Upper Back Pain Relief for Runners

The upper back is at a crossroads between the lower back, neck and shoulder blades and is therefore a common place to have pain and dysfunction in runners. Upper back pain between the shoulder blades is a frequent location as is upper back pain with breathing. It can be hard to take in a deep breath and it can be extremely painful. The pain can also occur off to the sides, which may make it seem like it is under the shoulder blades. It can feel like a general tightness but is often a sharp and stabbing pain. Thoracic spine pain can also lead to pain in the anterior chest wall.

Studies have reported up to 22-65% of adults will experience pain in the upper back each year and about half of these cases are related to muscle and joint pain. While upper back pain is not as common as lower back pain, pain in the upper back is just as disabling as having low back pain. It is very common for people that have had chest and upper back pain to have the problem recur repeatedly considering that about half of these people still have pain after 2 years. Pain in the upper back seems be even more prevalent in younger patients, including adolescents, compared to older adults. It is concerning that preliminary evidence suggests upper back pain is occurring more frequently in adolescents now compared to the past, which may predict more problems for adults in the future.

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What Causes Upper Back Pain in Runners?

Mid and upper back pain in runners is extremely common due to the normal stresses placed on the area being amplified by the impact of running. The actual pain can be from the thoracic spine, the associated musculature and/or the posterior rib joints. Ribs in the body have joints in the front and in the back which can become dysfunctional and extremely sensitive to movement and pain. Often, pain that is located off to the side and is worse with deep breathing is due to rib restrictions and dysfunction. These pains can be so bad that a significant number of people actually go to the hospital to be checked out for a heart attack, only to find out that their heart is completely fine and the pain was from the muscles and joints in their chest or upper back.

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Problems with posture dominate the reasons for having upper back pain in runners. Slouching is something that people do now on a regular basis, especially when much of the population sits for most of the day at a desk. Sitting at a desk and then sitting in traffic and then slouching when you watch TV or play video games all has an adverse effect on the health of your thoracic spine. Over time, it leads to muscle imbalance and asymmetry where the muscles in the front part of your chest begin to tighten up and the muscles in the upper back begin to weaken and lengthen. This could cause a decrease in the mobility of your ribs and your spine and can directly lead to problems with your capacity to breathe. This decrease in your ability to breathe can be further exacerbated by dysfunctional breathing patterns. Overall, it becomes harder for someone to straighten up, extend their back and take a deep breath in.

The repeated pounding of running takes a toll on your legs, but the legs are meant to withstand repeated impact. Proper running mechanics are needed to ensure the legs do not break down and develop pain and the same is true of how improper running mechanics are related to upper back pain. The thoracic spine will also become painful when excessive loading places undue stress on the spine due to slouched structures. As I have mentioned in previous articles, the type of foot strike that a person uses can affect the forces and loads in the body, including the spine.

Lack of strength and endurance in the muscles of upper back means that the ability to compensate will be compromised. Overtraining will decrease your ability to train / perform, increase muscle soreness and increase your perceived level of exertion. Proper running form and proper programming will be less likely to have upper back pain as a result, which can make it a good idea to use a running coach.

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Something that can occasionally be an issue with upper back pain is indigestion. Eating too soon or too much before a run can contribute to indigestion.

Bra Fit, Running and Upper Back Pain in Women

Another issue that can cause upper back pain in women is when a woman’s bra is not fit properly. Up to 75% of women do not wear the appropriate sportswear and do not know how to correctly choose a sports bra, let alone a regular bra according to the medical literature. There are obviously multiple factors that contribute but it is best for you to go someone who has attended a nationally recognized fitting school and not just on-the-job training in the national chain store. I would recommend that women go to “That Special Woman” for a proper bra fitting. “That Special Woman” is located in Toledo and carries mastectomy bras and regular bras, which can include plus-size and nursing bras.

A woman should be refit if she has lost or gained around 10 to 15 pounds. Often, women will tighten the strap more than is needed or buy a sports bra that is too small. Squeezing the thoracic spine too tight can cause restrictions that result in problems and pain in the upper back and ribs.

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