Sunday, April 25, 2010

A Tutorial of a Different Kind

Photo credit: schmitee from

It was The Day. I turned FORTY. Finally one of the big girls!

Now for the birthday present.

I'm constantly seeing clients who have upper back pain. You probably know this pain. This is the knot on the inside border of your shoulder blade, or higher up in the traps, something like that.

Obviously I can't open an online clinic, but I can show you a combination of stretch and strengthening that goes a long way toward alleviating some of that upper back tension. I give these instructions to clients almost every day.

When the pectoralis major muscles are over-strong, they pull toward the centre and rotate the humerus (upper arm bone) forward, which creates a head-forward, rounded-back posture that over-stretches the smaller, weaker rhomboids between your shoulder blades. When the rhomboids are in a constant state of stretch, they spasm in an attempt to regain their optimal length, which HURTS. This sequence addresses both.

So first off, you need to stretch out those pec major muscles on your chest. They're a type of muscle called "postural", which means that in general they tend to be strong and tend to shorten. They need to let go first, before trying to strengthen the back. The pec major originates along your sternum (breastbone), and attaches at the upper humerus. Here's a picture, courtesy of Wikipedia:

Here's the Lovely Poppy showing the stretch:

Stand beside a wall, and place your forearm along it. Lean forward, until you feel the stretch across your chest. Hold for 15-30 seconds. Do the same to the other side.

Here's a picture of it from behind:

Right. Now that the front is less tense, it's time to work on the rhomboids in back. The thing is, and here's the thing, that because these back muscles are spasming, trying to pull the shoulder blades back into position, it feels like they need to be stretched. THEY DO NOT NEED TO BE STRETCHED. They need to regain tone, so they stop firing off distress signals.

So here's Poppy demonstrating a strengthening exercise:

Stand straight. Drop your shoulders, and keep 'em dropped. (Shoulders have a tendency to migrate north when we're concentrating, which is another piece of the upper-back-pain problem.) Bend your elbows to 90 degrees, and bring them back, pinching your shoulderblades together. Then, when you've got maximum contraction, bring your fists forward slightly, maybe an inch, until you just start to feel that your losing the contraction between your shoulder-blades. Hold this for 10-15 seconds. Repeat, repeat, repeat.

When I first learned this sequence, I'd been having constant misery in my upper back for many years, and I would do the stretch/strengthen combo many, many times per day. Now that it isn't nearly the chronic problem that it was, I do it maybe 3-4X/day, enough to counteract the habitual postures of life and work.

If you came to my clinic presenting this problem, I'd do some myofascial release work on the pecs, and give the rhomboids some tone, and then I'd give you these exercise. Since I can't see you all under my hands, at least I can give you something to try at home. Just another piece of the pie. Or cake, I suppose.


arcolaura said...

Thanks! I had a series of massages recently for exactly this problem, and was given these exercises, but your explanation makes it clearer what to do and why. Maybe I will actually do them now (wry smile)...

Madcap said...

I'm glad someone found it useful!

annetteinalaska said...

How very cool! And generous! Thank you.

Madcap said...

You're welcome!

Mercutio said...

That is very cool.
The exercise seems a bit odd, probably because there's not any weights involved.
Just doing an exercise with no weights makes me want to go lift.


Happy Birthday!

Amanda said...

Happy Birthday!!! And thanks for the how-to!

Madcap said...

Mercutio - I guess a person could do the rhomboid thing with weights too. There's probably even special gym equipment for it... not that I've ever darkened the door of a gym!

Constantine - Thank you! Mentally I turned forty on my thirty-eighth, so it wasn't quite the milestone it might have been.

Amanda - Thanks for the wishes, and I hope the sequence is useful for you. Carrying little people around is hard on the back, for sure.

clairesgarden said...

happy birthday!!
nicely explained exercises, had been doing teh peck stretch but did not now to balance it with the strenghtening of the shoulderblades, thankyou.

Madcap said...

Good morning Claire,

You're welcome, and I hope it's helpful!