UKC

Hello,

I've been suffering from sporadic but quite bad upper back pain over the last year, every so often i get what feels like a pulled muscle in my upper back between my shoulder blades in the exact same spot, it's sore enough to make my breath catch whenever it twinges, and ussualy seems to last about two weeks

I now seem to be on the 5th or so time it has happened and wondering if I need to do something about it. It usually goes either lifting things with a wide arm span (e.g lifting bike into the back of a car) or bouldering. Fairly certain it's related to muscle imbalance From climbing and doing a desk job.  I'm wondering if:

Anyone has experienced something similar?

Would a physio be able to help with something like this?

Do I need to think about avoiding steep bouldering long term if I want to maintain a decent back into middle age?

Yes, but you might need to try a few before you find the one who will really give you a holistic view of how to correct the imbalances from your desk job.

No, as long as you correct the imbalances from your desk job 😁

Hi

Sounds like it could be the rhomboids.

These stabilise and retract the scapula when pulling. I used to have similar and it’s  PITA.

Try this stretch on the affected side to see if you can replicate the pain. Lift the arm of the affected side up to 90 as if pointing at someone, then wrap it across your neck so the hand is on the opposite shoulder.

Grab the elbow of the affected side and pull it further across the body, keeping the torso and head still. Let me know what happens. 

You have an arse between your shoulder blades . . . . . . . . .?

Weird

My arse is directly between my shoulder blades but a bit lower. Where’s yours

Stand on your head, so it's lower back pain.   

Do you know of a decent physio who could treat you, following a visit to a doctor to see what they say?

In my experience, private physios are magicians...

Hmm elbow in front of face or elbow behind head? In both cases once Ive grabbed and pulled elbow it feels ok, getting it there induces sharp pain which makes me catch my breath!

Elbow in front of face.Can you press into an are of soft tissue that hurts?

I've had something similar on a number of occasions. The first time it happened my physio massaged the area and suggested I do something similar at home with a tennis ball in a long sock and holding it between the affected area and a wall, then moving around to apply pressure around the area. It worked, and when I've had similar problems I've used the same approach.

There's some instructions for this and similar self-massage here-

https://therapitylino.co.uk/blog/diy-tennis-ball-therapy-for-pain-managemen...

Some would say it's on the front of my head

Get any advice on any exercises to prevent it happening?

Judging by the positioning I think rhomboid seems like the one. I'll be doing a bit of Google self physio

There’s a lot of paraspinal muscles it could be, but rhomboids seems a good possibility given the mechanism of injury and your desk job.

Treat the symptoms first. Ibuprofen if you can take it and ice the area. Bobs self massage idea is valid if it’s in the soft tissue.

If my stretch targets it do it 3 times for a minute hold, 3 x a day or as it bothers you.

Do regular chin retractions and really watch your posture.

Once it’s settled, google chariot pulls with theraband  to strengthen or if you have access to a weights bench, some really light 0.5kgor unweighted reverse flys.

Not exercises but stern admonitions to watch my posture. And connected with this, to check my working habits and the ergonomics of where I was working. Apparently stress causes tension and tightness around shoulders and back, so working on that helps.

That's true, about stress. I had sore shoulders/shoulder blades after my Mum's diagnosis, before she passed, and it lifted once she had. 

On a lighter note, hopefully it's nothing like that lurking in the background for the OP. It doesn't appear to be.

P.s

When doing the stretch use your good arm to lift the bad one in to position. Don’t bother ‘pointing’ until it’s settled.

Cheers!

Probably not the same cause, but I had unusual back pain between my shoulder blades. It continued on and off for 6 months with a sports therapist trying a few things... Eventually I ended up floored by the pain. Turned out it was slipped discs at T5/6 and T6/7 following a fall while climbing and landing on my butt. I'm not the only one I know where back pain from a climbing incident went on for a few months before getting really bad.

Sort of what I was going to suggest - more likely to be a nerve thing, especially if it stops and starts without obvious physical cause.  Happens to me from time to time, and it's usually down to something in my neck

How is it?

You could explore a bit of self treatment with Trigger Points.  Google "trigger points between scapular" or something, and it will bring up loads of info.  Firm pressure/massage in the appropriate (often tender) spot can bring incredible relief to associated local -- and sometimes not so local -- muscles/tendons.  Usually a first point to explore for any musculoskeletal issue with me.

I pop in from time to time on here to say (as a physio) there is no bad posture, there is no good posture. If you stand still like a soldier at attention (good posture) for 8 hours a day, 5 days a week things will start to hurt. The problem isn't the position, it's the time spent in the position.

Regular movement breaks are all that is required to stop things becoming a problem, even if your monitor isn't at eye level.

Once you have problems though then yes i'd (obviously) recommend you see a physio. 

There's been some research done recently on where this pervasive idea of good/bad posture has come from. Believe it or not it can be traced back to ancient times, religion and then the good old Victorians. This was to do with your appearance reflecting your inner morals, not muscle health. But then in modern times we stick an entire business model on the top of that (physio's, chiro's, health and safety at work etc) and it's no surprise it's stuck around as an idea. We're taught it. 

I hope you get a solution to your issue quickly. 

Yep - agree with this. But maybe see a physio as well. I've got this bit of plastic called a "theracane" that I use on a couple of trigger points on my shoulders. 

I had something similar a few years ago (maybe 8 years), I'd get a pain in one of my shoulder blades and my neck would click when I lifted my head up, after changing the chair I was using I ended up with additional pain over the top of my head and around my left eye.  When I went on holiday and wasn't sitting at the desk all day the pain went.

After the holiday I went to see an osteopath and she said it was mostly due to bad posture at my desk, I slouch a lot and my shoulder blade had rotated around and the other muscle compensated until it got to a point where they got fed up and let me know.

The osteopath cracked my back and gave me some exercises to do and said I should take up yoga, which is what really fixed it for me.  I had assumed that I'd have tight shoulders for the rest of my life but the yoga really sort it out.  I use a standing desk now and enough yoga to keep me healthy.