October 5

Shoulder Pain and Upper Back Pain: Related?

What does my shoulder have to do with my upper back?

The short answer: a lot.

If you’ve ever gone to Edmonton physiotherapy for a sore shoulder, chances are your therapist is also taking note of how you move through your upper back. If you’ve never been to physio for a painful shoulder after an injury or overdoing it at the gym, then here’s one way you can prevent that – thoracic mobility.

Normal thoracic-humeral rhythm is important for injury prevention (this is the way your arm, shoulder, and upper back coordinate movement). Particularly for those who engage in a lot of overhead activities – whether this is occupational or sport specific. The higher we raise our arms; the more thoracic motion is needed from the upper spine to maintain good shoulder alignment.

If there is insufficient thoracic mobility, the load placed on the neck and shoulder is greater and can result in injury when we exceed our body’s capacity for loading.

Whether you’re a mechanic, a CrossFit athlete, or a weekend warrior in the gym or on the field, if you’re doing a lot of overhead lifting, your thoracic mobility is of importance (among other things). If you’re already injured, have a nagging shoulder after workouts, or have zero shoulder pain, but do a lot over overhead activity, our physiotherapists can help screen your movements, prevent injury, and get you back on track with a rehab and strength program tailored to your specific needs.


  1. Crosbie J, Kilbreath SL, Hollmann L, York S. Scapulohumeral rhythm and associated spinal motion. Clinical Biomechanics, 2008;23:184-192.

  2. Greenfield B, et al. Posture in patients with shoulder overuse injuries and healthy individuals. Journal of Orthopedic Sports Physical Therapy, 1995;5:287-295.

  3. Stewart S, Jull GA, Ng, JKF, Willems JM. An initial analysis of thoracic spine movement during unilateral arm elevation. Journal of Manual & Manipulative Therapy, 1995;3:15-20.

  4. Theodoridis D, Ruston S. The effect of shoulder movements on thoracic spine 3D motion. Clinical Biomechanics, 2002;17:418-421.

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