A Massage Therapist’s Insight
By Daniel Berro, Licensed Massage Therapist
As a Denver massage therapist and licensed massage therapist for almost a decade, I can say that there is one complaint more common than all the rest: upper back pain. Have you ever experienced a seemingly constant, dull, achy pain somewhere between your shoulder blades and spine? If so, this is for you. I am going to offer you a more holistic way to think about and address this specific issue in hopes that you might see more lasting results from your massage sessions and/or self care regime.
How Muscles Work
Let us start with a quick description of muscles and how they work. Your body is a complete system, and the way different parts work together isn’t always intuitive. I will not go too far in the weeds here, but I will touch on why pain and negative sensations occur. Let’s start with what muscles do: they shorten and contract, and they also lengthen and stretch.
I want to spare you the anatomical mumbo jumbo, so let's keep it simple. Repetitive positions, like those that accompany working from a desk, invite our nervous system to hold muscles in shortened positions. On the opposite side of that contracted muscle, however, is a muscle fixed in a stretched state. Aside from a specific injury to a joint, muscle or ligament, pain or discomfort usually originates from a stretched muscle rather than a contracted muscle.
Muscles and Posture
Upper back pain is incredibly common—roughly three out of five of my clients present with this issue. With these concepts in mind, it’s easier to understand what postural deviations may present with this common complaint. Upper back pain can impact almost anyone, including clients who might be quite sedentary or who participate in vigorous workouts. Usually they work from a desk on a computer or something similar. Upper back pain is not limited to the “desk jockey” and can manifest in people of all ages, including kids and teens.
To address the question of “what is causing my upper back pain?” I would invite you to do a quick assessment of your posture. Position yourself so you can see your posture from the side/lateral view. What do you see?
Is there any forward head posture?
Are the shoulders being pulled forward?
Is there any rounding of the upper back or even bony protrusions near the bottom of the shoulder blade?
What muscles are contracting and what muscles are being stretched as a result of that contraction?
Let's dive into this example a little more and talk about ways to address this pain and move beyond the “hurt here problem here” mentality.
How Not To Fix Upper Back Pain
What do most people do when they experience a bout of uncomfortable upper back and neck pain? Most tend to use the pressure of a Theracane, lacrosse ball, foam roller or the trusty door frame or wall corner directly in the areas that hurt. Or they may ask for massage to be done exactly where it hurts. Without direction it is easy to end up in the “hurt here problem here” mentality.
I wager this fix is very temporary, and more often than not the pain returns soon after. If you answered yes to any of those questions above, let's start to think about which muscles are contracting so slack can be given to the stretched muscles of the upper back.
Fixing Upper Back Pain
The two most common culprits in this scenario are actually the muscles on the front of the chest, including the pectoralis major and pectoralis minor. There are outliers however, and sometimes the serratus anterior and that devious subscapularis may also contribute to upper back pain. These four muscles aren’t obviously connected to tissues of the upper back—they are on the other side of the body, after all. Yet these muscles can have a profound effect on the tissues of the upper back to which they are linked. We have to start with a view of the whole system and not just the single piece. Notice how the front side of the body has an effect on the back side of the body.
Let's take this concept and run with it. I want to leave you with some tools to take with you. First, start paying attention to your posture. In real time, do your best to make small corrections to your posture. Notice if your head and shoulders are pulling forward and make a small adjustment. Start to notice and correct these small deviations. Second, start looking for the contracted muscles and understand that contracted muscle is doing its job and it typically does not elicit pain while doing so. Lastly, talk to your massage therapist about what you’ve observed in your posture and the sensations you experience. Make sure not to leave the chest muscles out during your massage session or your self care practices. Thank you for reading, please have a glass of water and I will see you for your next massage.
Daniel Berro is a licensed massage therapist at Washington Park Chiropractic in Denver, CO. Learn more about Daniel by reading his bio on our website! https://www.washparkchiro.com/kayce-weaver
Comments