How to Avoid Upper Back Pain When Running

Man with backache. Pain in the human bodyImagine how much the average person actually slouches during a day.

Slouching during breakfast, then hunched over the kitchen sink to wash dishes, slouching while driving a car, and then slouching while sitting at work or at a school desk.

Don’t forget about slouching while texting, watching TV or using the computer. When you are not slouching, you’re bending over to clean or pick up children and/or pets. The list of slouching possibilities is endless!

Now envision your running posture. Does it look any different? Many of us run in a forward head and rounded shoulders position–a slouched posture! Runners experience many of the same aches and pains as their sedentary counter parts. Upper back and neck pain is a common occurrence. The most typical cause is almost always poor posture.

How to Avoid Upper Back Pain When Running

Our spines are designed to move many directions including both forward and backward. The problem is that we spend most of our times in a slouched, hunched over (flexed) position. Slouching is often associated with a posterior pelvic tilt, which causes a reduction in the normal lumbar curve that increases your risk of developing low back pain (LBP). The rounded shoulders forward head posture tends to be even worse in people who are taller than average or in teenage girls and women (as many will slouch to modestly hide their chests).

Over time, this constant flexed position causes excessive strain on the posterior muscles of the spine. It begins to overload the vertebral discs and ligaments which can also lead to pain and injury. As runners pound out mile over mile, this creates even more pain and dysfunction.

Young woman out jogging suffers a muscle injury

Poor posture causes improper spinal positioning and affects the neck, shoulders, low back, mid back/thoracic, and ultimately, the entire body. This flexed (slouched) posture leads to postural muscle weakness which causes us to slouch more as well as predisposing us to injury. This position (specifically for runners) can also cause limitations in performance as rib and vertebral mobility worsen. This reduces your ability to utilize your full lung capacity and to adequately transmit forces up and down the spine.

Runners often experience increased neck and upper back pain when running a longer distance and particularly, when running on a harder surface. Symptoms typically begin as an achy feeling in your neck, shoulder or upper back. This achiness can quickly become a sharp and piercing pain. This may cause you to lose focus and running form. Often, you must end a poor training run or worse yet; lose some of your training days.

Treatment Strategies

How can we eliminate upper back pain (particularly, pain when running)? As simple as it sounds, first work on your posture!  Sit and stand up straight.  Be very critical of your running posture. Don’t allow your head to jut out too far from your body. Some degree of forward head posture is expected as this allows for an easier passage of air (when mouth breathing) down the trachea and into the lungs.

Even small changes in posture can have big benefits. Initially, it may be difficult because the posterior back muscles, which are responsible for maintaining an upright posture, are weak. Correcting your posture initially may actually cause some pain as the muscles will be utilized in a way that they aren’t used to. Persistence is crucial if you want to eliminate pain permanently and decrease your risk of future or further injury and pain.


Sitting is not only a major risk factor for low back pain, but it is also a major risk factor for neck, upper back and shoulder pain because most of us tend to sit in a slouched posture.

  • Limit your sitting. Limit the amount of sitting that you spend at one time. Move from your sitting position every hour, and ideally, walk. If you aren’t able to walk, then try to shift your position at least once every twenty minutes in order to regain a more erect posture. Frequent position changes can help you to avoid prolonged static postures that cause excessive strain on tissues and muscles resulting in pain. Avoid a long car trip directly before or after a long run or a race. For destination races, it’s best to arrive at least a day or two early and wait a day prior to returning home.
  • Sit with correct posture. Whenever possible, make sure that your knees stay below your hip level and that you are able to maintain your natural lumbar curve. A McKenzie Lumbar Roll is a great tool to help you maintain correct posture.

Trail Packs and/or Hydration Packs

  • Loads and compression forces add up. Limit the amount of time that you are wearing the pack. Take it off unless you are actually walking or running. If you’re standing to visit for a while or rest, then take it off.
  • Use larger shoulder straps and a waist strap. Properly fitting straps can help distribute the load more evenly.
  • Only carry what you have to. Many times, we carry more items than we really need to. Carry only what you need, and be efficient in the way you pack items. Don’t over pack! If you are participating in a long distance event, rely on your team to carry items for you.

Postural (Extensor) Muscle Strength

I prefer to utilize a combination of standing and prone (face down) exercises. Please refer to Exercises for Scapulothoracic and Postural Muscle Strength for instructions and photos of exercises that you can perform in order to strengthen the scapular (shoulder blade) and postural muscles.

Foam Roller (or Towel Roll) Stretches

A foam roller is the best option, but you could substitute one by tightly rolling up a beach towel or by rolling a beach towel over a water noodle. Make sure to keep your knees bent and your head supported. Subscribe to my e-mail list to gain immediate access to My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain for step by step exercise instructions and photos.

Man with backache. Pain in the human body

Activation of the Nervous System

In the case of poor posture, it’s common that the upper trapezius muscles become over active (which causes pain and muscle spasms) while the lower portion of the trapezius muscles become weak and disengaged. This is partially due to the nervous system. The nervous system often works like a dimmer switch for lights. It can cause certain muscle groups to become over active while dimming the involvement of other groups.

The trapezius muscle is an important postural muscle. The more you slouch and hold a forward head and rounded shoulders posture, the more signals the nervous system will send to the upper portion of the trapezius. This causes pain and spasms.

Work to improve your posture by keeping your shoulder blades back and downward while engaging your lower trapezius. When this occurs, the nervous system will automatically send increased signals to the lower trapezius in order to help the muscle hold the posture. Meantime, the signal to the upper portion is reduced. This combined with improved thoracic mobility (through foam roll use) should immediately reduce muscle spasms and pain.

Topical Agents

For immediate and short term pain relief, you may want to try a topical agent. Many topical agents can help to decrease and eliminate muscle spasms. The method of action varies greatly according to the product used. You may find that one product works better than another. Some of my favorite products in my medicine cabinet include: Biofreeze Pain Relieving Gel; Arnica Rub (Arnica Montana, an herbal rub); and topical magnesium.

Another option is oral magnesium. You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates. Taking additional magnesium (particularly at night) can help to reduce muscle cramps and spasming. It is also very helpful in reducing overall muscle soreness and aiding in a better night’s rest. Most people are deficient in the amount of magnesium they consume on a regular basis. I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose as needed. I would caution you that taking too much magnesium can lead to diarrhea. Mag Glycinate in its oral form is the most highly absorbable. Although not as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.

Kinesiological Tape

Utilizing Kinesiological tape can be particularly effective when treating upper back pain. It provides additional support, and more importantly, a mechanical reminder to maintain proper posture. I have had luck using Kinesio Tape, Rock Tape, and Mummy Tape brands. You could also utilize Spider tape or KT TAPE.

Many of the techniques are easy to apply by nearly anyone, but you will need assistance from a spouse or friend. To visually learn how to apply the tape, please refer to these two simple, yet effective, techniques: How To Tape for Upper to Mid Back Support Using X Technique and KT Tape: Middle Back. For application and removal tips, please refer to Skin Care with Taping.pdf.

Physical Therapy

Upper back pain, neck pain, and/or shoulder pain is a common complaint among runners. However, the reasons for developing the pain are typically no different than those of the general population. The key to a long term treatment and recovery is to improve your posture, thoracic (upper back) mobility, and your upper back postural muscle strength.

If you continue to experience pain and discomfort after implementing these treatment strategies, please seek additional assistance from a physical therapist. The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

For additional information on common running injuries and how to self-treat, please visit

18 Responses to How to Avoid Upper Back Pain When Running

  1. Kyle @ SKORA Running January 28, 2016 at 9:01 am #

    Rolling out the back is definitely something I don’t do! Good reminder to try it out 🙂

  2. Ben Shatto January 28, 2016 at 9:30 pm #

    Kyle, I think you will find that if you spend just a couple of minutes every day using the foam roller to improve thoracic extension any cervical or shoulder problems you may have will improve. Or if you don’t have any issues then it will just feel so good you will want to make it a permanent part of your recovery protocol.

  3. Hermert September 8, 2018 at 4:24 am #

    It is advisable to wear an upper back brace during running?

    • Ben Shatto September 8, 2018 at 8:26 am #

      Hi Hermert…..I don’t think wearing a brace while running would work all that well. Particularly for an upper back issue. Sometimes women find that an sacroiliac (SI) style belt can be helpful or a belly belt if pregnant can be helpful when running. But otherwise I think there are a lot of issues with comfort that make wearing a brace while running not practical. Here is article I wrote about bracing for the thoracic spine that you may find helpful. I would address the issues that are causing you to want to wear a belt for support.
      It is typically a spinal mobility issue in combination with weak postural muscles.

      Hope this helps.


  4. Riley September 11, 2018 at 5:46 pm #

    Do you recommend using KT Tape for your upper back in order to reduce tension and stress?

    • Riley September 11, 2018 at 5:47 pm #

      And I just read the section where you talked about it… Sorry!

      • Ben Shatto September 11, 2018 at 8:57 pm #

        No problem!!! KT or Kinesiotape can be an effective treatment but is best if used for short term use. I find that following my foam roller sequence and working on strengthening of the mid and lower trapezius and Rhomboid muscles can relieve most tension.


  5. shailesh November 5, 2018 at 10:26 am #

    During my cardio session I got this problem after 10 minutes on treadmill.sometimes .its very frustrating. by the way its nice explanation I will try more thing should I take serious suggestion from physiotherapist.
    Please suggest…

    • Ben Shatto November 5, 2018 at 10:06 pm #

      Hi Shailesh, I’m sorry I don’t fully understand your question. But yes upper back pain is a fairly common issue for people during running. In most cases some upper thoracic stretching and self-mobilization in combination with some upper back strengthening exercises and most issues will self resolve quite rapidly.

  6. Diane March 4, 2020 at 1:30 pm #

    Don’t mind me, just “modestly slouching” to hide my breasts over here…

  7. Marissa Friedl April 11, 2021 at 9:05 am #

    Would heat or ice help better for healing an upper back running injury caused by poor posture.

  8. Ben Shatto April 11, 2021 at 9:31 am #

    Either one can be used according to your preference for pain relief. For treatment, it should be focused on mobility and strength.

  9. Ruth May 5, 2021 at 3:35 am #

    Hello everyone, I have been running for the past 6 years, and I greatly enjoy it. Recently, I found that I have had to stop running in order to fix posture issues with my neck, upper back, and shoulders. My initial doctor told me to go swimming and to stop running, (three months ago) so I stopped running and did low impact exercise in the pool. (and walking, plus posture exercises) Three months later, my neck and shoulder pain are better–I don’t get the same intensity or amount of neck and shoulder pain, but I see that I still need to work on my neck and upper body posture. I would like to get back to running as soon as possible. I am going to see a new doctor for a check up, and for help rehabbing a small rotator cuff injury. (The old doctor told me that the small rotator cuff injury was not a big deal, but I am not sure.) Is there any cardio I can do, now, that feels the same as running? I find that it is actually easier for me to maintain better posture when I am running as opposed to walking. (Strange, but true.) Sure, I know to do stretching and strengthening exercises, but I would like to know if there is anyone out there who found cardio that was similar to running. (I would like to do longer cardio sessions before returning to running on a treadmill.)

    • Ben Shatto May 5, 2021 at 9:28 pm #

      Hi Ruth, you may try an elliptical machine or stair climber. Or just walking on the treadmill on an incline. I would have to say there should be very little reason to stop running completely in a case as you described. You can work on posture and strengthening concurrently with running. There are several articles on the MTA website that may help. Also the resilient runner program has a great section on running and upper back pain. Keep doing what you love while you improve your posture and strength. You might taper back mileage some or need fewer run days at first but it is definitely possible. Wishing you all the best!

  10. Ruby October 21, 2021 at 2:18 am #


    I love running. However, every time I run I have pain on the left side especially at the left breast line under my under arm. This could be because earlier i would swim my arms to get my watch running. I wear my watch left side. And the pain go all the way back mid left back. Please advice. When I press on the left side just next to the breast, it hurts.

    • Ben Shatto October 27, 2021 at 2:23 pm #

      Hi there. This is an interesting symptom. It’s hard for me to say without a complete evaluation, but often times pain like this is caused from an issue within the vertebral segments for the joint between the vertebrae and the costovertebral joint. It’s typically not serious but can be very painful. I would start with the foam roller exercises I recommended pre-run and see if you can loosen the area and if that makes a difference. If you continue to have pain you may need someone to evaluate the inter-segment on mechanics of your spine and ribs. Either a PT or a chiropractor could help you with that. I hope that helps get you going in the right direction. All the best.

  11. Anu November 7, 2021 at 9:13 am #

    i have the same problem as Ruby has described, only on the right side. When I have warmed up well and have eaten well in advance of running, it is less or doesn’t exist. I don’t experience the pain when i run at a slower pace to start with and later keep similar pace. Whenever I have just eaten, had water, run fast suddenly, I get the pain!

  12. Ben Shatto November 7, 2021 at 9:03 pm #

    Hi Anu,

    It is a curious symptom. It sounds like you have identified some causative factors. Now try manipulating each one independent of the others and see if you can narrow down the exact cause. This will help you work on either a work around or treatment plan to avoid the pain when running. Just curious, but are you an experienced runner or a fairly new runner? Sometimes newer runners will get odd aches and pains as the body adjusts to the running and the jiggling during running. Nutrition will often impact this.

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