This is the first in a series of articles on common problems, of the aches and pains, that active people regularly put up with and alternative solutions that an Athletic Therapist can suggest given our background in working with both active individuals and elite performers. As a clinician and coach with extensive experience in high-level sports including work with Hockey Canada, in the Western Hockey league and multiple provincial and national level programs in a variety of different sports, I can help someone see things most would miss. The perspective I can offer as an Athletic Therapist is different from other professions and will help you fully understand your injury or limitation and how we can work together to help you move, play and feel better
Today’s example is one I’m sure that any person working in an office or sedentary industry can easily relate to. Perhaps it shows up in the mid afternoon or during an especially long commute home. It is that nagging pain in your upper back, just near your shoulder blade. Your first instinct is you try to reach around and massage it, but you can’t quite get it and besides you look like your giving yourself a one arm hug while sitting in traffic. You try rolling your shoulder around and maybe you find a position where it’s manageable, but you just end up looking like a turtle. While a little bit of self massage, a few Advil or a glass of wine when you get home might help a bit, really what’s going on is a battle for stability around your shoulder and you are the main casualty.
The two combatants in this situation are potentially the Rhomboids (they are located around where you feel the discomfort in your upper back) and the Pectoralis Minor situated where your chest and the front of your shoulder meet, just under the much large Pectoralis Major. Many of us spend a large amount of time sitting at work and mouse or slumped over our phone and generally not moving enough. When this happens, the front of our chest tends to move into a tightened position and the pec minor gets the signal to remain shortened and contracted to help stabilise our shoulder blade (scapula) and this can lead to a shoulder shrug like motion and a forward rounding of our shoulder. Think about how often you might reach forward to use a keyboard or mouse while at work or your steering wheel while driving. With this anterior tightening, the Rhomboid at the back, tends towards becoming neurologically weakened and disconnected from its responsibilities. Consequently, it become stuck in a weak and lengthened position, often leaving us a literal pain in the neck (and back) at the end of the work day. There are many potential after effects that can come from such a dysfunctional relationship, including our breathing becoming altered, shoulder impingement, and pain developing in our neck as the body attempts to correct this jigsaw puzzle.
While the first instinct to release the area with something like heat or massage is not wrong, it is only a part of the larger picture. The real lasting correction to this problem could be to release (with massage or stretching), the tight Pectoralis Minor first. Then once the Pectoralis Minor is relaxed, the brain and the Rhomboid just need to get reacquainted with very easy exercises. So, if this is a situation you face, give the following a chance next time that upper back pain sneaks up on you at work. Find a doorway, raise your arm up like you are asking a question and rest the arm on the doorway. With your elbow at or slightly above the height of your shoulder, step through the doorway and turn both your chest and head away. You should feel a nice stretch across your chest and specifically in the most lateral part near your armpit. Hold this stretch for at least 30 seconds, even if your coworkers are laughing at you. Then once completed, stand up with a tall posture (think Superman) and perform a rowing motion with that same arm, imagine opening a door with it’s handle at your waist and gently squeeze your shoulder blades together. Perform six to eight repetitions of this pulling motion, in a controlled and easy manner (don’t break a sweat). Try repeating this pair 3-4 times a day since it only takes about a minute and I suspect your afternoon guest will disappear in no time.
Now the relationship mentioned above is not the source of every problem in the upper back, since there are no cookbook type of answers with the human body. The important thing is to get your issues assessed and examined by a qualified professional, such as an Athletic Therapist. Whoever you see, should provide you with a very personalised and one or one plan to help you find and correct the real sources of your injuries or problems.