17 Jun Mid Back Prehab Program
When it comes to mid back and scapular pain, nothing beats a mid back prehab program with tons of thoracic spine mobility and stability work. Mid back pain can be caused by a variety of structures in the mid back itself like the thoracic spine, ribs, or trigger points in the upper back muscles. Furthermore, the pain could even originate from other regions, not in the mid back like the neck or shoulders. That’s a lot of potential pain generators and triggers! Making matters even more complicated is that it’s often times difficult to recreate a “trigger”. In physio terms, a trigger is something that causes your familiar pain. Meaning if you ask yourself the question, “what typically causes my mid back pain?” The answer for many with mid back pain is typically something vague and difficult to pinpoint. “Uh, this weird position I put my arms in… it just aches… it’s always there, etc.” Don’t worry, this is common! But because of this conundrum, you can never go wrong with a holistic mid back prehab program focused on improving thoracic spine mobility and strength and above all else, keeping moving!
Desensitize Your Triggers and Move!
If you currently have mid back pain, before we [P]Rehab – we must rehab. The goal of rehab is to desensitize your mid back to those “triggers” we talked about earlier. And even if you don’t have any clear movement based triggers, introducing general mobility into the mid back in a graded manner is always step one before progressing to more advanced exercises!
The cat cow is my go-to for desensitization. It’s a movement that is inherently easy to control if you have pain. And if you don’t, it just simply feels good. For mid back pain, the key is to bias the mid back region during the cat cow movement rather than the low back region.
Cat Cow Thoracic Spine Bias
Work on Thoracic Mobility
When it comes to mid back prehab, improving thoracic spine mobility is a must! As the area that sits between the cervical spine (head) and lumbar spine (low back), the thoracic spine is meant to be very mobile. Often times due to the sustained postures we find ourselves in, we tend to lose the ability to move fluidly through this area. Thoracic spine extension and rotation are both equally as important. Here are some of our favorite thoracic spine mobility drills below. All of the exercises in this article have been conveniently bundled into a free program with exact parameters and exercise instructions that you can download and access on your phone from anywhere in the world! Check out the free mid back prehab program HERE.
Quadruped Thread The Needle To Open Book
This exercise combines a thread the needle with an open book exercise to hit rotation in both directions. The secret to unlocking more mobility through your thoracic spine is to use your eyes when turning! Notice how I look in the direction I want to turn. You’ll find yourself getting more degrees of rotation in any exercise by guiding yourself with your eyes!
Also, notice how I use my fingers to “get a little extra rotation” during the thread the needle. Try to get as much rotation actively as you can on your own first. Then, use your fingers to gain a couple more degrees of rotation as you exhale and relax your body. You can also use a foam roller like in this video to get more rotation.
If putting weight through your shoulder/wrist is an issue, a simple solution is to lie on your side and perform the just the side-lying open book exercise. You’ll want to perform it on both sides.
Sidelying Open Book
There are a thousand different ways to work on thoracic spine extension. I’m a big fan of using a foam roller to “mobilize” your thoracic spine in segments. You can also roll out the erector spinal muscles on each side of your back in a sweeping motion. The biggest keys when using a foam roller for your mid back are:
- Make sure your head is supported/not completely flaccid and relaxed
- Only roll your mid back. Don’t roll your lower back.
- It should feel good and comfortable!
Mid Back Foam Rolling
If you don’t have a foam roller you can pick one up here or simply use a towel roll against a chair. This is a great alternative if you have issues getting up and down off the ground as well!
Seated Thoracic Mobilization
Mobilize – Then Strengthen
After mobilizing, a mid back prehab program wouldn’t be complete without some properly dosed strengthening and loading to build a strong back! I’ve included some of my go-to exercises for building up a strong back – you’ll notice that strengthening the mid-back essentially means the entire pillar from the shoulders to the hips. Furthermore, your strengthening exercises should address all three planes of motion (sagittal, frontal, and transverse).
I’m a big fan of any prone swiss ball work as your entire back must actively be on the stabilize your pillar. It’s a great entry level exercise if you currently have mid back pain that hopefully shouldn’t aggravate any of your symptoms. Adding the snow angel component also hits many of the scapular stabilizers like the traps and rhomboids.
Kettlebell Goblet Squat
Any front rack squat/lunge like a goblet squat, Zercher squat, or front squat will force your mid back muscles to turn on to maintain proper positioning. Again, it’s a very easy way to learn to turn your mid back muscles by simply holding a weight in front of you while doing a leg exercise you are comfortable with. The key is to not let the weight pull you down. Your goal is to try to maintain an upright position!
Working up to a weighted barbell deadlift would be the ultimate holy grail when it comes to mid back prehab. But if you’re not comfortable with a barbell deadlift, there are still tons of other deadlift variations you can perform without a barbell that will strengthen your mid back similarily!
Thoracic Spine Active Rotation
This is a super tough drill that Arash makes look easy. The key is to minimize any bending away from the wall. Try to just rotate your mid back.
The sideplank hits everything in your mid back, shoulder girdle, and hip to truly build a bulletproof flank. You can regress the exercise by dropping onto your knees. If you have a TRX available try TRX sideplanks! The TRX is amazing for strengthening the mid back as you have to stabilize your pillar the entire time.
Improve Your Posture
Mid back pain is often times very posture related. Long days of sitting. Computer work. Driving. Studying. Reading. Gaming. Want to know what’s similar between all the previous examples?
A lack of movement
Improving your posture can be as simple as taking movement breaks throughout the day! It doesn’t have to be a long 15-minute walk around the office (although that would be great!), and can easily be taking a standing break for 10 seconds. Or simply shifting from an upright sitting posture to a reclined sitting posture. Movement is medicine! Check out some of these stretches you can do at your desk below!
Work Stretches for Mid Back Prehab
And remember, your posture does not have to be perfect! Check out this video by Dr. Greg Lehman on why perfect posture does not exist!
Mid Back [P]Rehab Program
We’ve put together all these exercises into a FREE PROGRAM with detailed instructions and parameters. The program is hosted on our very own platform, PrehabX, which allows you to create your own programs like this one! Download your free mid back prehab program by clicking on the image below.