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Best Exercises for Upper Back Pain

by Jaydee Vykoukal, PT, DPT October 30, 2019 0 Comments

Upper back pain is typically about an imbalance of muscle strength, joint mobility, and posture. This leads to muscle strain and stiff, sore joints. Exercises that address the thoracic spine help to restore movement and provide pain relief. Naturally, shoulder exercises that focus on the shoulder blades, or scapulae, are an important part of an upper back program because of their close connection to the rib cage, thoracic spine, and shoulders.

Additionally, the neck is intricately connected to the mid-back via back muscles and connective tissue of the spine and trunk. When the normally mobile neck gets stiff it can make the thoracic spine to move more than it should. The thoracic spine is built for stability, so any excessive movement can lead to pain and maladaptive stiffness.

With the right balance of exercises and care, upper back pain can be pretty simple fix. Check out more treatment options for upper back pain here.

Core and Back Exercises

Knee to Chest

Core strength is what helps the entire spine move in a coordinated, pain free fashion. If the upper back is hurting, focusing on core strength can help restore stability and proper movement.

To get in the starting position, lie on your back with the knees bent and feet flat on the floor. Engage the abdominals by tightening the muscles (draw the belly button towards the spine and hold, as if to protect yourself from being punched in the stomach). With the abs tight, lift one foot off the ground up until the knee reaches the height of the hip. Don’t forget to breath.

Focus on slow controlled movement. This means little to no movement at the hips and no excessive arching of the back (no more than a hand should fit under your lower back). Alternate as if you are marching for 10 reps on each side. Repeat 2-3 times.

*This is just one example, with many other core exercises you could complete. Find more core strengthening exercises for lower back pain here.

Thoracic Mobilization

Lie on your back with your butt on the floor and knees bent. The foam roller will be placed horizontally behind the mid-back. When ready, place your hands behind your head and lift the butt off the ground so you slowly roll up and down along the entire thoracic spine. Focus on staying relaxed, with the arms staying wide and chest open. Do not pull on the head or “crunch up” on the roller. When you’re relaxed, it will allow the upper back to extend into the roller.

Go back and forth 1-2 minutes. Repeat up to 3 times per day.

Thoracic Extension on the Wall

Stand facing the wall with your hands behind your head, be careful not to pull on your neck during this exercise. You will bring your elbows closer together until they are in line with the shoulders and then put them against the wall. Tighten your abs and tuck your pelvis under to keep your low back from moving. You will then push your elbows further up the wall as you extend your back upper back.

Hold for 3 seconds at the highest comfortable position. Repeat 10 times, 2-3 times.

Opposite Arm and Leg Raises

Lie on your stomach on the floor with your arms stretched out in front of you. With your abs gently tightened and neck in a comfortable position, lift the left arm and right leg up at the same time toward ceiling. You should feel this move in the shoulder blades and butt. The motion should be small, the low back shouldn’t arch, and the neck should stay relatively relaxed. Repeat on the other side.

Alternate between sides, complete 10 times total, 2-3 sets. An alternative is to try this motion while on your hands and knees.

Shoulder Strengthening Exercises

Scapular Squeeze

In a comfortable seated or standing position, assume a good posture as you squeeze the shoulder blades together. Do not let the top of the shoulders or neck feel tense. Focus on using the muscles between the shoulder blades, which will cause your chest to open and shoulders to move down toward the floor.

Hold 2-3 seconds, 10 times, repeat 2-3 times.

Prone Shoulder Blade Retraction

A great progression from the exercise above is to use body weight for resistance in prone. Lie on your stomach with arms out to the side (shoulders at a 90 degree angle, elbows straight) and forehead resting on the ground. Squeeze the shoulder blades together as you lift the arms up off the group a few inches. Keep the neck relaxed.

Hold 2-3 seconds, 10 times, 2-3 sets.

Low Row with Resistance Bands

Using resistance bands (or weight), take each end of the resistance band with your palms facing inward toward each other. Make sure your band is secured around a pole or shut in a door just below chest height. Keep the elbows bent (at about a 90 degree angle) and tucked into your sides. Bring the elbows back and squeeze the shoulder blades together. Keep your shoulders steady, don’t slouch forward or let your neck feel tense.

Choose resistance that is challenging while still being able to keep good form withou strain. Keep the motion slow and controlled. Complete 10-15 reps, 2-3 sets total.

Wide Row with Resistance Bands

This is a progression from the exercise above. Bring your arms out in front of you with the elbows slightly bent and palms facing down toward the floor. Keep both arms at shoulder height as you bring the elbows backwards (bending them further) and squeeze the shoulder blades together. You should feel this between the shoulder blades and in the back of the shoulders, not the neck.

Choose a weight that you can stay in control with while still challenging the muscles. Repeat 10-15 times, 2-3 sets.

Neck Strengthening Exercises

Neck Flexion and Extension

This exercise is good for neck pain too. Sitting or standing comfortably, make sure you are in good posture (try rolling the shoulders back first). Without slouching forward or forcing the motion, bring the chin down toward the chest and hold 2-3 seconds. Then reserve the motion and look up toward the ceiling. Take care to keep the motion comfortable without strain or pain. You can add overpressure to the first motion with use of your hands if you can stay relaxed. Try moving with your breath (breath in, one direction; breath out, other direction).

Alternate back and forth slowly 10 times, 2-3 times throughout the day.

Isometric Lateral Neck Flexion

Sitting in a comfortable position while holding good posture, bring the palm of one hand up and place it on the same side of the head near the temple. You will then gently push against your head in a sideways motion, matching the tension from your hand with your neck. This activates the muscles in the side of the neck, as if you were going to bring your ear towards your shoulder. Keep it pain free.

Hold 2-3 seconds, 10 times, 2-3 sets. You can repeat this exercise in other directions as well, such as neck rotation, flexion, and extension.

Wall Angels

Stand with your back against (the feet 1-2 feet away from the wall). Make sure your butt, shoulders, and back of the head are all touching the wall. Take note of your low back (not too arched) and your chin position (eyes pointing forward, not up). This position itself is a great posture trainer to start.. However, if possible you will bring your arms up against the wall, with the elbows bent and knuckles touching the wall (a “touchdown” position). You will then lift the arms up toward the ceiling as your arms make an arcing motion. Keep going until the hands touch over your head. If you are unable to maintain good form or can’t keep your arms on the wall, stop in the range that is possible and return.

Move slow and controlled 10-15 times, 2-3 times per day for posture training and slouching.

Tips to Maximize Relief

The key to a good upper body workout is making sure the right muscles are being targeted. As iterated throughout the explanations above, the neck should stay relaxed and poor posture avoided with all back exercises. That way you can adequately restore balance and circulation to the shoulder blades and mid-back while minimizing use of the over dominant neck and chest.

If you feel too stiff to complete any or all of these exercises, start with back stretches first. Also consider other tools for promoting good posture and pain relief to maximize your program.

    Working Out Your Upper Back Safely

    As with any exercise, you should be comfortable with your program. If something feels excessively awkward or painful stop and try to adjust it. Consider talking to a physical therapist for a personalized program. Further medical advice may be needed if you experience an exacerbation of pain, nerve symptoms, or an overall decrease in quality of life due to your upper back pain.

    An upper back program is a profoundly important part of an exercise and strength routine. It is commonly under-emphasized for exercises that over-train the chest and upper neck. This is a great way to restore balance to the entire body when pain or other dysfunction appears.

    Jaydee Vykoukal, PT, DPT
    Jaydee Vykoukal, PT, DPT

    JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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