By Stephen Portee, MS, CSCS
Back pain is one of the most common reasons people seek care — and it is rarely caused by just one thing.
Often, it is the result of how the body moves, compensates, and adapts over time. One of the most frequently overlooked contributors is poor control of the ribs and pelvis — and addressing it can make a meaningful difference in how you move and feel.
Many people with back pain are "stuck" in a certain position without realizing it. They may lack adequate spinal or hip rotation, or they simply cannot move their spine through its full range of motion.
The body is remarkably good at finding workarounds for limited movement. If you try to push yourself into a position, you will usually get there — but not without compensating somewhere else along the chain.
True spinal rotation, for example, requires more than just turning your trunk. Your shoulder blades need to glide and tilt around the ribcage. Even lifting your arms overhead demands that the scapulae move smoothly in relationship to the ribs.
If your ribs are "stuck" — either flared or depressed — they restrict how the rest of your body can move. That restriction may not feel dramatic initially, but over time it adds strain to the wrong places and often leads to back pain.
Learning to reposition your ribs and pelvis through proper movement can unlock safe new ranges of motion and significantly reduce discomfort.
Before you can improve control, you need to develop awareness of what your spine is actually doing.
Exercises like cat-cows and spinal segmentations are excellent starting points. These drills help you feel how each vertebra can move individually — flexing, extending, and rotating.
The more awareness you build around rib and pelvis positioning, the easier it becomes to notice when you are stuck and how to adjust.
Once awareness is established, the next step is learning to stabilize your spine and pelvis while your arms and legs move independently.
Exercises like bird dogs and dead bugs are excellent for this. They look simple but can be surprisingly demanding — because the further your limbs move from your center, the more your core must resist flexion and extension.
This type of training develops the anti-movement strength that protects your back in everyday life, sport, and the gym.
Rotation is often where back pain worsens, because people try to twist from the wrong place.
The lumbar spine — your lower back — is designed primarily for stability, not rotation. Research measuring range of motion across the spine confirms this: the lumbar spine allows only about 7–9 degrees of axial rotation, compared to roughly 33–37 degrees at the thoracic spine and 27–32 degrees at the pelvis.[1] When people force rotation from a joint that isn't built for it, that mismatch can create long-term strain and may contribute to injury over time.
Instead, focus on driving rotation from the thoracic spine (mid-back) and the hips and pelvis — the regions anatomically built to handle rotational demand.
Addressing back pain is rarely just about stretching one muscle or strengthening one area. It is about understanding the interplay between your ribs, pelvis, and spine — and training the awareness, control, and rotation capacity that allows the whole system to move efficiently.
When these three steps are layered together, you do not just reduce back pain. You unlock new ranges of safe, efficient movement that carry over into sports, daily life, and long-term resilience. It's the same kind of movement quality we build on in Speed and Power Training for Active Adults.
Stephen Portee, MS, CSCS is the Managing Partner and lead strength and conditioning coach at Apollo Performance Chiropractic & Training in Pleasantville, NY.
