Updated: Feb 1, 2019

Let's face it, we all do it. We sit for periods of time in less than optimal positions and posture. Some more than others. This can and will lead to muscular restrictions, weaknesses, discomfort, pain and eventually you get injured.

We see this common issue everyday. This is especially prevalent in our upper-back...aka thoracic spine (t-spine).

"The thoracic spine is comprised of twelve vertebral bodies (T1-T12) that make up the mid-region of the spine. This section of the spine has a kyphotic curve (C-shape). The firm attachment to the rib cage at each level of the thoracic spine provides stability and structural support and allows very little motion, which means that thoracic disc injuries are rare. However, irritation of the large back and shoulder muscles or joint dysfunction in the upper back can be very painful." (

That said, the T-spine needs movement and stability. If you don't, I can almost guarantee you will experience discomfort followed by pain and eventually injury if preventive measures aren't implemented.

There seems to be a common theme across the "general population" as far as the T-spine. Lack of mobility, stability and strength due to everyday life and inactivity.

This is a recipe for disaster.

We need to minimize your "motor control gap".

Your "motor control gap" is your passive range of motion minus your AUTHENTIC active range of motion. Minimizing this "gap" is what truly reduces the likely-hood of injury.

This is also what will keep you orthopedically healthy for years to come.

Here is a series of strategically programmed Self-myofacial release (SMR) techniques, mobilizations, corrective exercises, activation drills and stability exercises to keep you moving or get you moving pain-free again.

This can be be Incorporated daily if you have restrictions/dysfunctions through your T-spine.

(contact us for a individualized program to correct your dysfunctions/aches/pains)

***This is a general template that can help most individuals with above mentioned dysfunctions*** everyone will be a little different.

1) Start with SMR (foam rolling) work. Spend 1-2 minutes rolling up and down the spine as shown. Finish with 5-10 extensions (arching) through the upper back as demonstrated.

-Maintain tension through your core and take your time.

- Go "hunting" for trigger points. AKA area that are tender. Spend a little more time in the areas that feel tender. These are neuromuscular trigger points, which can be simply defined as areas with higher spontaneous electrical activity that causes that region to become tighter than the others adjacent.

2) Bi- phasic Stretching

We are going into 30-45 seconds of oscillating back and forth with a 15-30 second end range stretch. Ensure you are actively creating tension throughout your body here; Core, glutes and pecs. We want to create stability and maintain this throughout the entire duration of the stretch. That means that this stretching phase should take 1-3 minutes to complete.

Try 2 sets of this novel stretch that you probably haven't incorporated before.

3) Corrective exercise

The goal is to be very mindful here. Set a timer for 1 minute and get both sides in for a total of 2 minutes.

We don't want to be worried about counting reps. It's easy to be passive and go through the motions. We have all done it, so don't!

Focus on rotation through your upper back without compensating and reaching out with just your arm. There is a big difference between getting that last little bit if rotation through your t-spine and just cranking through the front of your shoulder. Be very mindful with your movements.

4) Stability based activation

This activation drill gets butchered A LOT. SO, be very mindful here as well. You should feel your upper-back muscles on fire my the end and maybe a stretch through the pecs as you come up and over your head, depending on how restricted you are. You should just feel the back of the shoulder with the last two drills (pull-apart and the banded face pull-apart).

You should not feel this in the front of the shoulder if you are doing them right. If you are, try a lighter band or reach out to us for some guidance.

I like to have clients think about moving their shoulder blades only in this movement, the arms just come along for the ride.

I know. It sounds crazy, but it works. When you lift or move your arms, your scapula (shoulder blade) needs to move synergistically with the humerus as well. Most individuals don't know how to move optimally. This is how shoulder dysfunctions start and how injuries happen.

Get a light band and let's get those shoulder blades moving and let's strategically activate the those dormant muscles in your upper-back.

Follow the sequence in the video.

Shoot for 2-3 sets of 10 reps each (total 30)

5) Movement Pattern Integration

Yoga Push-up

We are bringing everything together here as we build up to this point.

Try 3 sets of 8 quality reps here. Again, with everything try and be mind full.

- Maintain core tension (especially as we straighten out with each rep and resist extension of the low back)

- Push all the way through (upward rotation of the scapula)

- If you feel you are strong and stable enough you can do a full push-up then come up into the downward-dog position. But ONLY if they are quality push-ups. We don't want to destroy the work we did earlier in this sequence :)

6) Central Nervous System Stimulation (CNS)

Chaos carry

Here is a great way to functionally end this Thoracic spine deficit sequential warm-up.

Grab a couple of KB's or Plates and attach them to a resistance band. Let's get walking!

We are trying to maintain tension through our upper-back, core and hips as we walk with unstable load.

Again (last time), be MINDFUL! This is not about carrying the heaviest weight you can. We want to increase stability, neuromuscular activity, and proprioception (our bodies awareness is space)

So let's take preventative measures and keep you away from Physical Therapy and training for life long longevity, strength and fitness sustainability.

Don't get me wrong, I love my wife (physical therapist) and she is the best at what she does but nobody wants to spend months on end in Physical Therapy.

Lawrence Lee

Functional Movement Specialist

Lee Physical Therapy & Wellness

Larry is a Functional Movement Specialist located in Greene County, Ny. His primary focus is working both online and in-person with the general fitness population as well as post physical therapy patients to continue their rehab and gain back pain free function and strength into their life. Larry's passion is focused on enhancing overall quality of life and pain free performance for each and every one of his clients.


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