My Top 3 Thoracic Spine Mobility Exercises

Research as shown that manipulation to the thoracic spine can be beneficial for neck and shoulder pain (see articles HERE  an HERE). So it only stands to reason that improving mobility at this crucial area of the spine can be helpful for a large group of orthopaedic complaints. Neurophysiological rational aside, getting more ROM through the thoracic spine has impact on areas upstream and downstream the body. If we look at the joint by joint approach, we see that the the cervical and lumbar spine are primarily designated areas of stability (sort of…), and the thoracic spine is the mobile area of the spine (again, kind of…). If we develop stiffness in the upper back, common sense tells that the areas above and below will have to compensate to achieve functional ROM. This is why so many people who drive a lot get neck pain…if you’re torquing out your neck to look at your blind spot because you can’t rotate through your upper back you will get neck pain.

I will be honest in saying that 99% of the people I treat will have their upper back mobility assessed via the SFMA model to some degree. Plantar fascists, PFPS, carpal tunnel…they all get their spinal mobility looked at. I may not always address it right away but it will be looked at. I just think it’s good clinical practice to get an overall sense of how someone moves and try to find non-painful dysfunctions before I jump into treating the painful area (yes, I treat the site of pain…and so should you!)

Here is a BRIEF video explaining how I assess upper back ROM using an SFMA framework.

For clients who have persistent lower back, neck or shoulder problems I usually send them home with at least one of these 3 exercises depending on what I find as being the biggest problem and what the patient can effectively do on their own. These are exercises that help maintain the gains made in therapy and for the most part, clients actually report the exercises “feel good” to do…which helps with compliance.

1) Open Books

2) Quadruped (on all 4′s) thoracic rotations with variations

3) Foam Roller Thoracic Extensions

I’m always looking for better and easier exercises that patients will like doing and that will help them with their chief complaint. I have had success with these 3 and hope to learn many more as time goes on. I hope these help you in your clinical practice. Please share what upper back exercises you like giving your clients as the best way to learn is through sharing knowledge.

Thanks for reading!


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October 4, 2014 at 3:00 am

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back pain
July 9, 2015 at 11:15 pm

I can’t get last 2 videos to play…the first stretch felt great and I really want to see what other suggestions you have! Thanks so much!

Rita D'Alvarez
Rita D'Alvarez
February 4, 2016 at 2:51 pm

I also cannot get the last two videos to play. I get an error message directing me to try again late but later doesn’t work either. I really found the first two very helpful. I watched several on the internet but your’s is the simplest and require no equipment. Thank you for a helpful video!

Rachael Lowe

Hi Rita, sorry we’re not sure what the problem is with those videos, we will contact the author to see if he can correct it.

June 29, 2016 at 6:19 pm

Would be great to actually see the stretches in that first video, camera is pointed anywhere else but on him.. also volume is too low, connected to speakers that are on max – can still barely hear anything

Monica Tanaka
Monica Tanaka
June 30, 2016 at 5:22 pm

Hi Andrea – We’re sorry you’re having trouble viewing the videos. We’ll be sure to pass on your comments to the author.

June 19, 2017 at 9:51 am

Thanks for sharing – My physio colleague forwarded me your videos as I have been suffering with mid thoracic pain and we have been going over SFMA and manipulations together (I am an osteopath in the UK) . Your video was very relevant in bringing it all together. I especially like the exercises you have given. They are both personally and professionally very effective. Thank You

July 13, 2017 at 4:41 pm

Weird. For “mobilization of the thoracic spine” my physio told me to stand against a wall, bend my knees slightly, flatten my shoulders/back against the wall with my arms raised, and then flatten my “lumbar lordosis”. I get incredibly frustrated trying the exercise – I say try because cant seem to get my back to flatten like the instructions/diagram show. I’ve been looking for info online as to why, but now I’m finding different exercises like the ones on this page that that I didn’t even know about. I’m now wondering if I’m wasting my money… So frustrating because I don’t know how any of this stuff works or what half the anatomy terminology means, and I don’t know who to trust to boot. I really hope phsyios understand how frustration leads to noncompliance – not being able to do/understand something that looks simple brings on a huge sense of failure.

September 26, 2017 at 6:32 pm

hello, i wonder if this is only for decompresion and a little bit of movement in the spine or does it also help you to gain better posture.

September 27, 2017 at 10:10 pm

I have pain on the thoracic spine. Spurs on vertebrae 7-11.
As soon as I wake up and move around my pain starts. Today I was looking on YouTube and found my top three thoracic mobility exercises.
I am 75 1/2 years old and and I have always exercise but since I have this pain I cannnot do arms weights. I follow your open book movement and in just one time I felt better. I am going to this daily or maybe twice a day from now on. Amazing! The only thing that stopped the pain was cortisone shots. Thank you!

October 29, 2017 at 6:36 pm

Dear Jesse,
Thank you for these exercises. I live in the UK and have seen numerous physios and osteos and chiros for restricted thoracic mobility and pain following an accident, yet no-one has shown any level of knowledge close to this to help me (and I have spent loads of money for someone, anyone to help me!).

Thank you so much.

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