🤔 What Is It?

The thoracic spine (mid to upper back) is designed for rotation, extension, and flexion — but in many people, it becomes stiff or restricted due to poor posture, repetitive tasks, or lack of movement.

This stiffness doesn’t just affect the upper back — it can also place strain on the neck, shoulders, and lower back, leading to pain, poor mobility, and reduced performance.

💡 Common Physiotherapy-Related Causes:

• Prolonged sitting with rounded posture

• Inadequate thoracic mobility from inactivity or training imbalance

• Excessive focus on chest/shoulder strength without thoracic mobility

• Poor breathing patterns and rib immobility

• Overreliance on lumbar or cervical movement to compensate for thoracic stiffness

🛠️ What You Can Do:

• ✅ Take regular posture breaks during desk work or long drives

• ✅ Use a foam roller or peanut to mobilise the upper spine

• ✅ Perform daily thoracic rotation and extension drills

• ✅ Strengthen your postural muscles to maintain better positioning

• ✅ Seek physio guidance to target the right joints and movement patterns

👩‍⚕️ How Physio Can Help:

• Assess which thoracic segments are restricted and contributing to symptoms

• Mobilise stiff joints with manual therapy, cupping, or dry needling

• Re-train proper movement through mobility and spinal control drills

• Address linked issues in the neck, shoulders, or rib cage

• Tailor your rehab for sport, work, or gym performance goals

🙋‍♀️ Answers to Common Questions

1. What are signs of thoracic stiffness?

• Feeling tight, locked, or restricted in the upper/mid back

• Difficulty rotating your torso (e.g. reversing the car or swinging in sport)

• Trouble with overhead movements (e.g. presses, snatches)

• Compensations like neck strain or low back tightness

• Reduced breath expansion or shallow breathing

2. Why is thoracic mobility important?
The thoracic spine is crucial for:

• Rotating the torso (e.g. sports, driving)

• Allowing overhead shoulder movement

• Supporting deep, efficient breathing

• Reducing strain on the neck and lower back

3. How long does it take to improve?
Some mobility gains can be seen within a few sessions, but lasting results come from consistent mobility and postural strengthening — often over 4–6 weeks depending on severity.

4. Can this cause shoulder or neck pain?
Yes — lack of thoracic motion can cause compensatory stress in the neck and shoulders. Improving thoracic mobility often reduces pain and improves performance in these areas.

5. What exercises improve thoracic mobility?

• Open book and thread-the-needle drills

• Foam roller extensions over mid-back

• Wall angels and scapular mobility work

• Breathing drills to expand the ribs
  We’ll personalise your program based on how your spine moves.

6. Should I stretch or strengthen?
Both! First, we improve joint mobility and release restriction. Then we build strength and control to maintain better posture and movement long-term.

7. Do I need to get adjusted or cracked?
Manual mobilisation or manipulation may help, but lasting change requires movement and strength. We combine hands-on work with active rehab for the best results.

🤔 What Is It?

Rib joint dysfunction occurs when one of the joints where the ribs connect to the spine (costovertebral joint) or the sternum (costosternal joint) becomes irritated, restricted, or slightly misaligned.

This can cause sharp or aching pain that:

• Stays local or wraps around the chest

• Worsens with deep breathing, twisting, or reaching

• Feels like something is “out” or stuck in the mid back or ribs

• Comes on suddenly (e.g. rolling in bed, sneezing, lifting awkwardly)

Despite how intense it can feel, rib dysfunction is typically mechanical and treatable — not a sign of serious illness when properly assessed.

💡 Common Physiotherapy-Related Causes:

• Sudden movement or awkward twist (e.g. turning in bed, reaching back)

• Prolonged poor posture with thoracic stiffness

• Overhead lifting, pulling, or twisting under load

• Respiratory conditions, chronic coughing, or shallow breathing

• Poor thoracic or scapular movement and control

🛠️ What You Can Do:

• ✅ Avoid forceful twisting or positions that sharply provoke the pain

• ✅ Use heat, gentle thoracic movement, and breathing exercises

• ✅ Perform slow, controlled thoracic extension and rotation drills

• ✅ Try supported side-lying positions to offload painful ribs

• ✅ Get a physio assessment to guide hands-on release and mobility work

👩‍⚕️ How Physio Can Help:

• Confirm it’s rib-related and not referred pain from another source

• Mobilise the rib joints with manual therapy, dry needling, or cupping

• Improve thoracic and scapular mobility

• Rebuild movement patterns that avoid repeat strain

• Teach breathing mechanics and rib expansion control

• Refer to your GP if red flags or organ referral is suspected

🙋‍♀️ Answers to Common Questions

1. What does rib joint dysfunction feel like?

• Sharp or stabbing pain at a specific point in your back or side

• Discomfort when breathing deeply, twisting, coughing, or laughing

• Pain that wraps around to the front of the chest

• A sense that something is “stuck” or “popped out”

• Tenderness over the rib or spine where it meets

2. Can a rib actually pop out of place?
Not exactly. Ribs don’t truly “dislocate” unless from major trauma. But the joints can become irritated or restricted, which can mimic the feeling of something being out of place. We treat this successfully with hands-on therapy and rehab.

3. Is it dangerous or heart-related?
Most of the time, rib pain is musculoskeletal. However, if your pain is accompanied by shortness of breath, chest pressure, or other medical symptoms, your physio or GP will guide appropriate screening to rule out other causes.

4. How long does it take to feel better?
Many clients feel relief within 1–2 sessions, especially with joint mobilisation. For long-standing or movement-related dysfunction, full recovery may take 2–4 weeks with strength and mobility work.

5. Will this keep happening?
It can — especially if the underlying movement or postural issues aren’t corrected. Physio focuses on fixing the root cause so you’re not constantly chasing symptom relief.

6. What exercises help rib joint dysfunction?

• Open book stretches and thoracic rotation drills

• Foam roller extensions

• Breathing expansion drills (lateral rib breathing)

• Scapular control exercises

• Postural strengthening and core control

7. Can this affect my breathing?
Yes — rib dysfunction can make deep breaths painful, which may lead to shallow breathing patterns. Fixing the joint restriction allows you to breathe more fully and efficiently again.

🤔 What Is It?

Intercostal muscles are the small muscles that run between your ribs, helping your rib cage expand during breathing, rotation, and upper body movement.

An intercostal strain happens when these muscles are overstretched, overloaded, or torn, usually from a sudden movement, repetitive action, or excessive force.

It often causes sharp or pulling pain in the ribs or side of the torso, particularly with:

• Twisting or reaching

• Coughing, sneezing, or deep breathing

• Overhead or rotational movements

• Certain sleeping positions

💡 Common Physiotherapy-Related Causes:

• Twisting while lifting or reaching (e.g. putting something in the back seat)

• Sudden slips or awkward movements

• Forceful coughing or sneezing, especially during colds or allergies

• Overhead or rotational sports (e.g. tennis, cricket, golf)

• Poor thoracic control or breathing mechanics

🛠️ What You Can Do:

• ✅ Avoid sudden twists or deep breathing that aggravates the pain

• ✅ Apply heat, gentle compression, or tape for relief

• ✅ Try supported sleeping positions (e.g. lying on the unaffected side)

• ✅ Begin gentle breathing and thoracic mobility drills as pain allows

• ✅ Get a physio assessment to ensure it’s not rib joint or referred pain

👩‍⚕️ How Physio Can Help:

• Confirm the strain and differentiate from rib joint, nerve, or organ pain

• Use soft tissue therapy, dry needling, or taping to ease pain

• Guide safe return to breathing, movement, and strength

• Correct posture and thoracic mechanics to offload the area

• Progressively reintroduce rotation, overhead control, and sport or gym work

🙋‍♀️ Answers to Common Questions

1. What does an intercostal strain feel like?

• Sharp or pulling pain between the ribs, especially during movement

• Worse with twisting, coughing, laughing, sneezing, or deep breathing

• May feel like a “stitch” or pulled muscle that doesn’t stretch out

• Tender to touch and often one-sided

2. Is this the same as a “rib out”?
No — a “rib out” usually refers to joint dysfunction, whereas this is a muscular strain. Both can feel similar, so physio assessment is important to clarify and treat correctly.

3. How long does it take to heal?

• Mild strains: 1–2 weeks

• Moderate strains: 3–4 weeks

• Severe or recurring strains: 4–6+ weeks with full rehab
  Physio helps you move safely and avoid re-aggravation.

4. Can this cause breathing problems?
Not dangerous breathing issues, but deep breathing can be painful, which may lead to shallow breathing or tension. We’ll guide you to gradually restore rib movement and comfort.

5. Can I still train or work?
Often yes — with the right modifications. We’ll help you reduce rotation, overhead, or trunk loading while staying active. Rehab will help you return fully once healing has begun.

6. What exercises help intercostal recovery?

• Breathing drills (diaphragmatic and lateral rib expansion)

• Thoracic mobility (cat-cow, open books, foam roller)

• Core control and trunk rotation drills

• Scapular and shoulder stability to prevent compensation
  Your program will be phased and tailored to your activity level.

7. Can it come back?
Yes — if the underlying issue isn’t corrected (e.g. poor rotation control, tight thorax, poor breathing). Our goal is to treat the injury and prevent it from returning.

🤔 What Is It?

Postural overload occurs when your mid-back muscles (especially between the shoulder blades) are forced to work overtime to maintain upright posture, often under low load for long durations.

This can lead to a burning, aching, or tight sensation in the mid-back — commonly described as:

• “Pain between the shoulder blades”

• “Upper back fatigue”

• “Tightness that builds over the day”

• “Needing to crack or stretch constantly”

It’s a muscular endurance issue, not a structural injury — and responds very well to movement, postural retraining, and targeted strengthening.

💡 Common Physiotherapy-Related Causes:

• Long hours sitting or standing without support

• Rounded shoulders, forward head posture (tech neck)

• Weak or deconditioned postural muscles (mid and lower traps, spinal extensors)

• Overtraining push movements (e.g. bench press) without enough pulling

• Poor ergonomics at work, driving, or during study

🛠️ What You Can Do:

• ✅ Break up long sitting periods with micro-breaks every 30–45 mins

• ✅ Try thoracic mobility drills and postural resets throughout the day

• ✅ Strengthen your mid-back muscles with band work and rows

• ✅ Improve desk or workstation ergonomics

• ✅ Book a physio consult to build a postural and strength plan

👩‍⚕️ How Physio Can Help:

• Identify movement or posture patterns contributing to fatigue

• Release overloaded tissues with manual therapy, dry needling, or cupping

• Rebuild endurance and control in postural muscles

• Teach effective desk/work habits and anti-slouch strategies

• Progress you from relief to resilience with a tailored exercise plan

🙋‍♀️ Answers to Common Questions

1. What does postural overload feel like?

• Aching or burning pain between the shoulder blades or across the upper back

• Builds throughout the day, especially after work or study

• May feel better after movement, stretching, or lying down

• Can come with tension headaches or neck tightness

2. Is this serious?
No — it’s not a structural issue, but it can become chronic and frustrating if ignored. With the right strategy, it’s very treatable and preventable.

3. Why do I feel it more on one side?
It’s common to have muscular asymmetries or habits (e.g. mouse use, phone cradling, one-sided lifting). We’ll assess how your body loads and build symmetry into your rehab.

4. Do I need scans or imaging?
No — this is a clinical diagnosis based on your symptoms and daily patterns. Scans are unnecessary unless red flags or other structural concerns arise.

5. How long does it take to fix?
You may feel relief in a few sessions, but full resolution requires building endurance and strength in the postural muscles. Expect 4–6 weeks for solid progress.

6. What exercises help with postural fatigue?

• Band pull-aparts, face pulls, and scapular retraction drills

• Thoracic foam rolling and mobility work

• Lower trap and deep neck flexor activation

• Standing postural resets and mid-back endurance work
  We’ll personalise a plan based on your job, training, and goals.

7. Can I train at the gym with this?
Yes — and training often helps. We’ll adjust your program to avoid aggravation and build the strength you need for long-term postural resilience.

🤔 What Is It?

Scoliosis is a condition where the spine curves sideways in an “S” or “C” shape, most commonly through the thoracic (mid-back) or thoracolumbar regions. It can also involve rotation of the vertebrae, creating asymmetry in the ribs, shoulders, and hips.

While some people are born with scoliosis (congenital), the most common form is idiopathic scoliosis, often appearing during adolescence. It may be mild and painless, or cause:

• Tightness or fatigue on one side of the back

• Difficulty maintaining posture

• One shoulder or hip sitting higher than the other

• Stiffness or imbalance during training or sport

💡 Common Physiotherapy-Related Causes (or Contributors):

• Muscle imbalances and poor neuromuscular control

• Poor posture habits during development or training

• Lack of thoracic and spinal mobility

• Uneven loading in work, sport, or training

• Growth spurts in adolescents or long-standing adaptation in adults

🛠️ What You Can Do:

• ✅ Improve spinal and rib mobility through targeted exercises

• ✅ Strengthen postural muscles asymmetrically (based on your curve)

• ✅ Address breathing patterns and rib cage expansion

• ✅ Train core stability and spinal control under load

• ✅ Seek physiotherapy to monitor curvature and guide safe progression

👩‍⚕️ How Physio Can Help:

• Assess your posture, curvature, and movement asymmetries

• Provide hands-on treatment to reduce stiffness and tension

• Design a curve-specific strength and mobility program

• Improve symmetry in breathing, loading, and movement control

• Refer to specialists (e.g. orthopaedics) if bracing or imaging is required

• Support adolescent patients or adults managing scoliosis for life

🙋‍♀️ Answers to Common Questions

1. What does scoliosis pain feel like?

• Fatigue, tightness, or aching on one side of the back

• A sense that your body is pulling or twisting unevenly

• Stiffness when rotating or side bending in one direction

• In some cases, no pain — only visible asymmetry

2. Do I need an X-ray or scan?
Scans can confirm the angle and type of curvature, but aren’t always required if symptoms are mild. Your physio will assess the spine and refer for imaging if needed.

3. Can scoliosis be fixed?
Mild to moderate scoliosis isn’t typically “fixed,” but can be well-managed with physio. In growing children, early detection is key. In adults, we focus on optimising movement, strength, and comfort.

4. Will scoliosis get worse with age?
Not always. Many curves remain stable over time — but pain or stiffness may develop if the spine isn’t well supported. Physio helps you stay strong and mobile to reduce long-term issues.

5. Should I avoid certain exercises?
Some exercises may need to be modified to prevent uneven strain, especially overhead lifting or rotation. We’ll show you how to adapt your program without losing performance or gains.

6. Can scoliosis affect breathing?
Yes — particularly if the curve impacts rib positioning or diaphragm function. Breathing drills and rib mobility work are often part of our treatment.

7. What exercises help scoliosis?

• Curve-specific mobility and strengthening

• Unilateral postural drills to balance the spine

• Breathing expansion and lateral rib mobility

• Core and anti-rotation stability work
  All exercises are tailored to the direction and severity of your curve.

🤔 What Is It?

Breathing dysfunction refers to inefficient or restricted breathing patterns — often due to poor posture, stress, injury, or rib mobility issues. Instead of using the diaphragm and rib cage effectively, people compensate with:

• Shallow chest breathing

• Overuse of neck and shoulder muscles

• Limited rib expansion, especially at the sides and back

Over time, this can lead to:

• Mid-back and rib tightness

• A sense of restriction when breathing deeply

• Poor core engagement and spinal stability

• Fatigue and tension in the upper traps, chest, and back

💡 Common Physiotherapy-Related Causes:

• Poor posture (slouched or forward head) restricting rib movement

• Shallow breathing from stress, anxiety, or prolonged sitting

• Thoracic spine stiffness or rib joint dysfunction

• Past injury (e.g. rib trauma, abdominal surgery, chronic coughing)

• Weak or underactive diaphragm and deep core system

🛠️ What You Can Do:

• ✅ Learn diaphragmatic breathing with lateral rib expansion

• ✅ Mobilise the thoracic spine and rib cage daily

• ✅ Improve posture to allow full rib movement

• ✅ Avoid overusing chest and neck muscles to breathe

• ✅ Train core control and spinal positioning alongside breathing work

👩‍⚕️ How Physio Can Help:

• Assess your breathing mechanics and rib mobility

• Restore movement with manual therapy, cupping, or mobility drills

• Teach functional breathing patterns that support posture and movement

• Integrate breathing into core, lifting, and exercise rehab

• Address linked issues in the neck, shoulders, and thoracic spine

🙋‍♀️ Answers to Common Questions

1. What does breathing dysfunction feel like?

• A sense that you can’t breathe deeply

• Tightness or restriction in the mid-back, ribs, or chest

• Shallow, fast breathing — especially during stress

• Tension in the shoulders, traps, or neck

• Poor core engagement or fatigue with exercise

2. Is this dangerous?
Breathing dysfunction is rarely dangerous, but it can contribute to persistent pain, fatigue, and underperformance — especially in the mid-back, neck, and rib areas.

3. Can anxiety cause breathing-related pain?
Yes — anxiety and stress often lead to chest or shoulder-dominant breathing, which over time causes tension in the upper body. Retraining your breath can help both physically and mentally.

4. How long does it take to improve?
Most clients notice change within a few sessions, especially with breathing drills and mobility work. Long-term benefits come from building breathing awareness into daily life and training.

5. What exercises help breathing dysfunction?

• Diaphragmatic breathing in crook lying or 90/90 position

• Lateral rib expansion with band or towel feedback

• Thoracic mobility (open books, foam roller work)

• Breathing during bracing, lifting, or functional movement

• Postural and core training integrated with breath

6. Can physio help even if I don’t have pain?
Absolutely — we often work on breathing in clients wanting to improve performance, core stability, recovery, or stress resilience. Better breathing supports everything from lifting to sleeping.