spine 3D motion. Clin Biomech 2002;17:418–21. ↩︎
  14. Crawford H, Jull G. The influence of thoracic posture and movement on range of arm elevation. Physiother Theory Pract. 1993;9: 143–8. ↩︎
  15. Janda V. Evaluation of muscular imbalance. In: Liebenson C. Rehabilitation of the Spine: A Practitioner’s Manual. Baltimore: Williams and Wilkins, 1996. Pages 97-112. ↩︎
  16. Janda V. Muscles and motor control in cervicogenic disorders assessment and management. In: Grant R. Physical Therapy of the Cervical and Thoracic Spine, 2nd ed. New York: Churchill Livingstone, 1994. Pages 195-216. ↩︎
  17. Bang MD, Deyle GD. Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther 2000;30:126–37. ↩︎
  18. Bergman GJ, Winters JC, Groenier KH, Meyboom-de Jong B, Postema K, van der Heijden GJ. Manipulative therapy in addition to usual care for patients with shoulder complaints: results of physical examination outcomes in a randomized controlled trial. J Manipulative Physiol Ther 2010;33:96–101. ↩︎
  19. Boyles RE, Ritland BM, Miracle BM, Barclay DM, Faul MS, Moore JH, et al. The short-term effects of thoracic spine thrust manipulation on patients with shoulder impingement syndrome. Man Ther 2009;14:375–80. ↩︎
  20. Strunce JB, Walker MJ, Boyles RE, Young BA. The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain. J Man Manip Ther 2009;17:230–6. ↩︎
  21. Winters JC, Jorritsma W, Groenier KH, Sobel JS, Meyboomde Jong B, Arendzen HJ. Treatment of shoulder complaints in general practice: long term results of a randomised, single blind study comparing physiotherapy, manipulation, and corticosteroid injection. BMJ 1999;318:1395–6. ↩︎
  22. Cleland J, et al. Short-term effects of thoracic manipulation on lower trapezius muscle strength. The Journal of Manual & Manipulative Therapy. 2004;12(2):82-90. ↩︎

 

 

Get Your FREE eBook!
Why You Have Bad Posture and How To Make It Better
In addition, I'll send you one email per week with a link to new content. No Spam, I promise

Please note: I reserve the right to delete comments that are offensive or off-topic.

  • jo lo

    That s great idea and research. Just wondering how can you focus more on upper thoracic spine mobility?

    • Michael Curtis

      Mobilizing the upper thoracic spine is a bit more difficult on your own. Here are couple ideas:
      -lie with your back on a lacrosse Ball to the left of your spine to mobilize segment by segment. You can do this by moving your arm up and down as you lie on the ball. Then repeat on the other side.
      -lie with the foam roller on your upper thoracic spine and do repeated chin tucks.
      -lie face down holding a stick in an overhead position. Raise the stick off the ground slowly as high as you can. Repeat until you fatigue. This will engage your lower traps which can help facilitate thoracic extension and vice Versa

      • jo lo

        thank you!
        for the first one is it more of a rotation on each segment?

        • Michael Curtis

          Yes it has a rotation component to it, but also a posterior to anterior directed mobilization. This can also be done with two lacrosse balls taped together or in a sock, one on either side of the spine if you want.

          • jo lo

            Is that more or an extension movement?
            how can i specify rotation a bit more?

          • Michael Curtis

            Both. In the post I talk about how Shoulder elevation (flexion) requires thoracic extension, rotation, and side bend. It might be difficult to isolate pure rotation. Another idea might be to use that lacrosse Ball on the left upper thoracic segments with right neck rotation (then repeat on other side). The thoracic and cervical spine work together to facilitate cervical rotation.

          • jo lo

            Good idea thanks!! You know people always crack their necks or back themselves and feel much better after that. And I was told that if they crack their joint themselves, it making one level hypermobile and the level below hypomobile and that it’s not good for the cartilage in the joint. What ‘s your view on that?

          • Michael Curtis

            Check out this post I recently wrote on the topic: https://www.michaelcurtispt.com/cracking-joints/

  • Pingback: Mid Back Mobility & How It Also Affects Your Shoulders and Neck | Dr Jason Drivere()

  • Karen Atkins

    Hi Michael, Love this article and your tips. Wanted to see if you have heard of or tried a product I created, The Original Worm. It combines the benefits of therapy balls with a foam roller and has been very effective for increasing mobility in the thoracic spine and neck areas. If you have a minute, please check out http://www.theoriginalworm.com and let me know if you are interested in a sample. Sorry for the plug, just thought it was relevant and could be helpful to your patients.

    • Michael Curtis

      Thank you Karen! Checked out the worm and it looks very cool! Seems like it would have great benefits for myofascial release in a variety of body regions. I’d love to try it!

  • Betsy

    Postural Restoration Institute techniques to improve thoracic mobility and rib IR/ER via improving diaphragm position and function which improves scapulothoracic and thus glenohumeral function.