The thoracic spine, also known as the T-spine, is the area of the back between the neck and the lumbar spine (lower back). This area often becomes stiff, which can lead to compensations in other areas, namely the neck and the lower back.

It’s beneficial for runners to maintain good thoracic spine health. This can help with supporting good running posture, running mechanics, and efficient breathing. Plus, having a healthy spine will ensure you feel better in your everyday life. It’s a win-win situation!

In this article, we’ll go over some basic anatomy and function of the T-spine, why it’s important for runners, and some exercises you can integrate into your routine to work on this area.

Click here to skip directly ahead to the exercises!

Understanding the Thoracic Spine

Anatomy of the Thoracic Spine

The thoracic spine consists of 12 vertebrae labeled T1 to T12. T1 is at the top of the T-spine and T12 is at the bottom. The ribs are also an integral part of the thoracic spine as they connect to these vertebrae.

Structure and Function of the Thoracic Spine

The T-spine fills in some key roles for our bodies; here are the main ones:

• Provides stability and support as it is less mobile than the neck and the lower back.

• Protects the spinal cord.

• Protects our vital organs like the heart and the lungs due to the ribcage.

• Contributes to proper breathing mechanics via the ribs.

The T-spine is composed of many parts, including:

• Bones (vertebrae, ribs, sternum)

• Joints

• Discs

• Nerves

• Ligaments

• Muscles

It’s important to note that the thoracic vertebrae are large and thick compared to those in the neck. This helps provide more stability and support.

Importance of the Thoracic Spine in Running

An injury to the thoracic spine is not usually likely to happen while running. However, if runners have limitations of their T-spine, this can affect their running.

The most common issues with the thoracic spine that will affect runners are the following:

• Poor posture

• Limited mobility

• Recovering from an injury to the thoracic spine (e.g.: broken ribs)

We mentioned that the thoracic spine assists in proper breathing mechanics, running mechanics, and posture. If the T-Spine becomes stiff and/or painful, this can directly impact running efficiency.

Let’s dive deeper into each of these important aspects of the thoracic spine.

Breathing Mechanics

When we breathe in, our rib cage needs to expand to let air in. A stiff thoracic spine could impact this ability, affecting breathing mechanics. Some patients describe this as feeling “stuck” or “unable to take deep breaths.”

If you have felt this before, working on your thoracic mobility could help alleviate this feeling. Better thoracic movement will allow your ribs to move more freely and facilitate effective and deeper breathing, which is essential for runners.

Efficient Running Mechanics at the T-spine

If you look at a runner from the front, you can observe that when the T-spine rotates to the right, the pelvis rotates to the left.

The thoracic spine and the pelvis need to coordinate these opposite movements as we run (Preece et al., 2016). This contributes to propelling us forward.

If the thoracic spine is stiff or painful, this propelling motion might not be as efficient. Another consequence could be that the load is transferred to another part of the spine, such as the lower back. This could potentially increase stress for tissues in the lower back leading to pain or discomfort in this area.

Maintaining Optimal Posture

Nobody has perfect posture all the time. However, certain aspects of our posture can improve running efficiency.

One aspect of our posture that involves the thoracic spine is forward trunk lean. This describes how much a runner leans their trunk forward as they run.

Ideally, we want to limit this forward trunk lean as much as possible. Research tells us that forward trunk lean is associated with increased injuries in runners (Bramah et al., 2018).

Assessing Your Thoracic Spine Mobility

So how do we know if our thoracic spine needs some mobility work?

The first thing I will say is that preventative measures are always encouraged. Even if you don’t have pain or stiffness in this area, it’s still a good idea to include some mobility work a few times per week into your routine.

If you are experiencing stiffness in this area, you may need to work more consistently on your T-Spine strength and mobility.

Here are two simple tests you can perform at home to assess your thoracic range of motion. One is for extension, and one is for rotation of the T-spine. These are the most important movements when it concerns running. They are also often the ones that are the most limited for this part of the spine.

Rotation of the T-Spine

How to do it:

• Sit on a chair with your feet flat on the floor.  

• Keep your back straight and your shoulders relaxed.

• Cross your arms over your chest: place your right hand on your left shoulder and your left hand on your right shoulder.

• Keeping your hips stable and facing forward, slowly rotate your upper body to the right as far as possible.

• Assess the range of motion: ideally, you should be able to rotate to about 45 degrees to each side without excessive effort or discomfort. I recommend taking a picture or asking someone to look at the range for you.

• Note any stiffness or discomfort.

• Compare with the other side.

*Important to note: The range of motion of the T-spine in rotation varies greatly between studies. 45 degrees of rotation is an average and the range can differ from person to person (Borkowski et al., 2016). What’s important is to assess how it feels (restricted, stiff, or painful) and to compare both sides.

Extension of the T-Spine

How to do it:

• Sit on the floor with your knees bent.

• Place the seat of a chair or the base of a couch at mid-back level.

• Keep your back straight and your shoulders relaxed.

• Cross your arms over your chest: place your right hand on your left shoulder and your left hand on your right shoulder.

• Keeping your chin tucked in, slowly arch your back to extend it over the chair.

• Assess the range of motion: ideally, you should be able to extend about 10 to 20 degrees past a vertical line. I recommend taking a picture or asking someone to look at the range for you.

• Note any stiffness or discomfort.

*Important to note: The range of motion of the T-spine in extension also varies greatly between studies and decreases with age. Studies have found the range of motion in extension of the T-spine to be about 11 degrees in a seated position while others found it to range between 20 to 40 degrees (Edmondston et al., 2011).

Just like mentioned for the rotation, these numbers are an average, and the range can differ from person to person. What’s important is to assess how it feels (restricted, stiff, or painful).

Exercises to Improve Thoracic Spine Health

Rotation Exercises

If your main limitation was in thoracic rotation, I recommend these two simple exercises:

Watch the video first right here T-Spine Rotation Exercises.

The goal is to work on mobility first and then follow it up with some strength in that newfound range.

1)    Thoracic Rotation in a Split Stance (mobility)

How to do it:

• Take a split stance next to a wall.

• The leg closest to the wall has a slightly bent knee. The knee is over your ankle joint.

• The back leg (the one further away from the wall) is extended and you are pushing off your toes.

• Rest your arm furthest away from the wall on the thigh closest to the wall.

• Start rotating your arm closest to the wall in a circle.

• Your upper back will move into rotation.

• Repeat 10 times and switch sides.

• Do 2 sets of 10 repetitions on each side.

2)    Thoracic Rotation with Band Pulls (strengthening)

How to do it:

• Tie an elastic band so that it’s at the height of your hands with arms outstretched in front of you.

• Take a split stance.

• Start pulling the band away from where it’s anchored into rotation.

• Control the movement in both directions.

• Repeat 15 times and switch sides.

• Do 2 sets of 15 repetitions on each side.    

Extension Exercises

If your main limitation was in thoracic extension, I recommend these two simple exercises:

Watch the video first right here  T-Spine Extension Exercises.

The goal is to work on mobility first and then follow it up with some strength in that newfound range.

1)    Kneeling Thoracic Extensions (mobility)

How to do it:

• Kneel on the floor with your knees hip-width apart.

• Place a chair or bench in front of you at arm’s length.

• Bend your elbows at about 90 degrees and rest them on the chair or bench with palms facing each other.

• Your elbows should be shoulder-width apart.

• Ensure your back is straight and your hips are directly above your knees.

• Slowly lower your chest towards the floor by bending at the thoracic spine (mid-back). Keep your neck in a neutral position.

• As you lower, aim to increase the arch in your upper back while keeping your lower back and hips stable.

• Slowly return to the starting position.

• Repeat for 10 repetitions. Take a break before performing another set. (2 sets of 10 repetitions)

2)    Wall Angels (Strengthening)

How to do it:

• Sit on the floor with bent knees and your back against a wall.

• Press your lower back, upper back, and head firmly against the wall.

• Raise your arms to form a 90-degree angle at your elbows, resembling a “W” shape. Your elbows and the backs of your hands should be in contact with the wall.

• Slowly and smoothly slide your arms up the wall into a “Y” position, keeping your elbows and hands in contact with the wall. This movement mimics the shape of a snow angel.

• As you reach the top of the movement, strive to fully extend your arms while keeping them in contact with the wall.

• Slowly return your arms to the starting “W” position by sliding them back down the wall as you squeeze your shoulder blades down and back.

• Focus on maintaining contact with the wall and engaging your upper back muscles throughout the exercise.

• Do 15 repetitions. Take a break before performing another set. (2 sets of 15 repetitions)

Integrating Thoracic Spine Exercises into Your Routine

If you found that you had significant restrictions in your thoracic spine, I would recommend doing these exercises more frequently to improve your range of motion. Aim to perform these 5 times per week.

If your goal is more maintenance or preventative, you can do these exercises once or twice per week.

You can include them in your regular mobility routine if you have one. You can also do these as part of your warm-up or as standalone exercises.

After working on your thoracic mobility for a few weeks, try to re-assess your range of motion with the simple tests presented above. If you were consistent with the exercise, you should notice some improvement!

Final Words on Thoracic Mobility for Runners

The T-spine is often overlooked when it comes to its importance for improving running efficiency.

A healthy thoracic spine will help you have better running mechanics and better form. It will also ensure optimal rib cage expansion for breathing.

If you have stiffness, pain, or discomfort in this area, don’t ignore it. Try some of the exercises presented in this article and give it a few weeks to see if it helps.

It’s also advised to seek help from a physiotherapist if you have severe pain in the thoracic spine area that is limiting your daily function or preventing you from running comfortably. You will then be able to get a proper assessment and treatment plan.  

How is your thoracic spine doing lately? What is your favorite exercise for this area?

Let me know in the comments!

Happy running,

April 😊

References:

Borkowski, S. L., Tamrazian, E., Bowen, R. E., Scaduto, A. A., Ebramzadeh, E., & Sangiorgio, S. N. (2016). Challenging the Conventional Standard for Thoracic Spine Range of Motion: A Systematic Review. JBJS reviews, 4(4), e51–e511. https://doi.org/10.2106/JBJS.RVW.O.00048

Bramah, C., Preece, S. J., Gill, N., & Herrington, L. (2018). Is There a Pathological Gait Associated With Common Soft Tissue Running Injuries?. The American journal of sports medicine, 46(12), 3023–3031. https://doi.org/10.1177/0363546518793657

DeFroda, S. F., & Bokshan, S. L. (2018). Anatomy, Thorax, Rib Function. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459153/

Edmondston, S. J., Waller, R., Vallin, P., Holthe, A., Noebauer, A., & King, E. (2011). Thoracic spine extension mobility in young adults: influence of subject position and spinal curvature. The Journal of orthopaedic and sports physical therapy, 41(4), 266–273. https://doi.org/10.2519/jospt.2011.3456

Preece, S. J., Mason, D., & Bramah, C. (2016). The coordinated movement of the spine and pelvis during running. Human movement science, 45, 110–118. https://doi.org/10.1016/j.humov.2015.11.014