The open book stretch is a turning stretch for the upper back (thoracic spine), done lying on your side. Your bottom leg is straight, your top knee rests forward on a foam roller or cushion, and both arms reach out in front of you. The top arm then opens up and back like the cover of a book, turning your chest toward the ceiling while the supported knee keeps your lower body still.

How to do the open book stretch

Lie on one side on a mat with your bottom leg straight. A folded towel or thin pillow under your head is fine if it keeps your neck level.
Bend your top leg and rest that knee in front of you on a foam roller, a firm cushion or a folded towel.
Stretch both arms out in front of you at shoulder height, with one hand resting on the other.
Keep the bottom arm on the floor. Lift the top arm up toward the ceiling and then back as far as is comfortable, letting your chest turn with it. Your head turns gently to follow your hand.
Keep the top knee resting on its support so the turn comes from your upper back. Pause and breathe, then bring the arm back to meet the other hand.
Repeat, then roll over and do the other side.

What you should feel

A stretch across the front of your chest and shoulder on the top side, and a turning stretch through your middle and upper back.

Common mistakes

Letting the top knee lift off its support as you open, so the pelvis rolls back and the lower back does the turning.
Flinging the arm back. Move it slowly and let your chest lead.
Pushing through a pinch at the front of the shoulder. Bend the elbow a little or reach less far.
Holding your breath at the open position.

How often

Many programs use 5 to 10 slow repetitions on each side, pausing for a few seconds at the open position, once or twice a day. Your physio will adjust this.

Stop and check with your physio if

Sharp pain in your back, ribs or shoulder, or pain, numbness or tingling spreading into your arm.
You feel dizzy, faint or unsteady. Stop and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
Things look double, your vision suddenly blurs or goes, your speech slurs or becomes muddled, swallowing becomes hard, your face or lips go numb, one side of your face droops or one side of your body goes weak or numb, you suddenly become so dizzy or unsteady that you fall or cannot stand or walk, your legs suddenly give way but you do not black out (a drop attack), or you get a sudden severe headache. Stop and call emergency services, even if it goes away.

From the clinic

In the video the top arm opens all the way back to the floor behind, but your hand does not need to touch the floor. At first, opening until the arm points at the ceiling is plenty. If your shoulder complains, bend the elbow and rest that hand on your chest, so only the trunk turns. Your head can turn gently to follow the hand if that feels easy, or stay resting if your neck is sore. Thread the needle turns the same area on your hands and knees, and the seated trunk rotation does it on a chair.

If you have had a hip replacement, get the go-ahead from your surgeon or physio before you try the open book stretch. Resting the top knee forward on its support bends that hip to about a right angle and lets the knee drop across the middle of your body, and many surgeons ask you to avoid that for the first months after some operations. Lying on the operated side may not be comfortable yet either. With osteoporosis or a past fracture in your spine or ribs, talk to your physio before letting the arm open all the way, since a full twist is often limited. This stretch twists your spine and opens across the front of your chest and shoulder, so after surgery on your spine, heart, chest or shoulder in recent months, get the go-ahead from your surgical team or physio first.

Written and checked by the PocketPhysio editorial team. Last updated 2026-09-26.

This page is general education, not a diagnosis or a personal treatment plan. If you have pain, an injury or a health condition, see a physiotherapist or doctor before starting new exercises.

Open book stretch