Ribcage Opening Techniques for the Thoracic Spine, A Silent Culprit in Leg Stiffness

Joe Uhan’s method for enhancing thoracic spine and ribcage mobility, thus boosting overall running efficiency.

By on February 13, 2024 | Comments

Stay the CourseThe thoracic spine and ribcage are among the most overlooked and underappreciated parts of a runner.

Compared to the rest of the body, the thorax — unless banged and bruised by a fall — is seldom painful or injured. And while its utility as a breathing mechanism and heart protector is recognized, it plays another huge role in connecting and moving our legs, through fascia.

Through its fascial connections with the pelvis and hips, below, thoracic spine and ribcage stiffness may play a major role in lower extremity range of motion loss, as well as aches, pains, injury, and reductions in speed and endurance.

To address these crucial but oft-forgotten regions, I’ve devised a series of new stretches for all runners to both enhance thoracic spine and ribcage mobility, as well as optimize arm and leg mobility and overall running efficiency.

Stay the Course - Rib Cage and Thoracic Spine mobility - running

Mobilizing the thoracic spine and ribcage can help with overall running efficiency. Photo: iRunFar/Eszter Horanyi

The Roles of the Ribcage

In our first-ever article about it, we outlined several biomechanical functions and influences of the thoracic spine and ribcage during running, including:

Efficient Foot Strike

An efficient foot-under-body landing requires a balanced, neutral trunk.

Hip Power

A neutral thoracic spine facilitates the most efficient and propulsive hip flexion and extension.

Arm Swing

An efficient arm swing requires a balanced, mobile ribcage, over which the shoulder blade slides.

Joe Uhan neutral and forward trunk engagement

The author demonstrating an efficient arm swing. Photo courtesy of Joe Uhan.

“Short, Long, and Twist”

The thorax produces small-but-vital propulsive motions, including side bends and rotations, that result in unilateral shortening and lengthening — which creates optimal propulsion and a more cushioned landing.

Lung Expansion and Oxygen Uptake

An efficient ribcage, using the diaphragm muscle and surrounding fascia, can expand and contract the lungs for optimal breath volume.

Optimal Organ Function

Many vital organs are stored within the ribcage. The nervous system to them, and the organs of the digestive organs of the abdomen, flow through the thoracic spine.

I’m about to sound like an informercial voiceover, here: “But wait, there’s more!” Because the thoracic spine is responsible for even more than that.

Thoracic Fascia and Its Impact on Leg Mobility

As a running specialist of 15 years, treating — and failing to resolve — many cases of chronic and stubborn foot, knee, hip, spine, and everything in between pain, using conventional treat-the-pain approaches challenged me.

Rather than continue to hammer square pegs into round holes, demanding more patience, more visits, and more client money, I instead worked outside the box.

For local pain, I began to examine and treat the whole body:

Stubborn knee pain required I first address the hip and pelvis, as well as the foot. Treating the hip and pelvis got most knee pain better. But not all of it.

Then I recognized how mobility of the gut, which sits in the pelvis, impacts the pelvis and hip, which affects the knee. This improved even more knee pain, but not all of it.

These structures are all connected through fascia: a pervasive connective tissue that provides both connection and scaffolding structure for all tissues of the body.

Diagram of skeletal muscle showing the fascia

Diagram of skeletal muscle showing the fascia. Photo: Shutterstock

Finally, on the thoracic spine, I noted that those clients with stubborn hip and pelvic stiffness often had very stiff ribcages. And when I addressed thoracic mobility — namely with special attention not only to the vertebrae and ribs, but the fascia and organs within the ribcage — I got the best and most sustainable mobility gains.

How is the thoracic spine connected to the pelvis, hips, and legs? Through fascia.

Specifically, it is the transversalis fascia — a fascial layer beneath the transverse abdominis, considered the granddaddy of core stability muscles, which runs like a giant professional wrestling belt, across the front of the abdomen, all the way back to the spine.

Transverse abdominis

The transverse abdominis. Photo: Shutterstock

But more notably, it connects the circular rim of the pelvis to the lower ribcage and diaphragm, our big breathing and upper core stability muscle.


The diaphragm, shown within the rib cage. Photo: Shutterstock

If the thoracic spine — namely lower ribs and diaphragm — loses mobility, it creates tension through the transversalis fascia, which can then pull on the pelvis. When the pelvis is under tension, it can:

  • Get stuck in elevation
  • Get stuck into a rotation, most often anterior rotation
  • Fail to move far enough, or in the required directions

Without getting too nuanced, a stiff ribcage makes for stiff hips through this fascia connection. Thus, optimizing thoracic mobility — but namely lower ribcage mobility and this fascial connection — can significantly improve mobility throughout the lower body.

And here’s my new favorite way to do it.

Ribcage Opener with a Ball

Conventional thoracic mobility emphasizes extension. And while this is a key motion, it is one of only six important motions of the thoracic vertebrae and ribs, which includes flexion, side bending, and rotation. Moreover, what mobile thoracic-abdominal-pelvic fascia requires is efficient ribcage mobility that “opens and closes” — ribs that can functionally inhale and exhale.

During inhalation, most of the ribs move upward and outward. Then, in exhalation, they should relax downward. However, for various reasons — including posture, stress, and trauma — ribs can get stuck in either elevation (inhalation) or depression (exhalation).

Performing only trunk extension might facilitate some rib elevation, but the fascial system needs more motion. Trunk rotation is another good option, but it too fails to emphasize end-range rib elevation and depression.

How About Side Bending?

Side bending is a relative opening (inhalation) on one side of the body, with a closing (exhalation) on the other. This is an optimal ribcage intervention. And to really get the full range of motion, let’s try it over a ball.

The following video, and the steps outlined underneath, will show you how:

Performing the Ribcage Ball Opener

To perform, obtain a large inflatable therapy ball. The ideal size is large enough to feel a big stretch in the lateral ribs and trunk, but small enough to easily touch the ground with the bottom leg and arm.

Then, position the lower leg in a flexed position. This will help balance you and prevent too much low back extension. The bottom arm should be planted on the floor, like a modified side plank.

Once in position, there are a variety of strategies for different types and intensities of stretching, including:

  • Static side lying and breathing: In a side-bent position, breathing is a powerful mobilizing tool for the ribcage, diaphragm, belly fascia, and pelvis. Try a prolonged breath hold, with an inflated ribcage, and breath stacking. Take three breaths — a primary, then two extra — without exhaling, for maximal volume.
  • Rotate and reach: Rotation forward will facilitate relative flexion (or exhalation) of the upper ribs; a backward rotation, more elevation (inhalation) of ribs.
  • Short and long: Try the running-specific short and long maneuver to move both the arm and leg over the ribcage and pelvis, respectively.
  • Hip extension: Functional hip extension requires fascial mobility, not only through the hip itself, but around the pelvis, belly, and trunk. Perform repetitions of hip extension to both stretch and strengthen into your new range of motion.
Stay the Course - Ribcage opener ball exercise

The author performing the ribcage opener exercise on a ball. Photo: Joe Uhan


The thoracic spine may house our heart and pump our lungs, but how it connects to our arms and legs plays a huge role in alignment, mobility, and efficiency of the entire lower body. Keep it moving in all directions!

Call for Comments

  • Have you experienced stiffness in the thoracic spine?
  • Have you tried Joe’s recommendations for mobilizing this part of the body?
Joe Uhan

Joe Uhan is a physical therapist, coach, and ultrarunner in Auburn, California. He is a Minnesota native and has been a competitive runner for over 20 years. He has a Master’s Degree in Kinesiology, a Doctorate in Physical Therapy, and is a USATF Level II Certified Coach. Joe ran his first ultra at Autumn Leaves 50 Mile in October 2010, was 4th place at the 2015 USATF 100k Trail Championships (and 3rd in 2012), second at the 2014 Waldo 100k, and finished M9 at the 2012 Western States 100. Joe owns and operates Uhan Performance Physiotherapy in Eugene, Oregon, and offers online coaching and running analysis at uhanperformance.com.