Middle Back Pain 101

Spine_ 94752094

We’ve spent more time seated in this century than in any other period in human history. Even more alarming than the time we spend seated is our posture while seated. One of the many consequences of poor posture while seated (and in fact, while standing, as well) is an uptick in middle-back pain. Characterized by a chronic, nagging tightness of the muscles surrounding the spine, middle-back pain can potentially be alleviated by both fixing postural alignment and being mindful of our position in space.

The Facts

The middle of the back is generally defined by the area of the body that falls below the neck and above the bottom of the rib cage. While middle-back pain is typically most prominent between the shoulder blades, it can be anywhere within the defined region. The pain associated with middle-back pain can come from a variety of sources, and afflicts everyone from professional athletes to office workers, and everyone in between. Although this malady can occur suddenly due to a twisting injury, this article covers the much more common chronic, nagging variety.

The Symptoms

Although everyone experiences pain differently, most sufferers complain of a dull, nagging, tight feeling in the area between the shoulder blades. The pain often occurs when sitting in an uncomfortable seat, such as in a conference room, car, or airplane, or when standing for long periods of time. The pain may resolve as soon as the sufferer changes position, but in a chronic case when discomfort lingers for days or weeks, it may take significantly longer to fully relieve the pain or discomfort.

What Is Happening

Posture is the ability to maintain an upright anatomically aligned position for prolonged periods of time. In an anatomically aligned posture, the vertebrae (bones of the spine) are stacked one on top of the other. Aligned vertebrae, in collaboration with the many muscles connecting to the spine, help support upright posture. If you are sitting in an uncomfortable seat, or if you are standing for a long period of time, and your muscles are too weak to hold you up, or you are subconsciously in the habit of not using those muscles, you may start to slump into bad posture. The longer you stay in this slumped position, the more likely it is that the muscles of your middle back, specifically the erector spinae and rhomboid muscles, are called upon to maintain this poor posture. These muscles, designed to help support an upright posture, go into overdrive to support your new posture. Over time, the muscles become exhausted and consequently tighten and spasm, thus causing pain.

Why Is This Happening

The cause of pain in the middle back boils down to misalignment of the skeleton.

In most cases, misalignment can arise from an accumulation of tension from spinal imbalances. The spine endures minor traumas from improper lifting, bending, and twisting in daily tasks. Performing these everyday tasks incorrectly places strain on the muscles and joints, eventually pulling the spine out of alignment. Standing or sitting with poor posture for a prolonged period of time further exacerbates and/or contributes to this misalignment. Consequently, over time, spinal imbalances develop.

The muscles whose job it is to keep you upright and in alignment work hard to maintain the new alignment of the spine and, over time, become too weak to support an aligned upright posture. Consequently, other muscles, supporting muscles, are called on to help the weakened muscles. These supporting muscles, overburdened by the job they were designed for plus their new job of support, tighten as they try to keep you upright against gravity. The worse the spinal imbalance and the further you are hunched forward, the more leverage gravity has to push you down, thereby requiring more force from the supporting muscles to kick in. Specifically, your brain sends a signal to the muscles of the back to “turn on” to hold you upright. Unfortunately, over time, the help of the middle-back muscles causes the muscles to be overburdened, and the function and strength of the middle of the back declines. Pain is the result.

Lifestyle Adjustments
  1. Breathe. The muscles of the middle back attach to the rib cage. Deep, full breaths allow you to fully engage the rib cage, potentially releasing the tightness of overburdened middle-back muscles. See the exercises to address middle-back pain for further instructions on deep, full breaths.
  2. Move! Sitting for long periods of time, especially in poor posture, wreaks havoc on your body. Even if your work is sedentary, get up every hour to “walk it off.” Walk with an upright posture to the water cooler, to the bathroom, or even down a few flights of stairs. Taking yourself out of poor seated posture and standing with upright posture gives the middle-back muscles that are working to support a slumped seated posture a break, and therefore may help alleviate the pain you feel throughout or at the end of each day.
  3. Stand tall to sit tall. Practice your postural alignment while standing to inspire your seated position. While walking down the street, waiting for the bus, or engaging with others at a cocktail party, push your feet into the ground and equalize the weight between the right foot and the left foot. Be sure you are not sitting into one hip! Now, open your collarbones wide and reach the tips of your shoulder blades down your back. At the same time, pull your chin in toward your chest, as if attempting to make double chins. Our bodies are meant to stand tall, so keep your body as upright, long, and lean as possible!
Prevent It

1. Ground the feet. Firmly push the bases of all ten toes into the ground when standing or seated. One foot should not carry more weight than the other; the weight distribution between the left and right should be equal. Avoid crossing your legs while seated.



2. Equalize the sit bones. To avoid sitting in a twisted or unbalanced position, check how your weight is distributed on your right and left sit bones—the bones protruding from the middle of each butt cheek. Ask yourself if you feel your weight shifted to the left or right side. Now, equalize the weight so that you are sitting with equal weight on the left and right sit bone. To help you find this balance, equalize the weight on the feet.



 3. Engage your abdominals. Pull the external abdominal flesh toward the navel and lengthen the side body—the space between the hips and the ribs on the right and left side of the body. Once you find side-body length, equalize the amount of space between the right side and the left side. Keep your core engaged throughout the day.

Fix It

Improving your posture goes a long way toward avoiding middle-back pain. Practice corrective postural exercises (see exercises) and play the YL Posture Game:

Choose three activities that are interwoven into your everyday life. For example, you may choose brushing your teeth, walking your dog, or waiting in line to pay for your afternoon coffee. During these activities, stand tall in correct postural alignment. As a reminder of how to stand with proper posture, memorize these cues and say them to yourself as you stand tall during your designated activities.

Exercises

Standing Rows

Standing Rows_W Band _A Standing Rows_W Band_B


Repetitions: 15

Sets: 3

  1. Secure an exercise band around a solid object, such as a bedpost, at about waist level. Grasp band (or handles of the band) with hands, extend arms in front of chest, and position palms to face each other.
  2. Stand with feet hip-width apart and knees slightly bent. Stabilize your hips by opening your sit bones—the bones protruding from the middle of each butt cheek—wide, and engaging your abdominals by pulling the external abdominal flesh toward the navel.
  3. Reach tips of the shoulder blades down, bend elbows, pull the hands (and band) toward your body, and squeeze the shoulder blades together. Hold for a count of three. Release shoulder blades, straighten elbows, and return arms to front of chest.

 

Scapular Retractions 

Standing Rows_W Band _A


Repetitions: 10

Sets: 5 times throughout the day

  1. Secure an exercise band around a solid object, such as a bedpost, at about waist level. Grasp band (or handles of the band) with hands, extend arms in front of chest, and position palms to face each other.
  2. Stand with feet hip-width apart and knees slightly bent. Stabilize your hips by opening your sit bones—the bones protruding from the middle of each butt cheek—wide, and engaging your abdominals by pulling the external abdominal flesh toward the navel.
  3. Open collarbones wide, reach tips of the shoulder blades down, and squeeze shoulder blades together. Hold for a count of four. Release shoulder blades.

 

Spinal Release on Foam Roller 

Supine On Roller ASupine On Roller C


Repetitions: 1

Time: 5 minutes

  1. Place a foam roller vertically on the floor next to you.
  2. Sit at one end of the roller with feet flat on the floor, about hip-width apart, knees bent. Place hands on the floor, and lower the torso along the length of the roller. Touch the top of your head and the top of the roller to be certain the head is fully supported by the roller.
  3. Lie on the roller for 5 minutes. Breath naturally.

Scapular Retraction on a Foam Roller

Scapula Retraction_Roller A copy Scapula Retraction_Roller B copy


Repetitions: 8 to 12 times

  1. Sit at one end of the roller with feet flat on the floor, about hip-width apart, knees bent. Place hands on the floor, and lower the torso along the length of the roller. Touch the top of the head to be certain it is fully supported by the roller.
  2. Raise hands toward the ceiling, palms facing each other, elbows and fingers straight, and arms about shoulder-width apart.
  3. From this position, keep elbows straight and reach fingers higher toward the sky or ceiling. Initiate the motion solely from the shoulder blade.
  4. Now, keep elbows straight and lower the arms. Pull the shoulder blades toward the roller as if trying to wrap them around the roller.

This information is not intended to replace the advice of a doctor. Yoffie Life disclaims any liability for the decisions you make based on this information.