Improve Your Thoracic Mobility and Stability for Better Performance

Improve Your Thoracic Mobility and Stability for Better Performance

Your spinal column plays a critical role in housing and protecting the nerve roots that descend from your brain and branch off to innervate cells throughout your body. Without strong muscles and connective tissues to support and stabilize your spine, you would not be able to walk, run, jump or play sports. Your thoracic spine in particular must be both mobile and stable if you want to optimize your physical performance.

Thorax Anatomy and Function

Your thorax is the portion of your trunk located between your neck and your pelvis, made up of 12 thoracic vertebrae and your rib cage. The thoracic region houses many vital organs, including your heart and lungs. Whether you’re skiing down a slope, doing pirouettes or intercepting a football pass, a mobile and stable thorax is key to successful execution.

Thorax Anatomy and Function

Your capacity to rotate and stabilize your thorax directly impacts the function of your cervical and lumbar spine as well, since they are connected. Moreover, an unstable thorax with limited range of motion can cause pain and dysfunction in your upper back, neck and shoulders, and can restrict your ability to breathe deeply.

Thoracic Stability and Mobility

A popular rule of thumb in rehab is, “Proximal stability for distal mobility, and distal stability for proximal mobility.” When skiing, you need perfect coordination of all your thoracic vertebrae with their associated muscles and ligaments, but stability comes from your foot and pelvis. Stability and mobility are fundamental to efficient pain-free movement.

Increasing Thoracic Mobility and Stability

The most influential muscles on thoracic mobility are the spinal erectors, rhomboids and trapezius, none of which are normally mechanically shortened or over-activated, and therefore do not need to be “released.” Foam rolling, however, can help release the thoracic vertebrae to increase mobility.

Increasing Thoracic Mobility and Stability

The latissimus dorsi and pectoralis muscles also play an active role in thoracic movement, and they both shorten and lengthen considerably, and are prone to tightness. Foam rolling and static stretching may help to relax and lengthen those muscle groups, to increase thoracic spinal rotation and mobility.

Stability can be achieved with a thorough biomechanical analysis and a protocol of physical therapy exercises designed to strengthen and rebalance the musculature of the thoracic spine.

Motion Analysis Lab in NYC

NYDNRehab features the only complete outpatient motion and running analysis lab in NYC, equipped with technologies available only at the world’s top research labs. Efficient pain-free movement is key to all physical performance, whether you are an elite athlete going for the gold, or an average person with unwanted aches and pains.

As part of your total body analysis, we create a quantitative profile of your motor patterns to establish a baseline. We then define your physical therapy goals and begin working toward restoring full pain-free function. Your treatment plan may include chiropractic care, and some of your sessions may be done remotely via TeleHealth. By identifying and eliminating motor deficits, you will move better, sleep deeper and feel amazing, every day of your life.

TeleHealth is here!

Get all the benefits of physical therapy and chiropractic care via safe and effective online sessions, all from the privacy and convenience of your home, office or hotel room. Never miss a session, and keep moving toward your physical therapy goals.


Brasiliense, Leonardo BC, et al. “Biomechanical contribution of the rib cage to thoracic stability.” Spine 36.26 (2011): E1686-E1693.
Watkins IV, Robert, et al. “Stability provided by the sternum and rib cage in the thoracic spine.” Spine 30.11 (2005): 1283-1286.

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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