How many times during a given day do you hear something like, “my back is killing me today”? Maybe it is you with the back pain that just seems to linger, no matter what you try to do. Chances are, whether you are a highly active athlete or you are relatively inactive, you have experienced pain in your back. Trigger Point seeks to provide you with the most practical education and tools, so that you have an opportunity for therapy within your own home. Our approach to middle back pain is no different.

Most “middle back pain” is felt in the area around the T-12 vertebra. This is the last vertebra in the thoracic section of your spine, around the bottom of your rib cage. Pain that begins in this region is often felt throughout the middle of the back.

Causes
Simply put, any time you put an arch into your back, you get back pain. Carrying heavy bags on your shoulders or back will create an arch. The way that you sit in a chair, either slouching forward or pushing the abdomen forward, places an arch into the back. For athletes and those that are on their feet often, problems in the lower leg and quad region can lead to biomechanical dysfunction which results in arching the back.

What is biomechanical dysfunction? Follow this scenario: The foot is the first and last thing to hit the ground, so that is where we begin. When you lose elasticity in the lower leg, you compensate by shifting the knees forward and the butt back. Once you are in this position, your pelvis will tilt forward. In order to stand up “straight” after pelvic tilt occurs, you must put an arch into your back. This is when your back will begin to ache.

Relief
Many people will take the TP Massage ball into the erectors, the muscles along the sides of the spine. These areas do get tight and this is a great feel good technique that can relieve some of the pain. However, we want to address the areas that are causing the problem, not just the symptoms. No matter what the root of the problem, there are several key areas to address when dealing with middle back pain.

Once your body’s biomechanics are compromised, there are two key areas that affect the middle back: the psoas and the pectorals. At the end of this article you will see manipulations for the legs, which are key for creating positive biomechanics. For this article, we will begin at the waist.

The psoas is a muscle that connects at the T-12 vertebra in the middle back and in the groin area. Once the psoas muscle loses elasticity, the body is compressed and pain can be felt at the insertion points of the muscle, i.e. T-12. Overtime, continual compression of the upper body due to the overuse of the psoas will lead to chronic pain in the L-4 and L-5 (lower back) area.

To regain elasticity in the psoas, force-feed blood and oxygen into it using the TP Massage Ball. Increased elasticity in the psoas will allow your torso to remain straight and relieve tension around the T-12 vertebra, then take the Ball into the back.

Next we will address the pectorals. If your pectorals are over worked and lose elasticity, they will start to bind up. Once this happens, your shoulders will rotate forward. When your shoulders rotate forward, the muscles in the middle and upper back are forced to lengthen beyond their naturally capacity.

You must create elasticity in the pectorals and the TP Massage Ball is the tool of choice once again. Manipulate the pectorals to allow your shoulders to fall back into their natural position and relieve the tension on the back muscles.

After addressing those two critical areas, you then can address the actual back muscles. But remember, the back pain cannot be fully relieved without addressing the psoas and pectorals. See the illustrations and instructions below for manipulating the psoas and pectorals.

Food for Thought
Middle back pain is often a result of everyday life. However there are a few steps you can take to help avoid pain. Treat your muscles with the TPT tools and do some total body conditioning like CrossFit.

Also how often do you drive with one hand on the steering wheel? Placing one hand on top of the steering wheel for prolonged periods of time will typically cause compression on that side due to the forward position of the shoulder. Keeping the hands at 10 and 2 isn’t just for sixteen year-olds in driver's-ed anymore!

Middle Back Pain Manipulations

Soleus and Posterior Tibialis

2 - 3 times per day
Remember to breath deeply and keep the foot relaxed

Quads

2 - 3 times per day
Address the center of the quads as well as 45 degrees out and on the side (IT Band).
Remember to breath deeply

Psoas

2 - 3 times per day
Place the ball about 1 inch outside of the belly button, repeat on both sides
Remember to breath deeply

Pectorals

2 - 3 times per day
Remember to breath deeply