I used to have such trouble with upper back pain when I worked in tech! As a 20-something, I worked long hours in front of a computer with an aspirin bottle next to my keyboard. I eventually learned that a lot of my issues were due to Upper Cross Syndrome, and that massage was an excellent way to dial down neck and shoulder pain.
What’s Upper Cross? It’s a combination of Tight and Inhibited Areas.
Tight: Muscles along the black line are super tight and over working: in the front of the body, the Pecs are Short and Tight (hint: these are the real key to the issue!) In the back of the body, it’s the upper back: Traps and Levator Scapula are Overstretched and Tight.
Inhibited: Muscles along the blue line are inhibited. That's the neck flexors in the front of the body, and Lower Traps in the back of the body.
It feels like severe tightness in the upper back, “between shoulder blades” or “tops of shoulders.” And often neck pain.
Sometimes also:
Limited range of motion, ex. in the shoulder, or “I can’t turn my head”
Tension headaches
Anxiety. Head forward posture is part of the muscular pattern of the startle response. Staying engaged in this muscular pattern can cause your nervous system to assume you are perpetually in Fight or Flight, and to release the associated stress hormones.
Common in:
Tech workers who are stationary for long periods on laptops, or at a desk
People who do lots of driving
New moms. Holding a baby in your arms for long periods of time, with head to one side, looking down at them
People with skeletal issues, like extra degrees of curvature in the thoracic spine (read: a rounded upper back.)
What’s Happening in the Tissue? Short and Tight pecs are overactive, engaging for nearly every upper body movement, even when they shouldn’t. Over time, Short and Tight muscles are unable to return to a resting state, which inhibits the muscles responsible for opposing movements. The pecs act as pulleys - they pull the upper body and neck forward, sometimes with great force, causing muscles on the upper back to stretch all the way to their end range and beyond, and stay there. So, upper back muscles become overstretched, tight (actually taut), and painful.
When your chest caves in from tight pecs, your head moves forward of your body. And it takes a lot more strength to keep your head up and your eyes level to the horizon from here. (Think: the strength it takes to hold a bowling ball up, with the weight centered over your forearm, versus holding it shifted a few degrees forward.) Stabilizing your head becomes more difficult, and your body begins recruiting nearby muscles to help, usually those overstretched upper back muscles - Total overload!
Massage can help! The physical impact of massage is mostly to relax, ie, elongate muscles. So this is one of those interesting cases when getting “massage where it hurts” in the upper back feels good in the moment, but is actually elongating an already overstretched area, without addressing the shortened muscles that are pulling you forward - in this case, only working where it hurts puts you farther into dysfunction.
A massage plan with more lasting impact: Release the pulleys. Releasing the “short and tight” pecs allows you to return to a more normal posture. This, in turn, releases the force on the overstretched upper back muscles, letting them return to a normal resting length. (Yes, we typically work on the upper back as well, to check for trigger points, and also... hey, it feels really nice!) Pain levels go down, you see more ease of movement, and more normal range of motion.
Does this sound like you? Book a massage, and let’s get you feeling better!