Body Sense

SPRING | 2021

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Upper back pain, or thoracic spine pain (TSP), is common—especially for people who spend long hours in front of a desk or computer screen. TSP is more common in women than men, 1 and TSP also appears to be occurring with increasing frequency among adolescents. It is correlated with heavy loads, like a backpack full of books. Other factors that play a prominent role in adolescent TSP include the frequency of physical activity, daily time spent watching television, studying in bed, sitting postures when writing, and computer usage. 2 Despite the harm caused by poor posture and sedentary habits, massage therapy paired with home care and posture awareness can have a significant impact on upper back pain. CAUSES OF UPPER BACK PAIN A key cause of upper back pain is "biomechanical overload." Sitting for hours in a sedentary posture with a forward-head tilt to look at a monitor screen puts a significant biomechanical strain on the thoracic extensor muscles in the upper back. These postures require the muscles to work with long periods of contraction to offset the pull of gravity on the head. Some of these muscles are quite deep, so it is easy for them to be overlooked. Upper back pain may also be caused by factors other than mechanical overload and postural strain. TSP may result from bony disorders and degenerative conditions of the vertebral column, rib articulation problems, as well as various systemic disorders that may affect the gastrointestinal, cardiopulmonary, and renal systems. TREATMENT STRATEGIES Massage and Bodywork The vast majority of upper back pain complaints involve the soft tissues. As a result, massage is an excellent strategy for these complaints. If you haven't already done so, talk with your therapist about a treatment plan for your pain. Home-Care Treatment In addition to working with your massage or bodywork practitioner, home-care options can play a helpful role in reducing the pain from soft-tissue tightness in the upper back. Here is one exercise to provide relief: 1. Place two tennis balls in a sock and position them on the floor. Lie down with the tennis balls placed between the scapula, with one on each side of the spine. 2. Pull your knees to your chest to apply the appropriate amount of pressure to the upper back as you lie on the tennis balls. You can then move the tennis balls around and focus on the most sensitive areas, which are those likely to house myofascial trigger points. Movement The popular phrase that "motion is lotion" is true in this region. Engage in arm and upper back movements that help increase range of motion and decrease the chronic tightness that results from long periods of immobilization. When you can combine simple movements with the soft-tissue treatments from your massage therapist, it is far more effective than either one of them alone. As long as people are sitting for long periods in front of screens, there should be no shortage of work for their massage therapists. There are few treatment strategies as effective as massage for addressing most of the soft-tissue complaints in this region. Best results, however, come when clients work to gain greater freedom of movement while their massage therapists provide pain relief through their hands-on work. Notes 1. Andrew M. Briggs et al., "Thoracic Spine Pain in the General Population: Prevalence, Incidence and Associated Factors in Children, Adolescents and Adults. A Systematic Review." BMC Musculoskeletal Disorders 10, no. 1 (June 2009): 77, https://doi. org/10.1186/1471-2474-10-77. 2. Matias Noll et al., "Back Pain Prevalence and Associated Factors in Children and Adolescents: An Epidemiological Population Study," Revista de Saude Publica 50 (May 2016): 1–10, https://doi. org/10.1590/S1518-8787.2016050006175. Whitney Lowe is the developer and instructor of one of the profession's most popular orthopedic massage training programs. His text and programs have been used by professionals and schools for almost 30 years. Learn more at academyofclinicalmassage.com. massagetherapy.com—your resource for all things bodywork 13

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