When your mid-back begins to ache or the muscles between your shoulder blades spasm, you want immediate relief. However even when we are in pain our hectic lifestyles can make it difficult to find time for treatment.
Often we leave it too long before we finally seek help. Self-treatment relieves mid-back pain and discomfort, and learning some simple do-it-yourself techniques can help until you find time to see your therapist.
In the previous article we discussed changing your posture throughout the day, diaphragmatic breathing, and strengthening your core to relieve mid-back pain. All of these strategies make an incredible difference but they take time to be effective. When you need immediate relief, direct treatment can help but the problem with the mid-back is that it is an awkward place to reach with your own hands.
Fortunately there are a variety of self-treatment tools on the market which can help you treat this area. Some are easy to transport, many are affordable and can be used anywhere. For example many of my clients use the foam roller, tennis ball, Thera Cane/Shepherd’s Hook, lacrosse ball, as well as other devices. They find self-treatment between massage sessions helpful, but before you invest in these tools make sure that you know how to use them. Its also important to know which muscles need to be released as sometimes it’s not the muscle that is sore which needs treatment.

Foam roller

Tennis Ball

Thera Cane/Shepherd’s Hook

Lacrosse Ball
To help you get the most out of self-treatment here are some of the most common questions I find my clients ask about how to apply these do-it-yourself techniques.
1) Should I use Self-treatment before or after the workout?
Although there has been some controversy on whether foam rollers are helpful or harmful, a recent literature review in the American College of Sports Medicine concluded that this self-treatment tool has a beneficial effect on range of motion, soreness, and fatigue after exercise. In my practice I find that provided you use the foam roller properly after your workout, it can be very beneficial in relieving muscle soreness, improving circulation, flexibility, and increasing body awareness (biofeedback/proprioception).
2) Do foam-rollers work?

Using a Foam Roller
I have had clients ask me if the foam roller really works or is it just a torture device. Yes, it works. Foam rolling is a relatively new therapeutic approach. There is much more research needed to clarify the effects of foam rolling however the current evidence suggests it can help to improve flexibility, vertical jump, and reducing soreness.
3) How often should I self-treat?
When it comes to frequency, it is important to listen to your body. Treatment tools can be used everyday however I do not recommend treating several areas in the same muscle during the same session. Try releasing one area or trigger point and see how it feels before going onto another.
3) How long should I apply the pressure for?
Research shows that to produce change you need to hold the pressure on the muscle for a longer period of time. This means that each area should be held for about 2 minutes.
When you find a sore spot, stay on the spot until it disappears or if the soreness does not diminish or change in quality after 2 minutes then stop, apply heat and gently stretch the muscle. If you feel okay than try it again over the next few days as the tissue can adapt to stronger pressures with a course of regular treatment.
3) Can I make the my pain worse using self-treatment?
Absolutely! Rolling over the sore spots again and again will just aggravate the tissues. The trigger points you are trying to release with these self-treatment tools are by definition an irritated area within the muscle tissue, so it is important to not irritate the tissue further.
4) How do I know if this treatment is right for me?
When your muscle is relatively healthy and strong, it should release quickly. Be careful if you stay on the spot for a long time and hardly notice a change as this indicates that the muscle is likely too weak for this treatment. When this happens, keep the rolling to a minimum until you restore the strength.
A failure to respond or increased irritation may also suggest that another muscle needs to be released first. If the muscle is not releasing relatively quickly, try working on one of the other tight muscles first.
5) How much pressure should I apply?
When it comes to determining the amount of pressure it is really important to listen to your body. During the treatment you should experience a good soreness and not discomfort or pain. This treatment has a relieving, welcome quality, that feels better after the treatment.
If you find that the intensity is so much that you are clenching your teeth, then reduce the pressure as it is too strong. If the tissue is not releasing very well, or if you used too deep of pressure then you may end up feeling sore for the next day or two. A warm Epsom salts bath or any form of heat can be applied for twenty minutes, This will help the circulation to that area and reduce the soreness.
6) How do self-treatment tools work?
Our body has many subconscious, automatic controlling functions that work to help regulate tension. Self-treatment tools rely on these functions. Pressure on the muscle targets a structure called the muscle spindle and the Golgi tendon organ (proprioceptors). These structures are stimulated when we use pressure on a tight spot/trigger point. The application of tension creates a stretch reflex causing the muscle to send a signal to the brain. This signal is received in the brain as a message to relax the muscle, making this an effective treatment tool in reducing tension. These structures are one of the reasons that massage therapy is so effective in relieving tension as your registered massage therapist is trained in how to maximize the effect of pressure on these organs.
Video explaining muscle spindle/golgi tendon organ
Feeling our best is important to having a pain free, healthy and happy lifestyle. When we are sore and in discomfort, pain effects our whole self, both physical and emotional. Empower yourself by using treatment tools to aid in your own relief of mid-back pain or any other part of the body, whenever and where ever you need it! Research has shown good effects with the foam roller, and as long as it is used safely, and can assist with your progression in rehab and in sport.
Contact us at 416 925 4687 or physio@orthophysio.com
1 The effects of self-myofascial release using a foam roller or roller massager on joint range of motion, muscle recovery, and performance: a systematic review.
Cheatham SW, Kolber MJ, Cain M, Lee M. Int J Sports Phys Ther. 2015 Nov;10(6):827-38PMID:26618062
https://www.ncbi.nlm.nih.gov/pubmed/26618062
2 Is self-massage an effective joint range-of-motion strategy? A pilot study.
JBodywMovTher. 2017 Jan;21 (1):223-226
https://www.ncbi.nlm.nih.gov/pubmed/28167184
3 Do exercises with the foam roller have a short-term impact on the thoracolumbar fascia? – A randomized controlled trial.
J BodywMov Ther. 2017 Jan;21(1);186-193
https://www.ncbi.nlm.nih.gov/pubmed/28167176
4 The acute effects of deep tissue foam rolling and dynamic stretching on muscular strength, power, and flexibility in division I linemen
J strength cond Res. 2015 Jun 24.
https://www.ncbi.nlm.nih.gov/pubmed/26121431