Are you experiencing pain between your shoulder blades?  Does your mid-back ache at the end of a day at the computer?  If you experience this discomfort on a regular basis, these Mid-back pain self-treatment foam roller techniques will give you quick relief from stiff muscles. But before you get started its important to know which muscles to choose and how to apply pressure, as these tips can make the difference between finding instant relief or causing more discomfort.  

In my last blog I covered the principles of using the foam roller and other self-treatment techniques. Now it’s time to get rolling.  Helpful self-treatment strategies in this blog will focus on relieving the tension on the outer leg, front of the thigh, hip, mobilization of thoracic spine and releasing the chest. These techniques can be used in conjunction with your physiotherapy, kinesiology program or become part of your regular program at home. However if discomfort continues or progressively gets worse, then I recommend seeing your physiotherapist as it can be helpful to have an assessment to understand which specific muscles need to be targeted.

What causes mid-back pain?

Although it may seem unconnected, the pain in your mid-back area can be caused by general muscle tension even if the muscles that are tight, are even located in the mid-back. For example: tight hip flexor muscles (iliopsoas, rectus femoris, sartorius, TFL) pull your body forward, changing your posture and putting your body in a position that can cause strain on this area.

Other causes of mid-back pain include:

  • fracture
  • pressure on a spinal nerve
  • osteoarthritis
  • overuse
  • injury to the muscle, ligament and discs that support your spine

The pain you are feeling may be related to problems in the myofascial system. All structures in our bodies are wrapped in a thin membrane called fascia.  The pain is caused by an autonomic phenomena referred from an active trigger point.

Which muscles to target?

Although there are many muscle in the body that can contribute to mid-back pain, this blog focuses on the ones that I find often refer pain directly into the mid-back.  This group also has a big influence on your posture which is a major contributor to mid-back pain.

Some of the muscles I target are predicted by understanding that they are the opposites to the ones which you are having trouble connecting with.  This difficulty in being able to access muscles when you exercise can be caused by the opposite muscles being too tight. Using treatment tools allows these muscle to lengthen, allowing for a more efficient contraction. The foam roller aids in releasing muscles and fascia, allowing you to correct your posture, move better and gain more strength.

Before you get started take a moment to review the principles outlined in my previous blog.  This will help you to know what to expect and how to apply pressure safely and effectively as you get rolling with these self-help techniques.

Iliopsoas

Iliopsoas influences our posture by drawing the pelvis forward and changing our alignment. It connects our lower body and upper body and it gets tight as a result of weak core and buttock muscles.

This muscle is often held in shortened positions in our daily activities. For example: sitting for long periods of time, as many of us do because of our jobs, or sleeping with your knees to your chest. Anytime you hold your body in a posture for a prolonged period of time, the muscles shorten to that position and can develop areas of irritability within it (trigger points).

Symptoms: The referral pattern for trigger points in the iliopsoas muscle can be felt on the outer edge of the spine, tailbone (sacrum) and front of the thigh. If you find that you are unable to stand straight, if your legs feel heavy, if you feel tightness in your groin or even if you are having difficulty strengthening your butt, it may be because you have trigger points in this muscle.

Rolling Technique: If you have lower back discomfort, consult your physiotherapist prior to doing this stretch. Place a towel bolster to support the lower back area. Lie on the ground with the towel under the low back and hips. Place your buttock on the foam roller. Bring one knee to your chest and allow the other leg to relax and stretch. Hold until you feel the tissue lengthening or for at least one minute. When stretching, it should feel like a comfortable stretch however you should stop if you experience pain. I would not recommend this stretch for someone with a history of low back pain.

 

Pectorals

The chest area is often a big contributor to mid-back pain. When our chest muscles get tight, they pull our shoulders forward and bring our mid-back into a rounded position. Many of us find ourselves in this slumped body position on a daily basis. In addition to reducing muscle tightness, maintaining a healthy posture with muscle strengthening is also an important part of relieving mid-back pain and discomfort.

Symptoms: The pectoral muscles refer pain into the front of the shoulder, inner arm, inner aspect of the elbow and fingers.

Technique: To stretch your chest, lie on a foam roller lengthwise ensuring that your head is fully supported. Start with your arms at your side and gradually move your arms up to the place where you feel the first bit of a stretch and hang out until the stretch disappears or for 1 minute. Then gradually move your arms towards your head as you are lengthening the tissue. If you experience tingling in your arms, then ease off the stretch until it disappears. You can practice holding your arms for 1 min at varying degrees to stretch the different muscle fibers of the pectorals.

 

Rhomboids

The rhomboids, along with the other shoulder girdle muscles, act to stabilize the shoulder. Typically the rhomboids are weakened and inhibited by the rounded shoulder posture that so commonly results from our computer work. Other activities that involve overhead work with the arms raised above the head or sleeping on one side can cause over activity in these muscles.

Symptoms: This muscle refers pain and discomfort to the inner border of the shoulder blade and spine.

Technique: Lie on your back or stand against a wall. Place the tennis ball between your shoulder blades and roll up and down on the rhomboids until you feel the spot you want to release. Hold the spot until you feel the softening of the tissue and the “good sore” sensation disappear.

Rectus Abdominus

The Rectus Abdominus muscle is the”six pack” we all admire.  It is one of four abdominal muscles that help to give us core support. It’s function is to bend the spine forward. 

Symptoms: This muscle can refer pain to a lot of areas. It refers pain into the mid-back area, and upper pelvic crest. In addition it can mimic numerous conditions such as:

  • heartburn
  • chronic diarrhea
  • Irritable Bowel Syndrome
  • gallbladder
  • genital pain
  • kidney symptoms

A surprising connection was found by Dr. Travell regarding other symptoms from abdominal trigger points which could take the form of nausea, chronic diarrhea, loss of appetite, projectile vomiting, and simple indigestion.

If the rectus abdominus is too tight or harbors trigger points we tend to lean forward and slouch. If you find you prefer to sleep curled up in bed it may be because your rectus abdominus is too tight.

Technique: Lie on your back with a pillow under your knees, place your fingers on your breastbone and walk your fingers down until you find the first soft spot. This area is the upper attachment of the rectus abdominis muscle.  It can help to activate the muscle to let you know you are on the right area.  Do a little abdominal crunch to feel the muscle contract and then gently walk your fingers up and down the muscle belly, locating the sore spots or referral points. Hang out with your fingers on the sore spots until they disappear or for up to two minutes.

 

Using self-treatment tools is not a cure for chronic pain, although it helps. Implementing trigger point release in conjunction with a stretching and strengthening program, will aid in a quicker results. It allows you to get relief at your own convenience at no cost.

If you have any questions or would like to know other strategies with self-treatment for different area’s of the body, please contact me, Juliette Woodruff at jwoodruff@orthophysio.com or call us to make an appointment 416-925-4687.

References:

Travell, Janet, 1901 (copyright 1992) Volume 2 Myofascial Pain and Dysfunction-The Trigger Point Manual-The Lower Extremities

Pictures:

www.triggerpoints.net