Thoracic spine myofascial release

Stand behind the seated patient
Place your palms over the shoulders at the cervicothoracic junction
Place your thumbs over the posterior first rib and place the second and third digits superior and inferior to the clavicle at the sternoclavicular joints, respectively
Assess motion inferior and superior, left and right, and torsional (twisting) to determine position of ease or restriction
Gently stack the tissue in all three planes of motion into the position of ease (indirect) or into the barrier (direct)
Hold the force for 30–60 seconds or until a release is palpated

THORACIC, PRONE

With the patient prone, stand slightly superior to the patient’s iliac crests
Place palms on the paraspinal musculature around the dysfunctional segment
Assess motion inferior and superior, left and right, and torsional (twisting) to determine position of ease or restriction
Gently stack the tissue in all three planes of motion into the position of ease (indirect) or into the barrier (direct)
Hold the force for 30–60 seconds or until a release is palpated

PECTORAL AND THORACIC / RIB CAGE, SUPINE, LONG-LEVER TRACTION (DIRECT)

With the patient supine, stand at the head of the table
Instruct the patient to reach overhead (shoulder flexion) with elbows extended
Once the flexion barrier is met, grasp the patient’s bilateral wrists, add traction, and determine restrictive barriers (in pronation / supination, or internal / external rotation) of the shoulder girdles, distal upper extremities, and thoracic cage
Exert a gentle, direct force by stacking the tissues in their position of restriction; hold for 30–60 seconds or until a release is palpated
To facilitate this technique, a release-enhancing maneuver may be added by asking the patient to inhale fully, hold their breath for 5–10 seconds, and then exhale

SCAPULOTHORACIC ARTICULATION (DIRECT, RIGHT SIDED-EXAMPLE)

With the patient lying in the left lateral recumbent position, stand on the patient’s side near their head, facing them
Place right hand over the patient’s right shoulder with the thumb anchoring the clavicle, second finger on the trapezius, and the rest of the finger pads contacting the superior medial angle of the right scapula
Place left hand under the patient’s right arm and place finger pads at the inferior medial angle of the right scapula
Determine restrictive barriers of the scapula in inferior / superior motion, and scapular retraction / protraction
Exert a gentle, direct force by stacking the tissues in their position of restriction; hold for 30–60 seconds or until a release is palpated
To facilitate this technique, a release-enhancing maneuver may be added by asking the patient to inhale fully, hold their breath for 5–10 seconds, and then exhale

Author: Arman Israelyan, OMS-III

Editor: Matt Lipinski, DO

Editor: Robyn Hughes, MScBMC

Key Takeaways

Thoracic spine myofascial release is a manual therapy technique used to relieve tension and pain in the muscles and fascia of the thoracic spine. It involves applying gentle pressure and sustained stretching to the affected area to release restrictions in the soft tissues and improve range of motion. Thoracic spine myofascial release is often used to treat conditions such as thoracic spine pain, postural problems, and musculoskeletal disorders.

Thoracic spine myofascial release

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