Integrative Works

People complain of stiffness, tightness, and pain in their mid-back. They almost always make this awkward move where they reach back to touch the lower ribs on that side. Often, they complain about how it stiffens their lower back. They may even refer to it as low back pain as they touch the lower ribs. At times, they complain of how it extends up to the outside of the shoulder blade.

It bothers them when they are cycling or pulling weeds. This, unlike other low back problems, seems to be connected to breathing deeply while bending forward. This pain tends to ache. In contrast, most low back pain feels sharp and fragile.

Because of its involvement in breathing, this often hurts when people sneeze or cough.

For many, this trigger point refers forward to the abdomen. In my experience, people talk about how it wraps around to the front. However, most trigger point research cites it as referring forward and a little downward through the abdomen.

This pain pattern is particularly bothersome on the right, where appendix pain flares up. Most of my clients have already contacted their physician to check for gastrointestinal issues. If they have not, I refer them out to have it checked and avoid working in the abdomen until we confirm it is safe.

Deep Breathing While Bent Forward

The muscle that creates this pain, iliocostalis thoracis, helps depress the ribs in deep breathing. It gets to be a more likely problem in clients over 45. In the mid-40s, the sacroiliac joint starts to fuse, and the low back muscles typically atrophy. Typically, cycling is more appealing at this age as it is less painful and injury-prone than running.

Awkward Reaching and Twisting

This pain pattern also bugs people when they are reaching and twisting. This mid-back muscle helps to extend and twist the back. Combined with deep breathing, it can create an ache. Awkward and imbalanced reaching and twisting can be the activity that jams a joint and starts it all.

Musculoskeletal Anatomy

About these Illustrations…

This post on anatomy contains standard information about the origin, insertion, function, and innervation of muscles. It also includes information on functional considerations and anomalies.

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Anatomy posts have a grid of all related posts. This includes posts on pain patterns, self-care, therapy notes, NMT protocols, cranial techniques, and cases.

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