Mid-back pain that extends up and around

Client’s Description

referral-iliocostalis-thoracis-r10-posterior-cropped referral-iliocostalis-thoracis-r10-anterior-cropped

line - black 400People complain of stiffness, tightness and pain in their back as they reach around to touch their lower ribs. They often complain of how it extends up to the outside of the shoulder blade and seems to shoot through or wrap around their side into their abdomen.

It bothers them when they are bent forward as when cycling or pulling weeds. Some have concerns about digestive problems and have seen a nutritionists or gastroenterologist without relief.

This is usually a problem created by habitually bending forward, like when a mom is tending to children. Occasionally, this has an abrupt onset with an unexpected twisting of the trunk from a car accident, a fall while skiing, etc.


Self Care

lattissimus dorsi - stretchThe yoga position of cat and cow are good for those that want a very gentle start.

Exercise that extend the back are helpful. In particular, lunges, hyperextensions, supermans and deadlifts. In the beginning, this will often bother the back a little bit more. It usually stabilizes after about three weeks if the exercise is light, steady and consistent.

1470559364-london-bulgesIt can be hard to resolve this is the abdominals are over developed so that they pull the ribs and head forward into a chronic stooping position.

Ice and stretch of the low back can offer quick relief, although it may be temporary. Stroke the low back with ice from the sacrum and hip up to the bottom of the shoulder blade and then bend to the opposite side 3-4 times.

Therapy Notes


Iliocostalis can be difficult to resolve when it becomes chronic, especially when the client has over-worked abs and is chronically stooped forward. All of the affected joints in the picture are to be checked and mobilized. A posteriorly rotated ilium and overdeveloped abs can be strong contributors in this postural issue.

This pattern very similar to the pattern of latissimus dorsi, which is often overlooked.

line - black 400

Similar Patterns

fi-aching-mid-back-with-tired-triceps  tags-mid-back tags-stiff-back tags-shoulder-blade tags-abdomen tags-upper-back


schedule session

Tony Preston has written and taught about anatomy, trigger points and cranial therapies since the mid-90s. He has a practice in Atlanta, Georgia where he sees clients.

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