Your Upper Back…

Have you experienced a sharp pain in the shoulder blade area? Tension in your shoulders? Neck ache? Our upper back’s tend to take side stage to the attention-grabbing lower back. This however doesn’t mean that they’re not worthy of and in need of similar attention.

Today I’m giving some thought to the PROBLEMS that can arise in this area and what PHYSIOTHERAPY-BASED SOLUTIONS I can offer to give you a looser, more comfortable and more freely moving upper body.

Very briefly – Anatomy and Postures

By upper back I mean the area between where our NECK ENDS and our LOWER BACK BEGINS, shown in the shaded area of the image below. The technical term for this area is the THORACIC SPINE. Our upper back is fairly inseparable from our SHOULDERS and NECK and includes our SCAPULA (shoulder blades) most of our RIB CAGE and NUMEROUS MUSCLES that cross from our upper back to our necks and shoulders and vice versa.

The image above shows the four “types” of upper back as they are sometimes classed, based on the shape that the spine holds.

Some upper backs are more CURVED (KYPHOTIC) and some are FLATTER (FLATBACK). Most backs are also not perfectly straight when viewed from behind (SCOLIOSIS) though the word scoliosis tends to only be used when the wiggle is significant.

Do note that this is pretty over-simplified; a quick look around any room full of people will tell you that no two upper backs are the same. There are a number of overlapping back-shape spectrum’s and the ‘IDEAL’ is rare and by no means always ideal!

Why are we all different shapes?

In a mostly-inclusive sentence: genetics, lifestyle, life history, age, fitness, underlying health conditions, gender – female spine profile can be influenced by chest size and men tend to have broader shoulders than women.

Common Problems

There can’t be many of us who haven’t experienced  issues in this area at some point and these commonly include:

• STIFFNESS – commonly along the sloping tops of shoulders and/or between shoulder blades

• STRAINS AND PAINS – often near the shoulder blade or somewhere between shoulder blade and neck; caused by over-doing it, weakness, poor posture or trauma

• NERVE-RELATED ISSUES – tingling, hot/cold sensations or numbness in the upper back or arms

• PROBLEMS IN NEARBY AREAS – shoulder and neck complaints can stem from upper back issues

• ARTHRITIS – a natural part of the ageing process; there aren’t many 60+ year old backs that won’t show some signs of this on an x-ray; manifests as stiffness and pain

• THE SCARY ONES – spinal infection, lung cancer; these are rare and usually your symptoms will be constant, getting worse and you’ll display other more general signs of being unwell

Solutions

GOOD NEWS! Regardless of the reasons for our upper back shape, any discomfort in this area can usually be changed. As ever, modifications and movement are often key.

Posture

Simply “sitting up straight”, in my experience, isn’t always much help. More relevant is how much time you’re adopting a problem posture for. Try not to spend too much time in any one position, particularly if you know (deep down) that it’s likely the source of your ache.

Give some thought to what YOUR actual spine profile is, as this should influence any stretching that you do. Stand side on to a mirror and have a good look or get someone to take a side-on photo of you. Do you tend towards the Hunchback 0f Notre Dame (extreme end of the spectrum) or the military “broomstick up…” (also extreme!)

Whatever your shape, any stretching you do should aim to STRETCH YOU OUT OF THIS SHAPE.

So, depending on your shape, have a look at my scrawls below and try one of the stretches, spending a good couple of minutes on it.

What else can help?

1. OVERHEAD REACH

This move is the polar opposite of the slumped shoulder position that we tend to end up in and can even be done at your desk!

Reach overhead with both arms and push your hands towards the ceiling, hold for 5 seconds, come back to overhead arms position and repeat x 10

2. GET ROTATING

If you can’t get into a hands and knees position then do the following movement in sitting or standing…

in a hands and knees position on the floor, take your left hand off the floor and rotate to the left to reach with this hand towards the ceiling, repeat x 10 on both sides

PULL-UPS

Yes literally. Or, as these are beyond the ability of most of us mortals, try hang-downs. These engage a tonne of the muscles that make up your upper back and gaining strength is often key to settling niggles.

Find something you can hang from and… hang. And if/once you can hang, try mini-pull-ups by doing the initial ‘shoulder shrug’ bit of the pull-up

THE EASIER OPTION TO PULL-UPS / HANG-DOWNS:

Assuming you’re sitting, place your hands next to your hips on your seat and push down, aiming to lift your bottom from the seat. It doesn’t matter if you can’t raise your bottom, it’s the effort bit that counts! If you can raise your bottom and assuming that you’re not sitting on a wheely chair, push your hips forwards and upwards at the same time – looks a bit odd but just give your workmates a disparaging look and explain why it’s a great move to do.

A little attention and a little more movement can make a big difference.

We’re unlikely to ever have the muscle definition of Arnie (and I’m not convinced that we wouldn’t have back trouble if we did!) but most of us can have a comfortable back that allows us to do the things we want to do.