Upper back
What to do for pain between the shoulder blades
The ache between the shoulder blades often sits with a forward head, rounded shoulders and a stiff upper back. Reviews of exercise for that pattern support strength and mobility work together.
This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.
Before you start
Get emergency care rather than exercising if the pain comes with chest pain, breathlessness or feeling unwell. See a doctor first for weakness, numbness or pins and needles in an arm or hand, pain that followed a fall, or pain that wakes you at night. Stop and speak to a clinician if a movement brings on sharp pain, dizziness, or symptoms that travel down an arm or a leg, and seek urgent care for any loss of bladder or bowel control or numbness around the saddle area.
This is the version everyone gets. Yours is different.
Start your first sessionCheck this first
Back pain with chest pain needs emergency care, according to the NHS back pain page, which lists chest pain among the symptoms to treat as an emergency alongside back pain. If the ache between your shoulder blades comes with chest pain, breathlessness or feeling unwell, get urgent help instead of exercising.
What the reviews support
A 2024 review and meta-analysis of 22 studies on upper crossed syndrome, the pattern of forward head, rounded shoulders and a rounded upper back, found therapeutic exercise improved all three angles, with strength exercise, stretching and shoulder-based exercise among the programmes that worked. A 2026 review of 28 trials found large improvements in the angles but inconclusive effects on pain, so the honest summary is that posture changes more reliably than pain does.
The American Physical Therapy Association's neck pain guideline recommends scapulothoracic strengthening in the acute stage and combined stretching, strengthening and endurance exercise for chronic neck pain, which is the same shoulder blade muscle group.
Mobility and strength together
In a small trial of 26 office workers with chronic neck pain, a thoracic mobility programme that included kneeling rotations improved pain, disability and range of motion. The sequence below opens the upper back first, then strengthens the muscles that sit between the shoulder blades.
The sequence
- 1
Thoracic extension over a chair back · 45 to 90 seconds
The upper back bending backwards over a support, which opens the area between the shoulder blades.
- 2
Seated cat cow · 45 to 60 seconds
Aim the arch at the area between the shoulder blades, not the lower back. Easy enough to do at a desk.
- 3
Open book rotation · 30 to 60 seconds each side
Rotation through the upper back, lying on your side so the lower back stays out of it.
- 4
Scapular wall slide · 30 to 60 seconds
Teaches the shoulder blades to glide up and down the ribcage with the arms overhead.
- 5
Prone T, shoulder blades together · 30 to 60 seconds
Strengthens the muscles between the shoulder blades that draw them back toward the spine.
- 6
Prone Y raise · 30 to 60 seconds
Lower trapezius work that draws the shoulder blades down and in as the arms go overhead.
Open first, then strengthen. A few of these most days beats the whole list once a week, and each should stay comfortable.
That sequence was written for everyone with this. Yours would be built around your answers.
Start your first sessionWhat the research says
The NHS back pain page lists, as needing immediate emergency care, back pain alongside chest pain, numbness, tingling or weakness in both legs, loss of feeling around the genitals or anus, or changes in bladder or bowel control.
A 2024 systematic review and meta-analysis of 22 studies in people with upper crossed syndrome found therapeutic exercise improved forward head, rounded shoulder and thoracic kyphosis angles, with strength exercises, stretching and shoulder-based exercises described as effective.
A 2026 systematic review of 28 randomised trials with 901 people found corrective exercise produced large improvements in those angles, while effects on muscle activation, function, balance and pain were inconclusive.
The APTA neck pain clinical practice guideline (2017) recommends scapulothoracic and upper extremity strengthening in the acute stage and mixed stretching, strengthening and endurance exercise in the chronic stage.
A randomised trial in 26 office workers with chronic neck pain found a thoracic mobility programme including kneeling rotations improved pain, disability and range of motion, with effects similar to thoracic manipulation.
Sources
- 1NHS, back pain, nhs.uk conditions library
Lists as needing immediate emergency care back pain alongside numbness, tingling or weakness in both legs, loss of feeling around the genitals or anus, changes in bladder or bowel control, changes in genital sensation, chest pain, or onset after a serious accident, and advises staying active rather than resting in bed.
- 2Sepehri et al., the effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome, systematic review and meta-analysis (BMC Musculoskeletal Disorders, 2024)
Across 22 studies, therapeutic exercise improved forward head, rounded shoulder and thoracic kyphosis angles, with strength exercises, stretching, shoulder-based exercises and comprehensive programmes targeting all the muscles involved described as effective.
- 3Khorramroo et al., corrective exercises strongly improve posture but fail to produce consistent clinical or functional benefits in patients with upper crossed syndrome, systematic review and meta-analysis of randomized controlled trials (BMC Sports Science, Medicine and Rehabilitation, 2026)
Across 28 randomised trials with 901 people, corrective exercise produced large improvements in forward head, forward shoulder and thoracic kyphosis angles, while effects on muscle activation, function, balance and pain were inconclusive.
- 4Blanpied et al., Neck Pain: Revision 2017, APTA clinical practice guideline (Journal of Orthopaedic and Sports Physical Therapy, 2017)
Neck pain is classified into four categories, with recommendations including scapulothoracic and upper extremity strengthening in the acute stage, neck and shoulder girdle endurance exercise in the subacute stage, and mixed cervical and scapulothoracic exercise combining stretching, strengthening and endurance in the chronic stage.
- 5Seo, Song and Shin, thoracic spine manipulation versus mobility exercises in 26 office workers with chronic neck pain, a randomized controlled study, Medical Science Monitor (2022)
In a small trial of 26 office workers whose neck pain had lasted more than 12 weeks, a thoracic mobility programme that explicitly included kneeling rotations improved pain, disability and range of motion, with effects similar to thoracic manipulation.
Common questions
What should I do for pain between the shoulder blades?
Check the warning signs first: the NHS lists back pain with chest pain as an emergency. If it is a stiff ache, upper back extension and rotation plus shoulder blade strength work is what the reviews of exercise for a forward head, rounded shoulders and a rounded upper back support.
What stretches help pain between the shoulder blades?
A thoracic extension over a chair back, a seated cat cow aimed at the area between the shoulder blades and an open book rotation. A small trial in office workers found a thoracic mobility programme including kneeling rotations improved pain and range of motion.
Should I strengthen or stretch the muscles between my shoulder blades?
Both. A 2024 review found strength exercises, stretching and shoulder-based exercises were all among the programmes that improved posture angles. Stretch to open the upper back, then strengthen with a prone T or Y.
Can pain between the shoulder blades come from the neck?
Possibly, and we cannot tell from here. The APTA neck guideline includes shoulder blade strengthening in its exercise recommendations, which is why this sequence trains that area. Arm pain, numbness or pins and needles are a reason to be assessed first.
When should pain between the shoulder blades be checked?
Get emergency care if it comes with chest pain, breathlessness or feeling unwell. See a doctor first if it followed a fall, comes with fever or unexplained weight loss, wakes you at night, or comes with arm weakness or numbness.
This is the version everyone gets. Yours is different.
Start your first sessionAlso called what to do for pain between shoulder blades, pain between shoulder blades, pain in upper back between shoulder blades, interscapular pain exercises, stretches for between the shoulder blades, upper back pain between shoulder blades exercises. Movements are drawn from the clinically authored Vinys library. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.