Exercises for Upper Back Injuries
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UPPER BACK INJURIES
Common in sports like baseball, swimming and tennis.
WHAT CAUSES UPPER BACK INJURIES?
Upper back injuries can occur in almost all sports, especially those that require a significant amount of rotational motion, such as swimming, baseball and tennis. Injuries such as fractures and subluxation of the ribs are rare, but more common in contact and combat sports.
In most cases, upper back injuries resulting in debilitating injury are caused by a direct blow to the area. Chronic tightness and stiffness is also common in the upper back region and may lead to mild, aggravating pain and dysfunction.
COMMON UPPER BACK INJURIES IN SPORTS
RIB JOINT SPRAIN
Typically, when people say their “rib went out”, they have sustained a sprain or a subluxation (partial dislocation) to either or both of these joints:
the costovertebral joint - where the rib and the thoracic vertebrae connect to form an articulation or joint
the costotransverse joint - this joint is similar, but formed from the rib and the transverse process of the vertebrae.
With a rib sprain, the supportive ligaments around the joints are likely sprained and stressed - causing pain within the area. This is usually caused by minor trauma such as overextending when reaching for an item or a sneeze. Either of these may overly stretch the ligaments surrounding the joint and, in an attempt to stabilize and protect the area, the area becomes tight and stiff.
Common signs and symptoms of a rib sprain include:
discomfort and pain when breathing deeply
tenderness and muscle spasms over the ribs
mild to moderate pain with coughing or sneezing.
UPPER CROSSED SYNDROME
Upper crossed syndrome (UCS) is a dysfunctional pattern (rather than a medical diagnosis) that is common amongst desk workers and students who spend much of their day in front of a computer.
Visible signs of poor posture include:
the chin excessively protruding forward from the torso (anterior head carriage)
an overly rounded upper back (excessive thoracic kyphosis)
the front of shoulder rolled forward (forward rounded shoulders).
UCS is usually derived from chronically poor posture involving a habitual struggle between the muscles of the posterior chain and gravity. In these cases the path of least resistance has won, with gravity pulling the head and shoulders forward. In these cases, people may experience neck pain, headaches, a stiff upper back or tight pecs and shoulders.
RIB FRACTURE
Rib fractures can occur after direct trauma to the rib cage, such as during a rugby tackle, when getting hit by a hard object such as a hockey puck or after falling from a height.
Typically, people with a rib fracture will experience severe pain and extreme tenderness of the fractured rib and the surrounding area surrounding. Breathing can become laboured and painful, particularly when breathing deeply, coughing or sneezing.
Movements that require rib cage motion, such as sitting up from bed, rotating and bending forward, may also cause significant discomfort and pain.
Rib fractures may take anywhere between 6-10 weeks to heal. During this time, you should avoid physical activity that may aggravate the area or cause further rib injury.
EXERCISES AND STRETCHES FOR UPPER BACK INJURIES
THORACIC EXTENSIONS
Exercise instructions:
Place the foam roller across your back, along the bottom of the shoulder blades.
Supporting your head with your hands, extend backwards over the foam roller and hold for 3-5 seconds.
Rock yourself back to the starting position and slide your body down the roller so the roller is about 1 inch higher up the spine than the previous position.
Repeat the exercise all the way up the spine until your final starting position is at the top of your shoulder blades.
Tips on technique:
Breathe out as you extend back over the roller.
Once you’re extended over the roller take another deep breath in and out before moving back to the starting position.
Suggested workout:
About 3-5 different spots along the thoracic spine
Go up and down the spine 2-3 times.
THREAD THE NEEDLE
This exercise focuses on the rotational aspect of the thoracic spine. When the thoracic spine gets stiff and cannot rotate, the neck and/or lower back must rotate more than it should and this is when injuries often occur.
Exercise instructions:
Go onto your hands and knees (quadruped position) and sit back on your heels.
‘Thread’ one hand through the space between your other hand and your leg (the needle).
Reach this hand as far as you can through the needle, which should create rotation in the upper back.
Return back to the quadruped position.
Tips on technique:
Before you reach under your other arm take a deep breath in and breathe out as you reach out.
Suggested workout:
2 sets of 8 repetitions on each side.
OPEN BOOKS
The Open Books exercise also works on thoracic spine rotation but in the opposite rotational direction that the Thread the Needle exercise focuses on.
Working both directions of rotation is extremely important for rib and thoracic spine health.
Exercise instructions:
Lay on your side with your hip and knees flexed to 90 degrees.
Raise your higher arm backwards towards the ground behind you while rotating your entire spine (including your neck and head).
Hold the position where it feels comfortable and stretch for 5 seconds.
Return back to the start position.
Tips on technique:
Before you move your arm take a deep breath in and as you reach backwards breathe out steadily.
Suggested workout:
2 sets of 8 repetitions each side.
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