Upper back problem! Frustration! Help! :o(

Hi all! Just want your opinion on my problem!

I have been suffering from upper back pain for 4-5ish months now. It was caused by overstraining in the gym. The pain is mainly situated at the tip of the scapula (traps), and surrounding shoulder blades (rhomboids?) I have also noticed there are several really tender points around these bits. My lats also feel abit discomforting at times. Things that make it worse....Wearing a shoulder bag, resting back against sofa and any harder pushin and pulling movements.

X-ray and tests were negative. I went to a priv chiropractor halfway, and even though he did some spinal work, he hasn't really helped in terms of getting rid of what he said were trigger points (reason i went there). I got sent to the rehab sections and was told to do some forward arm raises against the wall and scap squeezes to strengthen my traps&back.

Since then I have been to a physio on the nhs but was dismissed and refered to a back to fitness class so i can do some stretches and exercises with a group.

I have also tried to improve my posture and exercise using the cross trainer at the gym as well as strengthen,stretch my back as already mentioned, but for some reason these nagging points are still there. I can't help but think ithese are the main causes and can be addressed (through massage?) but no one seems to be on the same wavelength as me not sure how to go about it now. What do you guys think? really need some direction! thanks!

[alophysio]

Hi,

Thanks for the information.

Are you able to say precisely what the different therapists said?

You have what sounds to me like a thorax problem (a fav of mine - i think people are probably sick of me saying it is the thorax!). It is either that or muscular problems.

It is very hard to say what is wrong without seeing you.

Can you upload an image of the area from something like gray's anatomy and colur in some areas where your pains are?

A common problem i find in women are trigger points in the levator scapula. If you shoulder blades "poke out", you might have a lot of poor muscular control of the shoulder leading to the lev scap overworking. It can then be made worse by training the rhomboids which essentially help the lev scap to rotate your scapula downwards.

Your upper traps doesn't actually attach the to scapula but to the clavicle (collar bone) so it pulls your collar bone into your sternum and helps hold the shoulder up. The serratus anterior muscle helps hold the shoulder blade to the rib cage. I would guess these muscles are not working properly.

Since you are female, i am going to guess that you might have a sway back (where your chest is behind your pelvis in standing) and thus you might have rounded shoulders. it is a very common posture in women. My personal opinion is that when girls develop breasts, sticking them out is not "proper" lest you be called a tart so you round your shoulders to conceal them a little. This can cause the pec minor to become tight and so tilt the scapula off the rib cage.

If you can, try to find a physio who isn't just going to give you exercises (even though this is a major thing you need). You need someone who will assess the ribs and how they are working.

Also, some phrases you should hear from the physio are
- "scapulohumeral rhythm" - you might need to just ask them how that is!
- "scapula winging"
- "pec minor tightness"
- "upper traps function/activity comapred to levator scap function/activity"

Lastly, have a poke around your ribs on the side and sround the front near the centre of your sternum (into the cleavage line). If any of the joints there are tender or any muscles there particularly sore, you will notice a difference from one side to the next. It will not feel like breast tissue but deeper than that. It is also not like breast tenderness around different times of the month.

If you have a particularly tender spot, more than other spots, it might be worth getting it released to see if that helps.

Hopefully you can find a physio who is good at "motor control of the thorax".

Good luck!

Hi! thanks for reply! I should've mentioned that i'm a 24/year old male soz! I have been told in the past that i have a flat back type posture, which has probably been made worse by the fact that i have a moderate pectus excavatum deformity .

To be honest my chiro didnt tell me much at all. Told me that those tender areas were myofascial muscular irritation and had weakness in my traps! By the time i finished the sessions he said he had more or less realigned and corrected alot of the areas along the spine, yet i still felt these points of pain and tenderness!

The physio at my hospital was just rude and didn't seem to want to know (hardly examined me ) anything and said more or less the same with added 'muscle spasms' and other 'muscles overcompensating' and referred me on to a class.

Here is a really basic image. Sorry for the lack of detail etc. It started on the right side at first but then as i wore my bag on both shoulders over the weeks the left side got affected! then my lower region. I can't really afford to see private help again and have to look forward to the back to fitness class at the hospital in a months time knowing that they havent really tried to help me, and potentially that it wont work, since i am already exercising steadily but feel the same. really frustrating!

Tom

[alophysio]

sorry - didn't know why i thought you were female!

It is very difficult to help without an examination. I am sorry...

With seeing a private physio, just out of interest, how much would it cost to see one in your area?

Obviously i dont know your financial situation but is it really that expensive?

i reckon the right person can diagnose and outline how to get you better within 3 treatments.

cheers. Any other extra info would be helpful. I am guessing but i think there are thoracic dysfunctions, likely serratus anterior and upper traps dysfunction.

Good luck