Middle back pain is usually caused by unhealthy posture, improper lifting or twisting, and minor injuries like muscle strains, sprains, and herniated discs. Thoracic herniated discs are less common than neck or low back herniations because of the thoracic vertebrae’s size and rigidity, but they do happen. Chiropractic care can treat thoracic herniated discs and prevent future episodes.
Thoracic Herniated Disc
The 12 thoracic vertebrae between the neck and the lumbar spine make up the largest and least flexible area. The rib cage adds:
Protection
Support
Stabilization of the spine
Symptoms
Herniated discs happen when the soft, gel-like layer of the shock-absorbing intervertebral disc bulges into or leaks through the disc’s tough outer layer. Due to the location, a herniated disc can cause various issues to the middle back, chest wall, and/or abdominal areas around the injured vertebrae. This displacement can cause:
Inflammation
Compression to the spinal nerves or spinal cord
Tingling
Numbness
Pain
Weakness
If the lower thoracic region is herniated, symptoms can radiate to one or both lower extremities.
Radiculopathy
If the herniation compresses a thoracic spinal nerve, it can cause radiculopathy or pain that radiates down the nerve and out from the spine into the surrounding muscles. The symptoms can present around the rib cage or upper abdominal area. A large disc herniation can compress the spinal cord inside the spinal canal. This is a condition called myelopathywhich can cause:
Numbness
Tingling
Weakness in one or both lower extremities
Sometimes bowel and bladder dysfunction
In severe cases, paralysis
Causes
Degenerative disc disease and trauma like vehicle collisions or falls are the most common causes of thoracic herniation.
Individuals between 30 and 50 are more likely to be affected.
As the body ages, the disc’s soft inner layer loses hydration, making it less effective as a shock absorber.
The tough outer layer loses elasticity, increasing the risk of disc tears.
Chiropractic Care
A chiropractor or neurologic physical therapist can personalize a herniated disc exercise treatment plan to reduce pain, improve strength and posture, and increase mobility.
Therapeutic massage can be useful in managing pain and decreasing inflammation.
Spinal epidural injections can be used with physical therapy to help manage pain and allow the body to heal independently.
Recommendations
Avoid bending, lifting, reaching, and twisting.
Apply an ice pack or cold compress for 15- to 20-minute intervals every two hours.
Sit in chairs with a firm back to support the spine.
When sleeping, place a small pillow under the head and knees to keep the spine in a neutral position to prevent pressure on the herniated region.
Avoid too much rest, which can worsen the injury.
Gentle physical activity will maintain circulation and keep the muscles strong.
Surgery
Most cases of thoracic herniation do not require surgery. Surgery could be recommended if there is intolerable pain, neurological issues, and conservative treatments are not working. A spine specialist can determine if surgery is necessary based on the injury’s size, type, and location. Spinal surgery will remove all or part of the herniated disc compressing a nerve root. Common surgical procedures include:
Court, C., E. Mansour, and C. Bouthors. “Thoracic Disc Herniation: Surgical Treatment.” Orthopaedics & Traumatology: Surgery & Research 104, no. 1 (2018). doi.org/10.1016/j.otsr.2017.04.022.
Dydyk, Alexander M, Ruben Ngnitewe Massa, and Fassil B Mesfin. “Disc Herniation – Statpearls – NCBI Bookshelf.” National Library of Medicine, January 18, 2022. www.ncbi.nlm.nih.gov/books/NBK441822/.
Yoon, Wai Weng, and Jonathan Koch. “Herniated Discs: When Is Surgery Necessary?” EFORT Open Reviews 6, no. 6 (2021): 526–30. doi.org/10.1302/2058-5241.6.210020.
Headaches are a common condition that most experience and can differ greatly regarding type, severity, location, and frequency. Headaches range from mild discomfort to constant dull or sharp pressure and severe throbbing pain. A headache chiropractor, through therapeutic massage, decompression, and adjustments, alleviates the headaches, whether tension, migraine, or cluster, releasing the tension and restoring normal function.
Headache Chiropractor
Ninety-five percent of headaches are primary headaches caused by overactivity, muscle tension, or problems with pain-sensitive structures in the head. These are not a symptom of an underlying disease and include tension, migraine, or cluster headaches. The other 5 percent of headaches are secondaryand are caused by an underlying condition, infection, or physical issue. Headaches have various causes or triggers. These include:
Long hours driving
Stress
Insomnia
Blood sugar changes
Foods
Smells
Noises
Lights
Excessive exercise or physical activity
Individuals spend more hours in one fixed position or posture, like sitting in front of a computer or standing at a workstation. This can increase joint irritation and muscle tension in the upper back, neck, and scalp, causing achiness and discomfort that builds up to throbbing soreness. The headache’s location and the discomfort experienced can indicate the type of headache.
Chiropractic Care
Chiropractors are experts in the neuromusculoskeletal system. Research shows that a headache chiropractor can adjust the spine’s alignment to improve spinal function, release and relax the tense muscles, and alleviate nervous system stress helping decrease the intensity and frequency. Treatment includes:
The Injury Medical Chiropractic and Functional Medicine Teamwill develop a personalized treatment plan for the individual’s specific condition and needs.
Migraine Treatment
References
Biondi, David M. “Physical treatments for headache: a structured review.” Headache vol. 45,6 (2005): 738-46. doi:10.1111/j.1526-4610.2005.05141.x
Bronfort, G et al. “Efficacy of spinal manipulation for chronic headache: a systematic review.” Journal of manipulative and physiological therapeutics vol. 24,7 (2001): 457-66.
Bryans, Roland, et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008
Côté, Pierre, et al. “Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario Protocol for traffic injury management (OPTIMa) collaboration.” European journal of pain (London, England) vol. 23,6 (2019): 1051-1070. doi:10.1002/ejp.1374
Spondyloarthritis is a group of inflammatory, immune-mediated diseases that cause chronic low back pain, inflammation, irritating aches, and pains. The conditions mostly affect the spine but can affect joints in the arms, legs, hips, skin, eyes, and intestines. Spondylitis types can significantly affect daily function, physical activity and compromise bone health.
Spondylitis Types
The main types include:
Ankylosing spondylitis
Psoriatic arthritis
Enteropathic arthritis
Reactive arthritis
Juvenile spondylitis
Undifferentiated spondylitis
Axial Spondylitis vs. Peripheral Spondylitis Types
Axial means relating to the body’s central region, as in the trunk and head.
Axial spondyloarthritis is arthritis and inflammation in the hips and spine.
The condition starts before age 45.
The pain typically starts in the low back but can begin in the neck or other regions.
Characterized by back pain, usually in the lower back and/or buttocks.
Morning back stiffness lasting 30 minutes or longer.
Sacroiliac joint inflammation can also present.
The back pain gradually progresses.
Lasts longer than three months.
Improves with physical movement, not with rest.
Peripheral spondyloarthritis is arthritis and inflammatory pain in the peripheral joints and tendons and does not include the spine.
Individuals can have peripheral and axial spondylitis symptoms simultaneously.
Diagnosis depends on whether symptoms are primarily peripheral or axial.
Spondylitis and Spondylosis
Spondylosis and spondylitis are similar in they cause pain and inflammation in the back and hips. The difference is in each condition’s triggers.
Spondylitis is a disease in which the body’s immune system degrades joints, causes inflammation, overproduces bone formation, and causes bone fusion.
Spondylosis is a category of arthritis that presents as the spine ages from normal wear and tear.
It happens during the degeneration of the spine’s discs and joints.
It also presents when bone spurs develop on the spine’s vertebrae.
Ankylosing Spondylitis
Ankylosing spondylitis is the most common form of arthritis affecting the spine, other joints, and body regions. The condition causes spinal joint inflammation causing extreme discomfort and chronic pain. In some cases, the inflammation progresses to ankylosis, where spine sections fuse and become immobile. Other body areas that can trigger inflammation include:
The ribs
Heels
Shoulders
Hips
Small joints of the feet and hands.
Ankylosing spondylitis symptoms vary from person to person. Common early symptoms include:
There is general discomfort, appetite loss, and mild fever early in the condition.
Persistent stiffness and pain in the buttocks and low back, gradually progressing over a couple of weeks or months.
The pain and stiffness can travel into the neck and spine within months or years.
The pain is usually spread out and dull.
The stiffness and pain are worse in the morning and night and improve with light exercise or a warm shower.
The pain typically becomes chronic, lasts for a minimum of 3 months, and can be felt on both sides.
Tenderness and pain in the hips, thighs, shoulder blades, heels, and ribs may also occur.
Treatment approaches include applications of ice and heat to reduce swelling, increase circulation, and decrease joint pain, posture exercises, stretches, physical therapy, and medication.
Psoriatic Arthritis
Psoriatic arthritis causes swelling, pain, and inflammation in the small joints of the hands and feet; however, the joints of the knees, ankles, and wrists can also be affected. Psoriasis is a rash that causes scaly skin patches.
Individuals can develop dactylitis when a finger or toe swells between the surrounding joints.
Spinal stiffness and pain can present.
Typically the ends of the finger joints are most affected and experience pain and inflammation.
Medications frequently utilized to treat ankylosing spondylitis can be used.
Exercise helps preserve the range of motion and maintain strength.
Isometric exercises work muscles without joint motion reducing the risk of further injury to inflamed joints.
Occupational and physical therapy can significantly assist in optimizing arthritic joint function.
Enteropathic Spondylitis
Enteropathic Arthritis is chronic inflammatory arthritis linked to inflammatory bowel disease. The most recognized are Crohn’s and ulcerative colitis.
The peripheral limb joints and sometimes the whole spine are the most prevalent body areas afflicted with enteropathic spondylitis.
The main symptom is intestine inflammation, including bowel and joint pain and/or inflammatory back pain.
Other symptoms can include weight loss, blood in the stool, abdominal pain, and/or chronic diarrhea.
Managing enteropathic arthritis typically means managing the underlying bowel disease.
Juvenile Spondyloarthritis
Juvenile spondyloarthritis is a group of childhood rheumatic diseases that cause arthritis before age 16 and can continue through adulthood. Juvenile spondyloarthritis encompasses:
Enteropathic arthritis
Enthesitis-related arthritis
Undifferentiated spondyloarthritis
Psoriatic arthritis
Reactive arthritis
Juvenile ankylosing spondylitis
Juvenile spondyloarthritis causes inflammation and pain in joints in the lower body, like the ankles, hips, knees, and pelvis. Other body areas that could be affected include:
The bowels
Eyes
Skin
Spine
Lethargy and fatigue can also present. The symptoms can be unpredictable and episodic, appearing and disappearing without a specific cause. The condition cycles between flare-ups and remission. Common treatment approaches include:
Medication
Exercise
Posture training
Physical therapy, medication
Ice and heat to decrease joint pain and relax muscles.
In severe cases, surgery could be recommended.
Reactive Arthritis or Reiter’s Syndrome
Reactive arthritis is arthritis that causes pain and inflammation in the mucous membranes, bladder, skin, joints, eyes, and genitals.
Reactive arthritis is believed to be a reaction to an infection, usually in the gastrointestinal or urinary tract.
Reactive arthritis does not affect the sacroiliac joints and spine in most cases.
Reactive arthritis is typically treated with nonsteroidal anti-inflammatory medications, steroids, and rheumatoid arthritis medications.
A physician could prescribe antibiotics if a bacterial infection brought on reactive arthritis.
Undifferentiated Spondyloarthritis
Undifferentiated spondyloarthritis is where the signs and symptoms of spondylitis don’t meet the criteria for a specific rheumatoid disorder. Individuals diagnosed with undifferentiated spondyloarthritis will have one or more of the symptoms that include:
Fatigue
Back inflammation
Back pain
Buttock pain that alternates or presents on both sides.
Swollen toes or fingers
Heel pain
Arthritis in the small joints.
Arthritis in the large limb joints.
Enthesitis or inflammation where the ligament or tendon connects to the bone.
Eye inflammation
Individuals can also present symptoms of other spondylitis types, like psoriatic or ankylosing.
Treatment approaches include:
Exercise
Physical therapy
Posture training
Ice and heat to decrease joint pain and loosen up muscles.
Spondylitis Types Diagnosis of Spondyloarthritis
References
Carron, Philippe, et al. “Peripheral spondyloarthritis: a neglected entity-state of the art.” RMD open vol. 6,1 (2020): e001136. doi:10.1136/rmdopen-2019-001136
Gill, Tejpal, et al. “The intestinal microbiome in spondyloarthritis.” Current opinion in rheumatology vol. 27,4 (2015): 319-25. doi:10.1097/BOR.0000000000000187
Rosenbaum, James T. “The eye in spondyloarthritis✰.” Seminars in arthritis and rheumatism vol. 49,3S (2019): S29-S31. doi:10.1016/j.semarthrit.2019.09.014
Seo, Mi Ryoung et al. “Delayed diagnosis is linked to worse outcomes and unfavorable treatment responses in patients with axial spondyloarthritis.” Clinical rheumatology vol. 34,8 (2015): 1397-405. doi:10.1007/s10067-014-2768-y
Sharip, Aigul, and Jeannette Kunz. “Understanding the Pathogenesis of Spondyloarthritis.” Biomolecules vol. 10,10 1461. 20 Oct. 2020, doi:10.3390/biom10101461
Uneven hips can throw the back out of natural alignment and cause back stiffness, tightness, discomfort, and pain. Hips that are off-balance unhealthily affect standing, sitting, sleeping posture, walking gait, and overall movements. Biomechanics issues cause the core and spine stabilizing muscles to become weakened and fatigued from overcompensating to keep the body up and moving. Over time this can lead to chronic pain in the back, hips, knees, and feet. Chiropractic care can restore proper hip and spinal alignment and wellness.
Uneven Hips
Misaligned hips can be caused by work or sports injury, exercise, vehicle collision, and/or general wear and tear. When hips are out of alignment, they have shifted from their centered position. They could be rotated forward or backward, forcing the spine and the lower limbs to compensate, resulting in the spine tilting that can make the legs appear uneven. Discomfort may be one-sided low back pain near the sacroiliac joint, causing a stiff/tight back, limited motion, and/or pain symptoms. Because the spine and lower limbs have to compensate for the unevenness, the shoulders and upper back, connected to the pelvis through the spine, are also affected and result in:
Back pain.
Hip and gluteal muscle pain.
Uneven leg length.
Knee, ankle, and foot issues and pain.
Uneven shoulders.
The shoulder blades can stick out on the side of the lower hip.
Rib discomfort and pain.
The rib cage could protrude out on one side. However, this could be due to advanced scoliosis.
Therapy
Staying active is recommended and includes stretching and core strengthening. General stretches recommended to optimize hip equity include:
Hamstring stretch
For this stretch, lie on a flat surface with your legs extended straight out.
Bend the right leg at the knee, placing the right foot on the ground.
Use a towel, belt, or band to grab and wrap around the left foot.
Keep the hip/buttock on the left side planted on the floor.
Slowly raise the left leg upward as far as possible until you feel the stretch.
Once you feel a stretch or restriction in the hamstring, hold the position for 30 seconds.
Repeat on the other side.
Perform 2 to3 times.
Hip flexor stretch
Kneel on the affected leg and bend the healthy leg out in front with the foot flat on the floor.
Back straight.
Slowly push the hips forward until you feel the stretch in the upper thigh and hip.
Hold the stretch for around 15 to 30 seconds.
Chiropractic Care
Chiropractic treatment is a highly recommended non-surgical option for uneven hips and pelvic tilt. Depending on the severity of the misalignment, underlying issues, and body scanning images, hip alignment treatment could include:
Soft tissue therapeutic massage
Chiropractic muscle release for tight hip flexors, quadriceps, hamstrings, and glutes.
Kiapour, Ali et al. “Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain.” International journal of spine surgery vol. 14, Suppl 1 3-13. 10 Feb. 2020, doi:10.14444/6077
Lee, Jeong-Hoon, et al. “The effect of Graston technique on the pain and range of motion in patients with chronic low back pain.” Journal of physical therapy science vol. 28,6 (2016): 1852-5. doi:10.1589/jpts.28.1852
Patel, Rikin V et al. “Pelvic Tilt and Range of Motion in Hips With Femoroacetabular Impingement Syndrome.” The Journal of the American Academy of Orthopaedic Surgeons vol. 28,10 (2020): e427-e432. doi:10.5435/JAAOS-D-19-00155
Rivière, C et al. “Spine-hip relations add understandings to the pathophysiology of femoro-acetabular impingement: A systematic review.” Orthopaedics & traumatology, surgery & research : OTSR vol. 103,4 (2017): 549-557. doi:10.1016/j.otsr.2017.03.010
Suits, William H. “Clinical Measures of Pelvic Tilt in Physical Therapy.” International journal of sports physical therapy vol. 16,5 1366-1375. 1 Oct. 2021, doi:10.26603/001c.27978
Many individuals do not realize they are in pain until they begin to feel symptoms of stiffness or tenderness in certain areas of their body. Many people have two most common complaints: back and shoulder pain. The shoulder and the back have a casual relationship that stabilizes the upper body and protects the spine’s thoracic region. When injuries or ordinary factors affect not only the shoulders but the back, it can lead to symptoms of pain and stiffness along the muscles, causing the development of trigger points along the upper back and shoulder muscles. One of the muscles affected by trigger points is the rhomboid muscles located in the upper back behind the scapula (shoulder blades). Today’s article looks at the rhomboid muscle, how superficial backaches and round shoulders can affect the rhomboid muscle, and managing trigger points associated with the rhomboid muscle. We refer patients to certified providers specializing in back pain treatments to aid individuals suffering from trigger points associated with the upper back along the rhomboid muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure that education is a great solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Rhomboid Muscle?
Do muscle stiffness in your shoulders seem to be causing you pain? Have you noticed that your shoulders seem more rounded than usual? What about the unexplainable upper backaches after being in a hunched position for a long period? Many individuals with these pain symptoms could be associated with the rhomboid muscles. The rhomboid muscles are a collective group of muscles important for upper limb movement and stability for the shoulder’s girdle and scapula. The rhomboid muscles consist of two separate muscles: the rhomboid minor and the rhomboid major, deep within the trapezius muscle and behind the scapula (shoulder blades). The functionality of the rhomboid is that they provide stability to the shoulder and when they are active, the upper arms move back and forth while walking.
How Superficial Backaches & Round Shoulders Affect The Rhomboid
While the rhomboid muscles provide stability to the shoulders, they can succumb to pain like any muscles in different body sections. Ordinary factors like a bad sitting posture can cause the upper back and shoulder muscles to contract and strain. Studies reveal that the effects of bad sitting posture can lead to the development of a forwarding head posture with rounded shoulders, causing pain in the rhomboid muscles. When the shoulder muscles, like the rhomboid muscles, experience this sort of change over time, it can increase muscle tone and continuous stress in the neck and shoulders. To that point, it can lead to various symptoms like pain, numbness, loss of functionality in the upper limbs, and nerve root symptoms. Other issues like back pain can also be one of the symptoms that can lead to referred pain in the rhomboid muscles and can potentially lead to the development of trigger points along the shoulders and rhomboid muscles.
Other issues that can affect the rhomboid muscles are trigger points. Trigger points can be latent or active as they are tiny knots formed in the body’s muscle fibers. For the rhomboid muscles according to Dr. Janet G. Travell, M.D., when a person hears snapping and crunching noises during the movement of the shoulder blades, it may be due to the trigger points in the rhomboid muscles. Studies reveal that since trigger points can be either active or latent and elicit local referred pain, that can lead to muscle imbalance, weak and impaired motor function, and expose the joints to suboptimal loading. This means that trigger points in the rhomboid muscles can cause referred pain to the shoulder and mimic other chronic symptoms.
Stretching The Rhomboid Muscle & Managing Trigger Points-Video
Do you hear any snapping or crunching noises when rotating your shoulders? What about muscle stiffness along your shoulders or upper back? Or do you feel muscle aches from being hunched over for a long time? These symptoms could potentially involve trigger points associated with the rhomboid muscles. The rhomboid muscles help stabilize the shoulders and provide movement to the arms. When people overuse their shoulder muscles, it can cause the surrounding muscles to develop trigger points and inflict pain-like symptoms on the shoulders and upper back. Thankfully, all is not lost, as various treatments are available to relieve shoulder and upper back pain associated with trigger points along the rhomboid muscles. The video above explains where the trigger points are located on the rhomboid muscles and how to stretch that muscle to relieve trigger points from causing referred pain to the shoulders.
Managing Trigger Points Associated With The Rhomboid Muscle
Since the rhomboid muscles can become stiff due to overuse and could develop trigger points to inflict pain along the upper back and shoulders, this can cause many symptoms associated with pain and make the individual feel hopeless. Thankfully, various treatments can help manage trigger point pain associated with the rhomboid muscles. Studies reveal that thoracic spinal manipulation can relieve pain pressure sensitivity of the rhomboid muscles. Chiropractors are excellent when finding trigger points along the musculoskeletal system by utilizing spinal manipulation on the thoracic spine to loosen up the stiff muscles along the shoulders and upper back. Another way to manage trigger points associated with the rhomboid muscle is to stretch the shoulder muscles after a hot shower. This allows the muscles to relax and prevent future trigger points from forming along the rhomboid muscles.
Conclusion
The rhomboid muscles are a collective muscle group that has an important function in stabilizing the shoulder’s girdle and scapula (shoulder blades) while providing upper limb movement. The rhomboid muscles consist of two separate muscles: rhomboid minor and rhomboid major, which are behind the shoulder blades and deep within the trapezius muscles. When ordinary factors like poor posture or shoulder injuries affect the rhomboid muscles, it can develop trigger points that can cause stiffness in the rhomboid muscles. Various techniques can alleviate the referred pain along the shoulders, causing trigger points to develop along the rhomboid muscles. When these treatments are utilized on the rhomboid muscles, they can help prevent future shoulder issues.
References
Farrell, Connor, and John Kiel. “Anatomy, Back, Rhomboid Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 May 2022, www.ncbi.nlm.nih.gov/books/NBK534856/.
Haleema, Bibi, and Huma Riaz. “Effects of Thoracic Spine Manipulation on Pressure Pain Sensitivity of Rhomboid Muscle Active Trigger Points: A Randomized Controlled Trial.” JPMA. The Journal of the Pakistan Medical Association, U.S. National Library of Medicine, July 2021, pubmed.ncbi.nlm.nih.gov/34410234/.
Ribeiro, Daniel Cury, et al. “The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature.” BMC Musculoskeletal Disorders, BioMed Central, 25 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.
Yoo, Won-Gyu. “Effects of Pulling Direction on Upper Trapezius and Rhomboid Muscle Activity.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5468195/.
The low back is a common source of discomfort and soreness among volleyball players because of repetitive jumping, bending, and rotating of the trunk. Adolescents have an increased risk of this injury because their vertebral bones are still developing, which increases the risk for stress fractures. Chiropractic care, massage therapy, decompression, rest, and athletic training can help expedite pain relief and heal the injury.
Volley Back Pain
Muscle or ligament strains are the most common injury from repetitive jumping, bending, rotating movements, and hyperextension during serving, hitting and setting. This can lead to excessive compression forces on the discs and joints, causing reduced blood circulation, increasing the risk of overload injuries. One study reported that low back pain is experienced in 63% of players. However, if low-back pain is accompanied by pain that runs down the leg along with numbness or weakness in the foot or ankle, the issue could be a herniated disc.
Causes
One common reason is endurance imbalances in the muscles that stabilize the low back. The core muscles provide stability to the low back and spine for all movements. If imbalances are present, a player may spike or serve the ball with intense turning and arching. The added actions cause increased pressure in the joints and hip, gluteal, and leg muscles, affecting the spine’s stability.
The gluteals run from the back of the pelvis/hip bones down to the outside of the thigh.
The gluteal muscles prevent the trunk and hips from overbending forward when landing.
If the gluteal muscles do not have the strength and endurance to perform this motion, the upper body will bend too far forward, causing poor landing posture and decreased spine stability.
Anterior Pelvic Tilt
Studies have shown that players with low back pain tend to stand and land with an anterior pelvic tilt. This is an unhealthy posture when the front of the pelvis tilts forward, and the back of the pelvis raises. Landing hard with an anterior pelvic tilt causes increased arching and increases the pressure in the joints.
Chronic back pain
Warning signs of a more serious back problem include:
Pain that has lasted for more than 1 week and is not improving or getting worse.
Pain that prevents sleep or causes the individual to constantly wake up.
Difficulty sitting.
Back soreness when performing basic tasks and chores.
Significant pain on the court when jumping, landing, or rotating.
Chronic pain ranges from aches to shooting or throbbing pain that can run down the buttocks and legs.
Chiropractic Care
A chiropractor can alleviate volleyball back pain, rule out a more severe injury, such as a stress fracture or herniated disc, and provide a healthier and faster recovery. According to a study, athletes who received chiropractic care showed better speed and mobility. Quick reflexes and hand-eye coordination depend on an optimal functioning nervous system. 90% of the central nervous system travels through the spine. When one or more spinal segments are misaligned, the effect on the nervous system can seriously impact and disrupt nerve circulation, affecting speed, mobility, reflexes, and hand-eye coordination. Chiropractic adjustments will:
Relax and reset the back muscles.
Realign and decompress the spine.
Remove the pressure around the nerve roots.
Strengthen the core.
Improve and increase range of motion, strength, and overall endurance.
Anterior Pelvic Tilt
References
Haddas R, Sawyer SF, Sizer PS, Brooks T, Chyu MC, James CR. “Effects of Volitional Spine Stabilization and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recurrent Low Back Pain.” J Sport Rehabil. 2017 Sep;26(5):329-338. doi: 10.1123/jsr.2015-0171.
Hangai M. et al., Relationship Between Low Back Pain and Competitive Sports Activities During Youth, Am J Sports Med 2010; 38: 791-796; published online before print January 5, 2010, doi:10.1177/0363546509350297.
Jadhav, K.G., Deshmukh, P.N., Tuppekar, R.P., Sinku, S.K.. A Survey of Injuries Prevalence in Varsity Volleyball Players. Journal of Exercise Science and Physiotherapy, Vol. 6, No. 2: 102-105, 2010 102
Mizoguchi, Yasuaki, et al. “Factors associated with low back pain in elite high school volleyball players.” Journal of physical therapy science vol. 31,8 (2019): 675-681. doi:10.1589/jpts.31.675
Movahed,Marziehet al. (2019). “Single leg landing kinematics in volleyball athletes: A comparison between athletes with and without active extension low back pain.”
Sheikhhoseiniet al. (2018). “Altered Lower Limb Kinematics during Jumping among Athletes with Persistent Low Back Pain”
Look how young children position their backs. There is a natural S curve, and their movements are effortless. As the body ages, too much sitting, slouching, and inactivity can cause muscle fatigue and tension leading to posture issues. Rounded shoulders describe a resting position that has shifted the shoulders out of the body’s natural alignment, which can worsen if left untreated. Chiropractic care can realign the shoulders, as well as the spine, and restore musculoskeletal health to optimum levels.
Rounded Shoulders
Rounded shoulders are an excessive thoracic kyphosis referring to an uneven forward rounding or curvature of the middle and upper back. Rounded shoulders shift out of proper alignment with the spine, causing posture-related problems like shoulder/neck/back discomfort, tightness, stiffness, and pain. Overall unhealthy posture contributes to the following:
The head constantly being in a forward or backward position
Headaches
Body aches and pains
Muscle fatigue
Chronic back soreness
Bent knees when standing or walking
Body movement dysfunction
Joint problems
Potbelly
Rounded shoulders
Body responses to rounded shoulders include:
Chronic musculoskeletal aches and pains
Breathing problems
Limited body function
Impaired mobility performance
Increased mental and musculoskeletal stress
Causes
Rounded shoulders are typically caused by unhealthy posture, but can also be caused by muscle imbalances from, for example, overfocusing on building chest strength but neglecting the core and upper back. Other causes include:
Standing and sitting for long periods
Stress
Lack of physical activity
Environmental factors
Too much exercise, sports, and physical activities
Musculoskeletal Imbalance
Postural imbalances anywhere in the body can cause rounded shoulders.
For example, when an individual tilts their head forward to look at their phone, the upper back has to round forward to hold the head. Constantly tilting can begin to generate an unhealthy muscle memory causing the neck and shoulder muscles to remain in a semi-flexed position that starts to become the norm.
Another example is when the arms are held out and in front for prolonged periods, like driving, typing, and cooking, the chest muscles get shortened. As time goes on, this causes the shoulder blades to move forward on the ribcage, making the upper back and shoulder area hunch awkwardly and unhealthily.
Stress
When the brain perceives a threat, the body physically prepares to take action through the fight or flight response. Common reactions include:
Jaw tensing
Tightening the abdominal muscles
Holding one’s breath
Rounding the shoulders
Stressors can include:
Job worries
Money issues
Relationship problems
Family responsibilities
All can cause changes in the body that result in rounded shoulders.
Environmental Factors
Respiratory conditions like asthma, COPD, and allergies can affect the body’s breathing and the ability of the diaphragm to contract and relax correctly.
Ribcage restrictions caused by chronic breathing problems can result in the thoracic/middle back tightening up, causing excessive shoulder rounding.
Exercise and Physical Activities
Exercise and physical activities can contribute to rounded shoulders because of the long periods of spinal flexion. These can include:
Bike riding, martial arts, and swimming.
Knitting requires the arms to be out in front.
Gardening requires kneeling and being hunched over.
Chiropractic Treatment
Chiropractic adjustments, therapeutic massage, and decompression therapy can unlock tight shoulder and chest muscles. A chiropractor uses gentle targeted adjustments to relieve pain, restore function, and retrain the muscles.
The doctor will look at the individual’s resting position while standing.
An individual with slumped shoulders can slouch, even when standing up straight.
Their hands will likely face behind them, with their thumbs pointed at each other.
Once the adjustments are made, a correct standing posture will make the hands face the body with the thumbs facing ahead.
Exercises will be recommended to strengthen the core and stretches to maintain the adjustments.
Posture Chiropractic
References
Fathollahnejad, Kiana, et al. “The effect of manual therapy and stabilizing exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study.” BMC musculoskeletal disorders vol. 20,1 86. 18 Feb. 2019, doi:10.1186/s12891-019-2438-y
Go, Seong-Uk, and Byoung-Hee Lee. “Effects of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers.” Journal of physical therapy science vol. 28,11 (2016): 2999-3002. doi:10.1589/jpts.28.2999
Kwon, Jung Won, et al. “Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders.” Journal of physical therapy science vol. 27,6 (2015): 1739-42. doi:10.1589/jpts.27.1739
Lee, Do Youn, et al. “Changes in rounded shoulder and forward head posture according to exercise methods.” Journal of physical therapy science vol. 29,10 (2017): 1824-1827. doi:10.1589/jpts.29.1824
Park, Sang-In, et al. “Effects of shoulder stabilization exercise on pain and functional recovery of shoulder impingement syndrome patients.” Journal of physical therapy science vol. 25,11 (2013): 1359-62. doi:10.1589/jpts.25.1359
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