Thoracic Rotation-Extension Syndrome

Thoracic Rotation-Extension Syndrome


Pain occurs in activities that involve thoracic rotation and extension.  These might include the cocking phases of throwing and racquet sports and gymnastics and ballet.  A history of reduced shoulder motion on one side may contribute to this dysfunction.

Diagnostic Tests:

  • Pain with thoracic extension.
  • Sitting in excessive thoracic extension.
  • Asymmetry of the thoracic spine.
  • Weakness in the abdominals.
  • Decreased available thoracic flexion.
  • Thoracic extension and rotation with overhead reaching.


  • Abdominal stabilization exercises to resist thoracic extension during shoulder flexion.
  • Instruction to use a backrest more often to allow the thoracic paraspinal muscles to relax.
  • Dissociate upper extremity and lower extremity motion from spine motion.

These are primarily sourced from work by the great Shirley Sahrmann PhD. I use these pages as a personal reference for this type of information.


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