The number one complaint that I get as a massage therapist is a knot either under the shoulder blade or between the shoulder blade and the spine. When I first started doing massages I would go right to that area when people would complain about it. However, as much as I worked on it, it would never bring lasting results. I had to find a way to get this pain in the shoulder to go away for good. To get the desired permanent change I, and my clients, had to experience a paradigm shift.
Back Pain From Sitting at a Desk
A Bit of a Paradigm Shift
This shift was to understand the difference between a tight muscle and a taut muscle. Pain can come from a muscle that is too "tight" from being in constant contraction, or hypertonic. That is the pain we might first assume is the cause of the back pain under the shoulder blade. However, this is not typically the cause unless your are a rower or work out your rhomboids like crazy.
Tight versus Taut
Most people are not rowers, and for most people there are very few things they do that would cause very tight muscles in the rhomboids, or backs of the shoulders. What is most often happening when there is pain in that insatiable spot is a "taut" muscle.
People might understand this concept by comparing it to touching your toes. When you touch your toes you might be able to feel pain in the backs of your legs, but is the pain coming from your hamstrings being too tight, or contracted, or is it coming from them being too taut, or stretched? The answer is that they are being stretched.
A Counter-Intuitive Approach
If you think about the average person they are constantly in flexion, or rolling their shoulders in and reaching their arms forward. Whether they are driving, typing at a computer, reaching for a mouse, watching tv, or just about any other activity we do. My massage practice is mostly built around doing massage in a corporate setting on employees. That typically includes a great deal of people with back pain from sitting at a desk. I used to think that the real people who need a massage are construction workers or those who do manual labor, but I have been shocked to see just how much of a need there is for those who work at a desk. A desk job typically leads to terrible posture and a lot of low back and shoulder pain. The real secret to get rid of this pain is to reverse the constant state of flexion. There are many ways that it can be reversed. I will name a few.
Solutions for Back Pain
Some people have had their parents harp on them about bad posture and sitting up straight. Even though we may not have liked their critiquing, posture is so important to gettingrid of this pain. Sitting up straight and pulling your shoulders back to your spine will help to relieve the strain that has been put on the tissues and muscles in the back of the shoulder. If you felt uncomfortable stretching out your hamstrings, you would stop the pain by stopping the stretch. The same goes for the area behind the shoulder, stop the discomfort by stopping the stretch. Pull your shoulder towards your spine and bring your head back. Good posture is one of the best steps to alleviating the pain.
Since we still have to do our jobs, we still have to reach forward to reach the mouse, or to type on the keyboard, so posture might be compromised throughout the day. This is one reason why it is critical to stretch. However, be aware that not every stretch you do will bring positive results to relieve back pain from sitting at a desk. I always ask new clients with pain in this area if they stretch their arm in front of them, by pulling their bicep to their chest so that their right hand is now being pulled to the left side of their body, and they almost always say that they do. This is not helping the problem but is in fact compounding it. Stretching the back of the shoulder is the main reason the pain is back there in the first place. Stop stretching out the back part of the shoulder!
Now that you stop stretching it in the wrong way, you need to start stretching the problem in the right way. The way you would do this is to stretch the muscles that are putting you in flexion. Some of the main ones that I would focus on stretching would be Pectoralis Major and Minor, Subscapularis, or Serratus Anterior. If you do not know how to stretch these, look it up or look at my descriptions at the bottom of the article. Stop stretching it forward and start stretching your arms back, and that will bring a huge amount of relief.
Proper breathing is often overlooked with upper body problems. In our society we breathe far too much in our chest. There is a huge muscle we have for breathing called the diaphragm. This muscle is supposed to do the heavy lifting when it comes to breathing. However, we often use muscles called the scalenes to do the heavy lifting. This causes lots of pain and tension in the upper body. These muscles were meant to be accessory breathing muscles, they were not intended to do all the work.
Take a deep, low breath. Allow your stomach to come out when you breathe. This change will allow your upper body to relax, and even though the cause of your shoulder pain is not necessarily from these breathing muscles, all your muscles are interconnected through your connective tissues and fascia. Relaxation of one area often leads to relaxation in another. My experience has been that changing breathing habits have helped my clients drastically with their "taut" tissues in the shoulder.
Obviously as a massage therapist I would say this, but this is an amazing way of relieving pain in this area. If you get a good massage therapist, then they can be a huge aid in relieving this pain. For more info on the benefits of seated massage, see our last article.
I have seen dozens of my own clients find relief as they have come to see me. Sometimes there is a lot of built up tension in the muscles that is hard to stretch away. Sometimes you go so long in a forward contracted state that it is hard to reverse it. A competent massage therapist can be a soothing and easier way of getting the years of bad habits, to go away. I have seen years of pain and problems go away in just one session. Massage is an amazing way of getting that knot in the shoulder to go away.
5. Get Adjusted.
There are times that these flexion muscles can pull you out of alignment or can pull ribs out of place. If this is the case, correct your posture, stretch it out, and get a massage. If none of these have helped. Maybe it would be good to get adjusted, or to get the rib popped back in.
The best person to see in my opinion for this is a Chiropractor. If you don't like Chiropractors, go see a Osteopathic Doctor, or a Physical Therapist and they should be able to get things back into place. If you don't want to see any of these look at the end of the article for a solution to popping ribs back in that I have done for myself many times. Posture, stretching, breathing properly, and massage will all help, but sometimes getting adjusted can be the final step to lasting pain relief.
What About Low Back Pain from Sitting at Desks?
All of these principles can be applied to help with low back pain. Again, with a lot of low back pain there is a need for a shift in thinking. To get more details about this check out the article on Low Back Pain. There is a great billboard that I see on my way home from work that says, "'I love back Pain' - Said no one ever." I love to see that. It is so true! No one wants back pain, no one wants to be in pain anywhere.
These techniques should help to alleviate pain, change the way you might be thinking and try them out and it will bring amazing results.
How To Stretch...
For more info on stretching from your desk, see our article on better posture from your desk.
One of the easiest ways to stretch these is to use a wall or a doorway. If you use the door way put your arms out to your sides so that they are perpendicular to your body. Kind of as if you were going to fly. With your arms still outstretched turn your hands so that your pinkies are down and your thumbs are up towards the ceiling. With your arms like this start to step through the door so that the frame of the door brings your arms behind your body. Do this until your feel a stretch in your pecs, or you feel a stretch in your chest. When using the wall, same principles apply, but this time do one arm at a time. Put your arm out the same and face the hands the same way. Then place the palm of your hand on the wall and begin to lean forward. Breathe while you do it, and take some time, don't just do a half second stretch. Hold it there for a while.
Same principle applies as was done for the Pec Major, however, this time don't have your arms straight out but instead have have your arms bent at the elbows to make a half square with your arms, or like a referee would say touchdown. Have your palms the same way as before and lean through the door with your arms being pulled behind you again.
This stretch is much like the others. Stand in the doorway and this time reach straight up with your arms as if you were trying to grab something off of the top shelf. With your arm reaching up high like this, step through the door so that you can feel a stretch just behind and below your armpit.
Breathe your rib back into place
I have used this technique many times to get rid of discomfort for me. It is very relaxing and helpful. To do this lay down on the ground in your house. I emphasize the ground because you do not want something soft like your bed. A carpeted area is perfect. Lay flat on your back. Then tuck your shoulder blades in toward your spine so that the flat part of your shoulder blade is comfortably flat on the ground. The next step is to let your head fall on the ground as well, however, do not allow your head to fall back, where your chin points towards the ceiling. Instead lean tuck your chin down as if your were trying to make a little bit of a double chin. Do not hold your head down but allow it once it is on the ground in this position to relax. Now there are two things that you can do.
One would be to just take deep diaphragm breaths and wait to you hear or feel your back pop. If it is not popping on its own in this position, rub the top part of your chest from your sternum to the bump of the shoulder. Also, while doing this your can find a tender spot here and push on it while you take deep breaths and sometimes you will hear it pop. Do this until you get the result you want!