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Back Pain Across the Lower Ribs

Client’s Description

These people complain of a band of pain across the mid back. They reach back and trace a band across their mid back.

At this point, I have them stroke an ice cube over the arch of the ribs, in the front. They usually have a look of disbelief but comply. Then, I have them lay back on the table stretching their abdomen open and letting it close a few times. This could also be released with the yoga poses described below. They seem surprised when the pain is dramatically reduced or completely gone.

This pattern is usually initiated by some activity that overworks the abdomen such as crunches, coitus, kicking a soccer ball or sitting on a couch while folded forward to reach the libation on the coffee table repeatedly.

They usually have a large abdomen that is over-stretched or a very tight abdomen that has them slightly hunched forward. Sometimes, they are standing in this flexed position as a matter of habit to keep their abdomen from bulging.


Self Care

Some clients will put a vapocoolant, like Icy-Hot on their upper abdomen to relieve pain during the day or while sleeping at night. It is important to ice directly over the trigger point. It is at the top of the abdomen around the arch of the ribs, just below the pecs. If you press into this area with your fingers, usually, one side is notably more tender than the other.  A little ice-and-stretch is helpful here. Icing the rectus abdominus along the entire length offers more consistent results.

Sphinx pose from InLineHealthcare.com

There are many yoga poses that arch the mid back for stretching this. IT will pinch a bit if you don’t take it slow or use some ice/heat on the abdomen beforehand. Cobra, camel, pigeon and many others do this. I like this sphinx pose, but it requires some pelvic balance. Go with something more stable, if it is right for you. There’s no need to do any extreme back bending. This releases quickly, especially with some ice/heat.

You will get temporary relief from treating the muscle directly. It does not release the underlying problems in the pelvis. See your bodyworker for lasting relief.

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Therapy Notes

This trigger point is can be easy to release when the superficial and deep abdominals are balanced with the spinal erectors. Deep or involved work on the rectus abdominus is seldom needed.
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Tony Preston has a practice in Atlanta, Georgia where he sees clients.

He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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