Upper Back Pain and Pain Between the Shoulder Blades: Posterior Thoracic Release
Posterior Upper Thoracic Complex
This module teaches the release of the Posterior Upper Thoracic Complex, a layered group of muscles between the shoulder blades. When these muscles enter spasm, they can compress spinal nerves and produce upper back pain, rib restriction, and postural fatigue.
The upper thoracic region is the transition between the neck and the rib cage, and its posterior muscles hold the body upright against gravity all day. Computer work, postural strain and repetitive patterns fatigue them in layers until they lock in sustained contraction. The result is pain and stiffness between the shoulder blades, a feeling of being held or compressed through the upper back, fatigue from staying upright, restricted rotation and extension of the upper spine, and pain referred into the head, neck and shoulder. Because the sympathetic nerves to the heart, lungs and digestive organs exit here, a locked upper thoracic spine also keeps the body in a fight-or-flight state. Releasology releases the posterior upper thoracic complex directly, restoring the spine's flexibility and the freedom of the breath.
What this release relieves
- Pain and stiffness between the shoulder blades. The rhomboid and paraspinal layers in spasm ache between the blades all day. They release together.
- Upper and mid back pain. The sustained, layered contraction of the posterior thoracic muscles is the source; the ache eases as the layers let go.
- Limited rotation and extension of the upper spine. Turning to look behind you and straightening up both need thoracic movement; a locked thoracic spine allows neither.
- A feeling of compression or being held through the upper back, and fatigue staying upright. Clients describe finally being able to sit up without effort once the muscles release.
- Pain referred into the head, neck and shoulder. Upper thoracic spasm refers upward; releasing it often clears neck and shoulder pain that was being treated in the wrong place.
- Breathing restriction and fight-or-flight holding. The ribs attach here and the sympathetic chain runs here. Clients describe the breath opening and the body settling as the region releases.
The upper thoracic region is a transitional zone between the mobility of the cervical spine and the structural stability of the rib cage. It is designed to both support and adapt.
When functioning properly, this area allows for smooth transmission of force between the head, neck, and torso. It supports coordinated rib movement during breathing and distributes load efficiently through the spine.When dysfunction develops, this region does not typically fail at a single point.
Instead, it becomes progressively restricted across multiple layers of muscle.
Clients often experience:
• stiffness between the shoulder blades
• limited rotation or extension through the upper spine
• a feeling of compression or being “held” in the thoracic region• fatigue when maintaining upright posture
This is not a localized issue. It is a regional pattern of resistance that affects how the entire upper body moves and stabilizes.
Frequently asked questions
Why does my upper back hurt more the longer I sit?
Because sitting at a screen asks the posterior thoracic muscles to hold the head and shoulders forward for hours. They fatigue, spasm and ache. Releasing them relieves it; changing the position keeps it relieved.
I have been told my thoracic spine is stiff. Is that the bones?
Rarely. The thoracic vertebrae are held stiff by the muscles between and beside them in sustained contraction. When the muscles release, the spine moves again.
Can upper back tension affect my breathing or digestion?
Yes. The ribs attach to the thoracic spine and the sympathetic nerves to the heart, lungs and digestive organs exit here. A locked upper back restricts the breath and holds the body in a stress state. Clients describe both easing as the region releases.
Step 2
The Clinical Problem
Spasm of any of these muscles can cause impingement of the "long thoracic nerve", spinal nerves and even the spinal cord. Release these to relieve upper back pain.
A client reports pain between the shoulder blades, fatigue in the upper back, and dysfunction of specific organs, during fight, or flight - that I will mention soon.
Clinically, upper thoracic dysfunction presents as:
• pain in the upper back between the shoulder blades
• pain referred into head, neck and shoulder
• loss of thoracic flexibility during flexion
• loss of flexitility during rotation
• some restriction in breathing
Palpation reveals:
• which layers of muscle are in spasm
• decreased elasticity across multiple levels
• mobility of vertebra, ribs and scapula - which helps indicate which muscles are in spasm.
e.g, rhomboid spasm causes scapula to become immobile or serratus posterior superior causes ribs to become immobile. These muscles follow the same path, so mobility tests become essential for correct identification of which muscles are in spasm.
A key feature of this area is that the restriction can be caused by any of several layers of muscles being in spasm.
From superficial to deep, these layers are as follows:
• Trapezius
• Latissimus Dorsi
• Rhomboid layer (rhomboid major, rhomboid minor, levator scapulae)
• Serratus posterior superior
• Erector Spinae (semispinalis cervicis, semispinalis capitis, splenius cervicis, splenius capitus, longissimus thoracis, longissimus cervicis, longissimus capitis, iliocostalis thoracis, iliocostalis cervicis)
• Paraspinals
Any and all of these muscles will cause pain when they are in spasm, and limit mobility. They all have different insertions, but they all cause pain in between the shoulder blades. Release each of them, via process of elimination, and begin with the most sperficial layer and work your way to the deepest layer by releasing each of these muscles one at a time. The key muscle to release first is the infraspinatus, This is a genuine "Releasology hack." Do this first and the other muscles will be much easier to release.
By releasing each of these muscles the upper back will:
• rotate more freely
• flex while bending forward without effort
• distribute force efficiently
• become delightfully pain free
• breathing will become much easier.
The sympathetic nerves for several organs will be released, helping those organs work better during fight or flight.
These organs include:
• heart
• lungs
• liver
• gall bladder
• stomach
• spleen
• pancreas
These systems become blocked during sympathetic (fight or flight) mode because the sympathetic nerves that supply them are being compressed. by the muscles in this section. Release these muscles and release these nerves. Release these nerves to restore symnpathetic function to these organs. This means, that during periods of stress, these organs won't work well when these muscles are in spasm. This modality is about more than freeing pain. Releasing these muscles that cauase pain in the upper back also restores better organ
If back pain persists, one of these layers is in spasm. Release them all and pain will stop.
Step 3
Why This Happens
The Root Cause of Muscle Spasm
The upper thoracic complex is particularly vulnerable to dysfunction due to its layered structure and constant functional demand.
This region must:
• support the head and cervical spine
• stabilize the shoulder girdle
• coordinate with the rib cage during breathing
• transmit force between the upper and lower body
To accomplish this, multiple layers of muscle remain active throughout the day.
When fatigue, postural strain, or repetitive patterns are introduced, these muscles can enter a state of sustained contraction.
Because the region is layered:
• superficial muscles tighten to stabilize
• deeper muscles compensate and become restricted
• tension accumulates across multiple levels
Over time, the layers lose their ability to move independently and begin to function as a single unit.
From a Releasology perspective, this represents a disruption in conduction across layers.
Force is no longer transmitted efficiently. It becomes absorbed and restricted within the tissue.
Prana, understood as the integrated flow of force, fluid, and information, becomes limited in its movement through this region.
The result is a system that:
• holds tension
• resists movement
• and loses its ability to adapt
This is why the pattern feels persistent and difficult to resolve.