My Top 3 Thoracic Spine Mobility Exercises

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!


Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.
Jesse AwenusVoice post by: Jesse Awenus

Jesse is a practising physiotherapist in Toronto, Canada. He holds an undergraduate degree in Kinesiology and Exercise Science from York University and Masters of Physical Therapy degree from Queen's University. He holds certifications through Titleist as a Golf Fitness Instructor (TPI-CFI), Selective Functional Movement Assessment (SFMA), and holds an intermediate diploma of advanced manual and manipulative therapy through the Orthopaedic Division of the CPA. He has training in acupuncture, the McKenzie Method for back pain, and soft tissue release as well.
Jesse is a hands on therapist that seeks to figure out why someone develops pain and then builds strategies to make the patient an active participant in their recovery. He uses skilled manual therapy, corrective exercise, and informative patient education to help clients manage their conditions to the best of their ability.
Jesse currently works at a very well respected multidisciplinary clinic in Toronto that has sports doctors, physiatrists, naturopaths, massage therapists, physiotherapists, chiropractors, chiropodists and pilates/yoga instructors all under one ruff.
To find out more you can visit their website at:


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  3. This site was… how do you say it? Relevant!!
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  5. back pain says:

    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!

  6. Rita D'Alvarez says:

    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!

  7. 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.

  8. Hi all, thanks for your interest. I’m not sure why the videos won’t play here. You can view all the videos at the following link. Sorry for the confusion!

  9. 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

  10. Monica Tanaka Monica Tanaka says:

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

  11. 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

  12. 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.

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