The Problem
My client here has been complaining about a nagging pain in her mid back area around her scapula. The discomfort is more apparent when she is training upper body, but lately it has been bothering her outside the gym in daily life. The pain is more of an annoyance at a 4 out of 10 scale.
The Assessment
Her mobility was not bad at all after checking her upper body range of motion. Her problem here is more of a symptom of pain vs mobility. Plainly put, her supporting back muscles are overlengthened from sitting so often and (this is not a dig at her) not strong in the rotational plane to keep up with her demand in training.
The Solution
We first made sure her shoulder range of motion was adequate enough to have her train in the rotational plane. Moving to the back after some quick ART and PNF, we transitioned to work directly on her back. Specifically her rhomboid and low traps. These 2 supporting muscles are easily overlengthened from the forward-shoulder posture of sitting. We used dynamic cupping to restore mobility in the rotational plane. We had my client perform movements for her body to naturally accept the new found mobility without creating a defensive response. We did also address posterior serratus with breathing exercises to be thorough- these muscles also do rotation and should be considered.
Conclusion
The relief was immediate, she stated even during the session. After the session, she said the discomfort was completely gone after moving around. To keep this permanent, I explained that the habitual habits that keep us out of alignment must be minimized. I cannot realistically ask her to stop sitting, but simply being aware of her posture and correcting it with a “scap scoop” would help a lot. We further went on to different scenarios and set ups in the gym to make sure she is not exacerbating the issue during her workouts. All in all, her main homework was to add thoracic rotation exercises for strength and rotational stretches like “thread the needle” to keep her mid back happy.
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