Upper middle back pain, can I get over this?

[Muse]

My back's been great since I took up daily quad street skating (up to 10 miles/day now)... except for one really big thing:

My biggest problem skating is that after a mile or two or three (depending) I start to feel some pain in my upper middle back. It's around my shoulder blades, it seems. Sometimes more left, sometimes more right, usually I don't think about exactly where it is, but it's pretty painful. Well, on a scale of 0 to 10, it's anywhere from 0 to I'd say 8. It's never sharp, it's a dull pain and it makes me want to slow down. My best skates (when I achieve the highest average heart beats/minute) are those when the back pain is minor, when I can force myself to go for it and not worry that the pain will get worse or worrisome.

I'm not sure what to do about this. A PT in a thread said I can roll up and down on a foam roller that's perpendicular to my spine before I go for my skate. Do it a few minutes. My doctor said he thought that after the skate would be the time to do it, to help release the built up lactic acid.

Some people said to do stretches. Guess I should, but rarely do these days, I used to do them as part of my complex 3x/week gym routine.

Thing is, when I spend a few hours on my feet these days, generally doing various types of work around the house, I often feel that pain developing in my back and I recline, which causes it to go away. I'm right now, for instance, lying in bed on one of those reading pillow devices that elevates the upper body a foot or so.

When my back is already hurting, I'm reticent to try to skate, I'll rest before skating... but weather permitting these days, I skate daily.

The PT who recommended the roller also suggested I do planks, e.g. on my elbows. I haven't tried that yet. I do have two of those rollers (one upstairs, one downstairs), but haven't used them except for a few times. I figure that losing weight will help. I figure if I lose 30 lb I'll be a really lean guy, you know, gaunt! Um, I am 78, so that figures in, but for a guy my age, I'm really really healthy, my blood work is pristine, no conditions, don't take anything, drink almost not at all. Was hitting the gym 3x/week before the pandemic, doing a 90 minute routine (plus skate/bike 5 miles each way to the gym), now only doing the daily living things plus the 10 mile daily skate. I have a Concept2 Model D rowing machine for when it rains this winter, but it's hurting my butt so I'm looking into buying a cushion for the seat...

 

[Torn Mind]

Upper back has a load of muscles you wouldn't know existed.

Many sorts of muscles in the back can tense up on you can eventually get so tight your range of motion gets limited.

I'll be the first to admit my biomechnical muscular health has cost me productivity and money, but it has left me with anatomical knowledge.

Possible causes of your pain could be rhomboids, erector spinae. Supraspinatus, Teres Major, Teres minor, Infraspinatus if it is more on the shoulder blade.

Sometimes, the pain is not directly because of the muscle where the pain is but elsewhere. Tight hip flexors can be the first step to starting many other maladjusted muscular positions.

Sometimes, the muscle will feel tender and sensitive to pressure via a ball, elbow, etc. If that is the case, then a combo of trigger point massage(can be done by yourself with a tennis ball for starters) and stretching would be the first things to do.

Finding tight muscles is actually simple in that it is basically giving yourself a good firm squeeze at very specific points.

 

[nakedfrog]

Stretches were the first thing that came to my mind too.
And of course I always recommend planks to everyone, forearm position is what I use as well.

 

[Muse]

Upper back has a load of muscles you wouldn't know existed.

Many sorts of muscles in the back can tense up on you can eventually get so tight your range of motion gets limited.

I'll be the first to admit my biomechnical muscular health has cost me productivity and money, but it has left me with anatomical knowledge.

Possible causes of your pain could be rhomboids, erector spinae. Supraspinatus, Teres Major, Teres minor, Infraspinatus if it is more on the shoulder blade.

Sometimes, the pain is not directly because of the muscle where the pain is but elsewhere. Tight hip flexors can be the first step to starting many other maladjusted muscular positions.

Sometimes, the muscle will feel tender and sensitive to pressure via a ball, elbow, etc. If that is the case, then a combo of trigger point massage(can be done by yourself with a tennis ball for starters) and stretching would be the first things to do.

Finding tight muscles is actually simple in that it is basically giving yourself a good firm squeeze at very specific points.

I still remember: I had shoulder surgery exactly 19 years ago. The renowned shoulder surgeon didn't know what was ailing me, we'd tried quite a few things. I think I developed the problem swimming like a maniac, 7days/week for 10 years straight. I'd also go in the weight room for 90 minutes prior to my 2 mile swims. I'd had PT, MRI, Xrays, exams trying to do something about the chronic pain in my left shoulder, which also manifested in the forearm. He said I could do two things at one point:

1. live with it

2. have him go in there arthroscopically and explore, probably just cleaning up, maybe he'd find out more. I said, yeah, let's do that. He said I'd be in a sling for probably 3 days, recover in a month.

I wake up from the anesthesia and the surgeon's assistant explains that they'd found a torn labrum, technically a Type IV SLAP lesion and repaired it on the spot. I was in a sling for a month and the recovery was the better part of a year. They had a few PTs they could recommend, I took who I took to be the one they had the most confidence in, a very experienced woman working in a facility not too far from me. She prescribed stretches and exercises for my recovery, at first just developing some range of motion, because there was practically none to begin with. One day she was evaluating me and pertaining to my upper middle back she said "there's something going on in there." That was all, but, of course, I made note of that statement! I sometimes wonder if I don't have some scar tissue or peculiar injury in that area that never healed properly. Maybe not.

 

[Torn Mind]

I still remember: I had shoulder surgery exactly 19 years ago. The renowned shoulder surgeon didn't know what was ailing me, we'd tried quite a few things. I think I developed the problem swimming like a maniac, 7days/week for 10 years straight. I'd also go in the weight room for 90 minutes prior to my 2 mile swims. I'd had PT, MRI, Xrays, exams trying to do something about the chronic pain in my left shoulder, which also manifested in the forearm. He said I could do two things at one point:

1. live with it

2. have him go in there arthroscopically and explore, probably just cleaning up, maybe he'd find out more. I said, yeah, let's do that. He said I'd be in a sling for probably 3 days, recover in a month.

I wake up from the anesthesia and the surgeon's assistant explains that they'd found a torn labrum, technically a Type IV SLAP lesion and repaired it on the spot. I was in a sling for a month and the recovery was the better part of a year. They had a few PTs they could recommend, I took who I took to be the one they had the most confidence in, a very experienced woman working in a facility not too far from me. She prescribed stretches and exercises for my recovery, at first just developing some range of motion, because there was practically none to begin with. One day she was evaluating me and pertaining to my upper middle back she said "there's something going on in there." That was all, but, of course, I made note of that statement! I sometimes wonder if I don't have some scar tissue or peculiar injury in that area that never healed properly. Maybe not.

Given that info, it seems that some DIY trigger point is necessary in your case. Stretching helps but sometimes the muscle will not loosen without some pressure applied to the offending area.

The best technique imo is to combine stretch with trigger point pressure to speed up the muscle loosening process. Of course, it's easier with some muscles than others(hamstring, biceps).

Even without an injury, oft-neglected muscles that aren't easy to stretch or even known about eventually tighten up after heavy use(or lack of use).

I got a couple lacerations on my fingers(one right hand, the other left). The recovery then led to a lack of motion in the fingers and arms for weeks. The muscular tightening in the arms then happened. The laceration in my right arm led to worse aftereffects When I got a trigger point massage from a pro(male), his technique on my right forearm's undersided unleash a flood of pain and then relief afterwards. The hit on the wallet had to happen two times, because that forearm area was hard to apply pressure or stretch. The gap between the first and second sesssion was about a year, and between that time, the forearm tightness then led to tightness in the clavicle area.

Lingering tightness in my shoulder blade was dealth with by myself via some brute force Theracaning, and it wasn't easy because the area goes away from the Theracane. I've become really good at feeling myself for points of "tension" and my finger muscles have been worked out doing self-massage.

Also, the muscles in the front can also become tight, such as the Pectoralis minor and pectoralis major. The Latisimuss dorsi could also be affected.

 

[Muse]

Several different people at one time or another recommended I try to loosen up my upper middle back using things like two tennis balls taped together or foam rollers. Including my sister, who's a PT. I should do more of that. She says I should do regular yoga, too. I used to attend a lot of free yoga classes at my gym. Stopped pretty much when my favorite teacher stopped teaching after she had a child. I still have dozens and dozens of recordings I made of sessions, I'd turn on a recorder and set it beside me. I don't know if I could use those now, just wearing an MP3 player with earbuds. I should try. Did that for pilates classes they had there too. My favorite teacher taught those too. Don't know if I could make sense of it now, it's been over 10 years. But, yes, people were telling me I'm stiff up there.

Even if I start going to yoga classes when I get back in the gym (when pandemic calms down) I won't be like most people. I'm mostly OK but I won't downward dog because of my shoulders, maybe elbows too. But that's OK.

In general, I'm pretty functional. But I'd really like to be able to go for it when skating like I sometimes do. I'm slumping right now, well, partly because I went from 5.5 to 7 to 9 then 10 miles/day all in maybe 1.5 years. I was faster with higher BPM heart rate when I didn't skate as far. I'm pretty sure it's the back pain that's holding me back now. I had that when I was skating 5.5 miles but it improved. I was thinking it would improve when I went to 10 miles/day. I missed two days in a row a month or two ago and the pain had subsided, the rest really helped. But when I skate every day it's harder to recover. How I do has a lot to do with how well I'm sleeping and what I'm doing in my day before I skate. If I'm well rested, I do better. I should try to be conscious of my posture. I was told that by a PT when I was 19 YO! I was being treated for a lower back injury. I've never been sure that I fully recovered from that, but that could just be sciatica. At first, that injury was real bad!

 

[Torn Mind]

Without direct physical intervention, the muscles will remain tight. Stretching is a good start but without pressure, the process is slower and can remain unfixed. If your muscle tissue feels stiff upon firm pressure and contact, that is indicative that it is "knotted up".

I would try stretching and examining the whole body for hidden aches, including easy muscles like hamstring, etc because an injury from one place can mess with more than the local area.

I built up a lot of tension in my muscles all the way up to my 25th or so year of age and I still have plenty of areas to deal with. Had no awareness of muscles causing all the reduction in focus and concentration, and headaches in my body. Only through a fender bender car accident with my mother and I did I then have to get some therapy, and then I got some massage, but it was more pressure and rubbing (no "suggestive" stuff), so the relief was superficial and transient. That was the start of it but some areas can only be dealt with by yourself.

Electro-Acupuncture is purely superficial and a waste of money but since it was a car accident, neither me nor my mom had to pay out of pocket.

I also had a truly garbage mattress in my teen years as well. Soft weak foam was so bad.

First real therapeutic massage was a "deep tissue" with one dude. Only had one time with him, but that was the eureka session as I was made aware of all the tension built up from a combination of sitting and exercise over 12 years. (From middle school P.E through all the walking in college).

One time, my teenage self I actually did walk 15 miles from one place to another. No cell phone back then and the bus was done on that weekend.

I had fell on my ankle in high school and never ever both to stretch or massage my left leg. for years afterwards. Then in college, I walked a lot to class. That obviously added up over time.

Activity without relieving the tension within the muscle will only serve to make things tighter and tighter over time. Sometimes, if the pressure is applied to the muscle at the right spot, the muscle will actually "vibrate" in response and loosen. I managed to experience it when self-massaging my triceps.

I believe harder materials like balls are better than foam. I've used makeshift tools like big sockets, offset wrenches, or a hammer. Or my own fist and just lay my back on it.

 

[Muse]

I'm going to have to try some things. If not yoga classes (not until the pandemic morphs into endemic) then yoga at home. I can try my recordings, I also have a couple books and of course there have to be a great many excellent videos. I have a 43" 4K Roku TV in my workout room. I have some equipment in there too. I've focused on the skating, but that, great as it was has been harder lately. I didn't skate today, partly because I had a few projects I had to complete. Also, I reasoned that a day off wouldn't hurt. The skating is really fun when I'm not in pain, but the back pain ruins it. Even when I'm skating badly, with back pain, by the time I get home after skating 10 miles I feel some exhaustion... every time.

I might ask my doctor if he will prescribe my seeing a physical therapist to evaluate my middle back problem. I know, I shouldn't have to argue to get treatment, but he's often very parsimonious with the HMO's resources. I've been mulling over switching to another doctor, it's just a few clicks on my computer. My doctor assumes I'll stick with him, always has, but he's let me down a bunch of times. Part of my problem is that I didn't have any coverage for many years and was my own resource for whatever physical problems I had, so that self reliance is something that isn't easily shaken. However, as you get older it gets harder to be that way. Most people over a certain age need some help with some things. I had 3 outpatient surgeries that were basically essential if I'm going to have a decent life.

 

[MtnMan]

I would recommend a chiropractor... but one of the better ones.

Chiropractors have helped me immensely over the years, even when their emphasis seem to be on selling chiropractic. The first helped me from a numb leg and foot and debilitating lower back pain to virtually pain-free normal in just a few weeks, combined with a hard sell on chiropractic.

The absolute best was one that addressed the muscles as much as anything else. I would still be going to him, except he also provides K9 and equine chiropractics services, and the demand for that led him to give up his human practice.