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As we continue our trigger point journey down the back, I thought it pertinent to talk about the mid back. Besides trigger points (TrPs) along the spine referring localized pain, there are a couple of overlooked TrPs in neighboring muscles that refer pain to the mid back (thoracic region).

Two Funky Back Pain Causing Muscles

I’m calling these muscles funky because we just don’t think of them as possible culprits in back pain.

Rectus Abdominus

And because of pain in the back, we often only focus our attention there. It is rarely that simple. Besides lengthening the front of the spine, treating TrPs in the rectus abdominis, aka your abs, can provide great relief for mid and low back pain.

I have seen a few clients leave with so much relief for their back that they didn’t need their original scheduled surgery! All because this ab muscle was not checked. If you’ll notice in the picture, there is also a low trigger point that refers pain to the low back.

These abdominal points are not as common as trigger points in the QL (quadratus lumborum) or back muscles. I’ll get to those in our next article 🙂

Treating trigger points in the rectus abdominus can be a bit tricky on your own.. Sometimes doing some upward dog (stretching the front of your spine) can help. Generally, lengthening the front of your body can help with a host of issues, including back and neck pain. This is because we are so often hunched while we sit, drive, watch TV… So our tendency is to have shortened tissues in the front of our spine, along our sternum, neck and/or belly.

If you are having pain patterns like the picture to the right, a massage for your abs, is probably the best thing you can do to relieve the pain. You’d be surprised at how much tension we hold in our bellies.

Lats Lats Lats

latissimus trigger pointThe other often forgotten muscle for mid back pain is latissimus dorsi, aka your lats.

When this point becomes chronic or over-activated, you will also feel achiness or pain down the back of the arm, as the red stippling in the pic shows. But the main pain is felt around the bottom of your scapula. Sometimes this muscle gets strained during pullups, so if you’ve got this pain pattern showing up after a good pullup workout, chances are you just aggravated your lats.

Treatment for Latissimus TrP

The latissimus TrP shown (that’s just behind the armpit) can be addressed with a foam roller- You’d lie on the roller on the affected side and roll up towards your armpit. Find a nice tender area and hang out there for a min or so. This is a great technique if you just want to improve your overhead reach because chances are, you have short lats.

And then there’s always pain relief from a specialized massage.

As always, if you can’t figure out how to relieve your aches and pains, please see a professional. Doctors will most often tell you to take pain meds, and sometimes they’ll have you see a physical therapist or chiropractor, but around 85% of pain is from soft tissue issues. And a skilled massage therapist, who works with soft tissue and clients in pain, should be one of the first people you see.

Stay tuned for the next trigger point article on low back. It’s sure to be a doozy!

 

Addressing Shoulder Tightness & Pain Continuing on our trigger point journey, I thought the shoulders would be our next stop. A very common pain or soreness occurs just next to the scapula, around your midback.

Even though the pain is in the back, this is not due to muscles acting on your spine, but due to muscles acting on your lovely shoulder joint. And as I sit here writing on the computer, I am trying to keep my posture in check – not to force good posture, but to find a place where my spine can stack and my shoulders can rest back in their sockets.

The Overworked Rhomboids

Sure, it’s helpful to get trigger points out of your rhomboids (the muscles in the back that attach your scapula to your spine). But guess what might be creating those trigger points.. It’s usually shortness in the front of the shoulder.

So, while it’s great to hammer out the rhomboids, the front of your shoulder, where your pecs lie, is an important area to address.

The Lovely Pectoralis Major & Minor

Often overlooked because rarely is there pain here in the front of the chest, these pec muscles, when shortened (which is the case for most of us!), can cause much pain in the back of the shoulders, neck, or down the arm.

When they become short (usually from continuous sitting or standing with slumped shoulders),the muscles in the back of the shoulder become lengthened and have to work harder against gravity to hold your shoulders back! This is why we experience pain in the back and not where the short, tight, and much neglected pecs lie. They are doing just fine being tight and held, thank you very much… until you press on them and realize there is work that needs to be done!

It’s also extremely important to get your shoulder joint in good alignment.. when the front of our shoulders become overly shortened, it causes extra work for other muscles and in the end, the ligaments take a beating as well, and you are left with a rotator cuff injury. Not fun.

Self Care Techniques to Open the Shoulder & Decrease Pain

Ball on Your Pecs:  Grab a small ball (tennis, racquet, or lacrosse work well) and stand facing a wall. Place that ball (between you and the wall) a few inches below your clavicle, more towards your shoulder in the meaty area of your pecs. Use your weight to lean into the ball and get a minnie massage in that area. You should hit your pec major and minor, and feel free to move the ball to a slightly different location and hold for a few mins.

Work one side for at least 5 mins and see how it compares to the other side- you might feel a surprising difference.

Move the ball slightly to one side if you experience any sort of nerve tingling/numbness down your arm or in your fingers. You don’t want to aggravate the nerves of your brachial plexus.

The Wall Angel: Another great exercise that I recommend many of my clients do is called the Wall Angel. And here’s a video that shows how to do it. Be sure to follow the directions carefully on how you should stand, etc. It is a great shoulder opener and also strengthens your muscles on the back of your shoulder.

Please don’t hesitate to call Leah for any advice on how you can help free your shoulder joint, creating more ease and less pain!

Free Bodied, specialized massage therapists Salt Lake 801-906-3222