With age, mobility in the thoracic spine—the mid-region of the back—tends to decrease, especially for those who spend long periods sitting or maintaining static postures (such as when sitting at a desk or during long drives/flights). This reduced mobility can contribute to a range of problems including neck, shoulder, and even lower back issues further down the chain. The positive news is that specific actions and exercises can help restore and preserve thoracic spine flexibility even in those with years of immobility. 

What is the thoracic spine?

The thoracic spine is comprised of twelve vertebrae located in the center of your back, each connecting to the rib cage. This region enables roughly 80% of trunk rotation and plays an important role in neck movement. The ability to extend through the thoracic spine is crucial for the health and function of the neck, shoulders, and upper extremities. Adequate mobility in this area matters not only for sports involving rotation, like golf, tennis/pickleball, frisbee, but also for everyday actions such as walking, running, turning your head, and checking your blind spot while driving. 

When thoracic mobility decreases, the surrounding areas—the neck, shoulders, and lower back—often compensate, which can lead to overstrain, movement dysfunctions, and eventually pain. A stiff thoracic spine also limits the efficiency of your upper body by removing a stable base for the neck and shoulders, increasing the risk of pain and restricted movement over time. This is why physical therapists often assess the thoracic spine first when patients report pain in these neighboring areas. 

In fact, a randomized controlled study published in 2020 investigated the effects of combining thoracic spine mobilization with thoracic extension exercises in patients suffering from sub-acromial impingement syndrome—a common cause of shoulder pain. Participants who received thoracic mobilization and extension exercises showed significant improvements in thoracic alignment, improvements in shoulder function (including increased shoulder flexion range of motion and reduced pain and disability), and demonstrated better scapular (aka shoulder blade) positioning and movement efficiency leading to reduced impingement symptoms.

Furthermore another study explored the concept of regional interdependence, which suggests that dysfunction in one area of the body (e.g., the thoracic spine) can contribute to pain or dysfunction in another (e.g., the shoulder). Specifically, it examined how thoracic spine manipulation impacts shoulder pain and dysfunction. Thoracic spinal manipulation resulted in significant short-term improvements in shoulder pain, range of motion, and function. The study supports the idea that improving mobility and alignment in the thoracic spine can positively affect shoulder symptoms, likely due to improved biomechanics and load distribution.

So what can I do to improve my thoracic mobility?

-Visiting your physical therapist at Beacon Physical Therapy (contact us) is definitely a good idea to identify specific locations in your thoracic spine that need to be addressed, but if you can’t get in to see them right away, you can try a few things at home first to help free up your thoracic spine..here are some of our favorites: 

1. Cat Stretch, (Latissimus Dorsi Stretch)
2. Seated Thoracic Rotation
3. Thoracic extension over a foam roller 
4. Side Lying Arm Circles
5. Spider-man
   

The bottom line is, taking care of your thoracic spine will give you benefits for years to come, and if consistent, can likely improve your shoulder pain. 

References:

-Park, S. J., Kim, S. H., & Kim, S. H. (2020). Effects of thoracic mobilization and extension exercise on thoracic alignment and shoulder function in patients with subacromial impingement syndrome: A randomized controlled pilot study. Healthcare (Basel), 8(3), 316. https://doi.org/10.3390/healthcare8030316

-Park, S. J., Kim, S. H., & Kim, S. H. (2020). Effects of thoracic mobilization and extension exercise on thoracic alignment and shoulder function in patients with subacromial impingement syndrome: A randomized controlled pilot study. Healthcare (Basel), 8(3), 316. https://doi.org/10.3390/healthcare8030316