Not really sure where to put this thread but I suppose this seems the most reasonable place considering the options. I've had some chronic pain in my back for a long time now. There was no traumatic incident to cause it or anything like that. Just started up and does not go away. I've been to chiropractors, PTs, and massage therapy (thankfully covered or I would be a very poor man). Nothing has led to lasting improvement. Needless to say I am not particularly interested in continuing such therapy. I am more interested in self help.

I'll try to describe it as best I can. It has never really hindered my training it is more of a constant annoyance. It occurs in between my shoulder blades. It is aggravated if I move my shoulders forward. I would describe it as a tightness in the muscle or a nagging pain. I am not well versed in anatomy but I would say its rhomboid related. More so where the rhomboids attach to the shoulder blade.

I would love nothing more than to correct this. I've been reading up on it trying to figure out what my best course of action would be. I know Eric talked about the Trigger point Therapy workbook and I am wondering if that is just the thing I should pick up. Anyway I would greatly appreciate any help or advice anybody has. Thanks!

First, I'd definitely reccomend the Trigger Point Therapy Workbook to pretty much everyone. It's worth every penny and while I have no idea if trigger points are the problem or part of the problem..it ain't gonna hurt. If it were trigger points this could be referred pain from different sources but it also could be trigger points in the rhomboids themselves.

Question: Do you do a lot of shrugs in your training? Or have you in the past done them a lot. I'm talking about barbell shrugs or any shrugs that have your arms at your sides and you just shrug your shoulders straight up more or less.

Also, if you don't mind, what do you do for a living? People tend to focus on training as the cause of all their pain but it's much more likely to result from what you do all the rest of the time and habitual positions or repetitive motions that your job requires can have everything to do with it.

My guess is that it could be tight/short pectorals, pec minor, and anterior delts. If your rhomboids were overstretched and overworked you'd probably be displaying the forward head kyphotic position.

Don't try stretching them.

Did you see what Joe and I were talking about with the tennis ball?

http://www.gustrength.com/forum/t-141236/the-trigger-point-therapy-workbook-and-my-aha-moment

Just read the comments. I have been using a tennis ball along the wall. Also have a foam roller. Sock trick sounds like a sweet idea.

Gotcha. So it sounds like you've been thinking along those lines.

Do you do any pectoral stretches, pec minor stretches and lat stretches? You may want to do the tennis/ball foam rolling on the pecs and such if you aren't already. Plus incorporate some stretching.

What is your mobility training like?

And what type of self posture checks have you done?

I don't have a lot to go one without actually seeing you in action but certainly there are things that if you aren't already doing may be helpful to get things in balance. The classic syndrome for "desk jockeys" would be what I mentioned at the get go..tight in the front and overstretched worked in the back.

You mentioned that the pain is pronounced when you move your shoulder blades forward. Which means when you abduct or "protract" them. So that makes me wonder if you are constantly abducting the scapula. For instance during shoulder flexion bring the arm forward, do you get a since of the scapula moving forward in some type of unnatural way. There is actually a chance of someone basically replacing replacing movment in the joint itself with scapular abduction.

I am not a kinematic expert and don't know all the technical ends and outs but if it's happening then the pain you have would be explained. Is there any other pain you're not mentioning?

I have been neglecting my pecs in the foam rolling department. Tried using the tennis ball against a wall definite trigger points there.

As for posture check's I have gone through Cressey's Neanderthal No More series. And I got Joe to give me a diagnosis. No noticeable deviations from a good posture that I can tell.

Mobility training,
Well I do hip and shoulder work, wall slides, sleeper stretch, squat to stand, spidermans, thorasic extensions.
That is all that comes to mind at the moment.

I dont have any feeling of my scapula moving in an unnatural manner.

Additional Pain? Well there is noticeable adhesion. And some neck stiffness not pain.

Neanderthal no more is great but it takes a lot of experience to do these kind of checks. It is almost guaranteed that there are some deviations from a "good" posture since a good posture is just a mean.

Since you found a lot of spots on the pecs then I'd assume some more dedicated pec and pec minor stretching would be advisable. Check the lats as well. From what your saying though I'm pretty sure that the addition of some pec and lat stretches would be useful but I advize that you do the massage for a while FIRST until you have worked away a lot of the pain and then add stretches. Doing the stretches right away is not automatically a bad thing but I believe that improving the tissue quality through the rolling and massage first will make the stretching much more successful and quicker.

This is purely anecdotal but I had the same pain between my shoulder blades and it definitely coincided with a whole lot of hot spots in the pecs. Now I am hard pressed to find a hot spot anywhere in my chest since foam rolling, massaging, and stretching and the pain between my shoulder blades is gone. But the first thing I did (quite a while back) was to try to stretch the actual rhomboid/mid trap area and that was definitely the WRONG approach. Just made it worse. And I have found that to be the case more often than not.

Do that after you work upper body. And if you are dong rows you may want to stretch the pecs before hand as long as you don't plan on needing them again. It could help you find a bit more range of motion on rows. If it works than do it, if it doesn't don't worry with it and stick with the foam rolling and/or tennis ball before you workout (short period) and you can do a longer period after you work out or at any other time.

I'd still like to see you in action for myself. Not to discount Joe :)

I know you're getting the trigger point manual so that should allow you to figure out how you want to handle the self-massage and the tennis ball can go hand in hand with that. Foam rolling is more of a general thing but of course with certain muscles you can pause on the bad spots. Well..actually, you shouldn't really "pause" but more go back in forth with short rolls over the bad spot.

You may want to also look at Eric Cressey's Shoulder Savers. I know Joe is familiar with all this stuff.

I'll shoot you a vid with some good info on the pec stretching.

To stretch the lats (after working out):

Bend at the hips and grab on to any upright thing that is stable. Keep the back set. Then pull against the object and use your hips to change the angle until you feel a good stretch in the lats. You can move it around a bit to move the stetch. You just need to experiment with it.

Mike, here is the vid I mentioned. Very informative and on the same subject we are speaking of. He goes into pec minor problems and associated rhomboid problems (remember trigger points on rhomboid too) and some stretches.

Just to lend some information I've collected on Mike:

-He's push dominant, mainly transverse plane (I think I have the right plane), particularly benchpressing. BUT it is beginning to even out.
-A bit of forward head posture (deskjob), no apt, I'm thinking maybe a bit of scapular winging (again from deskjob) and maybe some elevation. I'll have to re-check again because I can't remember.
-He's doing the same routine as I am, with a couple of minor changes on pullups and pistols (some assisted pullups and pulldowns and box pistols)
-Mainly mobility work for the hips and thoracic, with some activation work for the glutes, core, scapula.
-Foam rolling and trigger points are recent additions, foam rolling has been in for a couple months now I believe.
-I think Mike has read shoulder savers recently or I atleast linked it to him recently

I thought the problem might be in the posture (scapula abduction) which lead to an overworked/overstretched rhomboid. So postural work was focused on, mainly thoracic extensions, foam rolling, scapula pushups, and just a general focus on maintaining good posture throughout the day. Once that was sort of squared away I's, Y's, and T's as well as wall slides were introduced. Facepulls were alwasy a part of the routine so they have been present since the beginning. Recently more pulling has been added in for Mike's benefit (specifically lat pulldowns and assisted pullups). Scapula depression is now being focus on during rowing exercises as well. Funny enough, I showed Mike how to do a lat stretch this morning at the gym.

Basically I've been looking at the back and didn't think to check the damn pecs. With these hot spots I'm fairly certain that it may be a pec and pec minor issue.

I'll re-check posture again tonight and see if I can't get Mike to pose for the camera hahaha.

I'm sure I'm missing alot of stuff here (lol?) but this is all that comes to mind right now. I need to drink another coffee and then maybe I'll remember everything else.

I've started working in regular massage with the foam roller and tennis ball. See if I cant get rid of most of the pain before I stretch more. I had been working in Pec minor stretches after I saw you post that video the first time on gus. Doorway stretches and Joe was showing me some alternatives that are easier on the shoulder.

Your anecdotal evidence sounds pretty similar to what I have been doing. I have been known to stretch out my rhomboids. In fact I can remember one doctor and at least one PT who advised I should because it "feels good". Needless to say I have stopped such foolishness. I am not sure it made it any worse but it surely didn't help.

Looking forward to getting the book. I have read through Cressey's shoulder savers once. But I'll go through it again. Make sure it sinks in.

AS to Joe's comments, havent been doing the I's Y's and T's for a while. But I plan to work them back in. And as far as posing for the camera I am half convinced Joe just wants photo's for private use ;)

LMAO.

Yeah, Mike, the pec minor stretch where you bring your arms down and back, like in the vid…I'm sure you can go ahead and do a bit of that, very gently. But focusing on the "massage" for the most part.

Stretching the part that hurts is the knee jerk response for many of us. And it is almost always, in my experience, the wrong response. And doing something because "it feels good"..any therapist should know better than that. This is why I have gotten into little arguments with so many PT's posting on the internet. Not all PT's are good ones. Just like not all house painters are good ones. But right off the bat I feel that you are ahead of the game recognizing the foolishness. Many things that are bad for us in the long run "feel good" when we're doing them!

I was really more interested in seeing vids of exercise form.