T/L Junction syndrome
T/L Junction Syndrome: The Hidden Culprit Behind Mid-Back and Lower Rib Pain
If you've ever felt a stubborn, nagging pain between your shoulder blades that just won’t go away — especially after long runs, rides, or even a tough gym session — you might be dealing with something called T/L Junction Syndrome.
It’s one of those conditions that flies under the radar but can cause a lot of discomfort if left unaddressed.
Let’s break it down.
What Is the T/L Junction?
The “T/L” stands for thoracolumbar — the spot where your thoracic spine (mid-back) meets your lumbar spine (lower back). Specifically, this is around the T12-L1 vertebrae.
This area is a natural transition zone.
Above it: a spine built for rotation and flexibility. Below it: a spine built for stability and load-bearing.
Because it’s bridging two very different roles, the T/L junction can experience extra stress with certain activities, especially when movement or load is concentrated in this region over time.
What Contributes to T/L Junction Syndrome?
T/L Junction Syndrome usually builds up because of repetitive stress and increased demand over time — not from one single injury.
Common contributing factors include:
Limited mid-back (thoracic spine) mobility
Low endurance or strength around the core and trunk
Changes in rib and breathing mechanics
Repetitive twisting, arching, or extension (common in running, mountain biking, and golf)
Long periods of sitting or static posture
As the area works harder to meet these demands, the joints and soft tissues can become irritated, leading to discomfort and protective muscle tension.
Symptoms of T/L Junction Syndrome
Achy, deep pain between the shoulder blades or at the lower ribs
Tenderness directly over the T/L junction
Pain that worsens with twisting, arching, or deep breaths
Occasional sharp twinges with certain movements
Feeling like you need to crack your back but can't quite get it
Why It Matters for Active People
If you love running, riding, lifting, or any outdoor sport, stiffness and irritation around the T/L junction can influence how you breathe, how you absorb force, and how you move over longer distances.
It’s not just an annoying mid-back ache — it can limit your performance and efficiency if left unchecked.
How We Approach It
At Base Camp Chiropractic and Sports Rehab, we don’t just chase the pain.
Our approach usually includes:
RESET: Calm down irritation with hands-on care, targeted mobility drills, and breathing work.
RESTORE: Improve mid-back mobility, build trunk strength, and expand breathing capacity to distribute load more effectively.
RELOAD: Reinforce strong, efficient movement patterns as you get back to running, lifting, and riding.
The goal isn’t just to feel better — it’s to build resilience and keep you moving at your best.
The Bottom Line
T/L Junction Syndrome is common among active people, but it’s very treatable with the right approach.
If you’ve been dealing with stubborn mid-back or rib pain that doesn’t budge — even after stretching and foam rolling — it might be time for a deeper look.
We're here to help you move, train, and perform without feeling stuck in that cycle of discomfort.