top of page
  • Writer's pictureCoach Matt Pippin

How to Use Thoracic Rotation for Upper Back Pain Relief

How to relieve upper back pain

Are you constantly experiencing pain or tightness in the upper back? Whether it’s first thing in the morning when you wake up, when you get out of the car, or after a workout, you are not alone in searching for a way to kick this pesky pain to the curb.

And just like so many, you’ve probably tried any of the following to make it go away:

  • Looked up postural exercises or bought gadgets that zap you when you slouch

  • Spent way too much of your morning foam rolling your upper back, just to get 5 minutes of relief

  • Googled everything "upper back pain" and thought “Am I cursed?!”

  • Started experimenting with strange upper back stretches

  • Repeat with zero permanent change

I’ve been there more times than I care to admit. Unfortunately, all of the above is not going to get to the root of your upper back pain and tightness. That’s because you're missing one crucial movement from your routine… thoracic rotation.

If you’re ready to get off the merry-go-round of upper back pain and doing the same things over and over again with no change, then keep reading because I’m going to show you how to use thoracic rotation to relieve your upper back pain for good. Plus, you’ll learn about all of the amazing benefits of having a mobile upper back that can rotate so you can be unstoppable.


I try to reiterate this in all of my coaching, which is, our bodies are meant to move and when that movement stops, or we stop using certain tissue and joints the way they were meant to, problems arise. That ultimately is at the root of your upper back pain and there are three big contributors.

Reason #1: Too Much Sitting

Most people think that sitting is the main reason why the upper back becomes locked up and it definitely plays a role but isn't the only reason. Sitting is problematic because it can cause all of the tissue in your upper back to tighten up if you're doing for hours on end. Have you ever stood up after a couple of hours at your desk and felt that snap, crackle, pop as you stretch out?

Reason #2: Pulling Shoulders Down and Back

Another key reason for your stiff upper back is a cue every coach has used way too much… pull those shoulder blades down and back. If you’ve ever worked with a trainer or strength coach, I guarantee you’ve heard this. I used it pretty much 3-4 times per hour, every hour, for 20 years of coaching!

Why is this not the best approach? To keep it simple, the scapula (aka your shoulder blades) must move all over the place, and if you’re always focused on pulling them down and back, they’ll lose the ability to move in every other direction that they're meant to.

Reason #3: Lack of Variety in Movement

Last but definitely not least, a key factor causing your upper back pain that most don’t think about, is that when hitting the gym, almost everyone does their exercises in the same plane of motion. This means either doing exercises that have you moving from side to side (frontal plane), or moving front to back (sagittal plane).

But there's a third plane we're meant to move in, which is rotation (transverse plane) and rotation in your upper back (thoracic rotation) is what most are missing. Think about it, when was the last time you incorporated rotation in your workout? I can't stress enough how important variety in your movement is, especially rotation.

Let's look at a bench, row, pull-up, squat, deadlift, lunge, and pretty much every machine in the gym. Ever notice how none of these asks the body to rotate? That’s a huge problem, especially if your job asks you to sit all day, and then you go to the gym and keep hammering this same non-rotating position.

Seeing a pattern here? You have to move your body in all of the ways it was meant to move. With prolonged sitting, the rigid scapula alignment we’re taught to lift in, and the gym exercises that neglect rotation, it’s no wonder we’re all knotted up!

Improving your thoracic rotation is going to give you major results for relieving upper back pain so let's dive in and focus on how you can make it work for you.


Thoracic rotation is where the vertebras that begin just below the neck and all the way down to just above your lower back, rotate side to side. This is your thoracic spine and it is connected to the tissue of your upper back.

What is the thoracic spine?

Imagine you have a heart rate monitor on and your sternum is a flashlight. You want that flashlight to move everything above your heart rate monitor back and forth without your belly button moving. That's thoracic rotation and if this part of your spine loses this rotational ability, the upper back will inevitably become locked up.


Even if my clients aren't dealing with upper back pain, we still work on thoracic rotation and many times as we're working on these exercises they ask “Why do we work on this stuff so much?” I of course respond with… “So glad you asked, and strap in because it’s a great list!”

Improving thoracic rotation and your upper back mobility helps to:

  • Improve shoulder mobility (your shoulder is connected to your thoracic spine so it makes sense that in order for a shoulder to move, the upper back has to be able to move as well)

  • Reduce chance of injury for those that do conventional lifting of the upper body (if you can’t move while doing exercises like bench press, deadlifts, squats, etc., and you add load, injuries will soon follow)

  • Mobilize the upper back for those who sit at computers all day (no one wants to look all hunched over)

  • Enhance performance for any sport that requires rotation and change of direction (pretty much everything; running, golf, basketball, tennis, etc…)

  • Increase breathing mechanics (your upper back must be able to expand during inhalation)

Watch anyone who moves well in a sport and I guarantee you that their upper back can flex, extend and most importantly rotate.


Some other issues that may arise when your thoracic spine doesn't rotate are:

  • Tight shoulders, neck, shoulder blade, and traps

  • Limited overhead flexibility (ever seen someone try to put their luggage in the overhead compartment on a plane?)

  • Low back pain

  • The last one is a big problem for my golfers. If your upper back can’t rotate, the body will find the rotation from somewhere else and this usually leads to nasty lower back problems.


When relieving upper back pain, the most important thing we have to do is teach the thoracic spine how to rotate. The easiest way to do that is in the seated position. This allows us to not use the lower back by using a block, but we can also immobilize the neck as well so we’re only hammering thoracic spine.

I'm sure you’ve already done a million thoracic rotation drills before, but I bet they were missing one important component: Thoracic rotation works best when your upper back is slightly flexed forward, like a baby abdominal crunch.

thoracic rotation from a seated position

Before you freak out on me and send angry emails with "Why would I round my back if I have upper back pain?! Are you crazy?!" you need to understand that the thoracic spine is meant to have a little bit of forward flexion (aka be rounded), and this allows us to get more rotation in the upper back.

You can hammer all those thoracic rotation drills you want, but if you’re not doing if from a flexed position, you’re reaping the full benefits and pain relief.


In the video below I give you everything you need to start isolating thoracic rotation from a slightly flexed position. Start out with 2 sets of 15 reps each direction.

Compensations to Avoid

You will probably feel very limited in the beginning when doing this and try your best to avoid these common compensations:

  • Leaning side to side

  • Moving your head

  • Moving your butt side to side

Just be aware as you move and adjust if you notice any of these happening. Also, watch yourself to make sure you’re always staying slightly flexed. As you get tired the sternum will want to start coming up.

Equipment Needed

To do this thoracic rotation exercise, you will need the following:

  • A non-rolling chair

  • Something to squeeze between your thighs like a yoga block, pillow or foam roller.


For even more of my favorite mobility exercises to bulletproof your body, click the link below where you can get my 3 must-have mobility moves for free. Once you try them, you’ll see why they’re my all-time favorite.


* I am an Amazon Associate and earn from qualifying purchases with some of the links on this blog.



Matt is a Strength and Mobility Coach with over 15 years experience in his field and has coached over a thousand professional, collegiate and everyday athletes with the goal to help them move, feel and perform at their highest level. He's incredibly passionate about bringing simple and effective online mobility training programs to everyone who wants to take control of their self care and make lasting change. CLICK HERE to learn more.


  • NSCA Certified Strength and Conditioning Specialist

  • Level 3: Fascial Stretch Specialist

  • Level 1: Institute of Motion Health Coach

  • Certified FRC Mobility Specialist (FRCms)

  • Level 1 Kinstretch Instructor

  • Weck Method Qualified


bottom of page