Massage Therapy

More and more clients are coming in with all kinds of upper back issues. Some of them haven't been to a massage therapist in years. As a result, I have been finding lots of "muscle knots" or "trigger points" in the upper back. They vary in size from something as small as a grain of sand to a golf ball. These trigger points can cause neck pain, headaches and refer pain signals to other parts of the body when pressed. A trigger point is usually located where a nerve enters a muscle. Muscles that have been traumatized by accidents, injuries, occupational stress, and overuse usually have trigger points. They are not necessarily confined to the upper back, either, but since this seems to be the area I see a lot in my practice, I want to share some helpful information.

What muscles live in the upper back? Quite a few especially if you count those in the neck (where the cervical vertabrae are located) and shoulders as well. In the cervical area most pain is caused by I would say the majority of my clients suffer pain due to postural stress and job-related activities, from working at a desk. But pain can also be caused by trauma.

In the neck, there are the superficlal muscles such as the sternocleidomastoids (SCM), scalenes, (posterior, medial, and anterior), upper trapezius which extends up to your scalp and across the tops of your shoulders, and the levator scapula. Underneath these larger muscles are smaller muscles such as the splenius capitus and semispinalis cervicis and capitas.

Levator scapula's purpose is to raise and lower the shoulder blade and plays a role in neck flexibility. It's origin is at the cervical vertebrae (Upper 3 or 4) at the transverse processes which are protrusions extending out from either side of the vertebrae. Each vertebrae has a pair of transverse processes, where spinal muscles attatch. Its insertion is the top (superior part) of the shoulder blade. In clinical terms this would be the medial border of the scapula. So it would be easy to understand that if one hunches his/her shoulders all day, or there would be pain and stiffness felt in the neck, and the tops of the shoulder blades, especially if you turned your head in the direction of the stiffness. For many of us, it works almost continuously and can become rather sore--massage therapists take note!! Relaxing the levator scapula muscle will allow the shoulders to rest easily and may also reduce this muscle soreness.

In the upper back, as mentioned before, there are the trapezius, the rhomboids, major and minor, which are muscles in the center of the back, and must be taken care of because one of their attachments is along the scapula or shoulder blade, as the levator scapula does. The rotator cuff muscles stabalize the shoulder and, yes have their attachments to the parts of the scapula as well. Then we can't forget the deltoids, which are also attached to the shoulder blade and the clavicle (collar bone).

Last, but not least, are the pectoral muscles. Pectoral muscles you say!!!! Yes...they can contribute to back pain if they are shortened. Shortening of the pectorals could occur by practicing bad posture, which could be a round-shoulder posture, causing the head and neck to be constantly projected forward straining the scalene and SCM muscles. Trigger points can also be found in these muscles. If we are not aware of our posture, we will experience all sorts of problems with our upper back. Additionally, some of the upper back muscles, which are attached to the upper ribs, assist in breathing. If you are a shallow breather, this might be another reason why you have pain, as the proper way of breathing is from the diaphragm.

So first of all, our shoulder blades have a lot of muscle attached to them--no wonder we have back pain and chronic possibly. Second, if you are suffering from the pain which I have described above, visit a massage therapist, to work our these trigger points and then you could do a maintenance program on your own, whether it be exercise, yoga, or other types of stretching, because stretching is excellent for muscles anyway. And please have your massage therapist check you out once in a while in the same year. Don't wait years before you see one again. Third, I found a very interesting website which has some good information on how to take care of your upper back. Check out the link below:

It's interesting that many people I have come in contact with don't know what a hot stone massage is. It is one of the most realaxing massages ever! So here is the procedure (the way I learned it).

The stones used are for the most part, basalt stones of various sizes, and are heated in water between 120-150 degrees. The client starts face-up on the table, and is draped with a sheet. Before the client lays down, about 6 large stones are placed on the table to line up with the client's back, and a large bath towel is laid on top. Then the client lays down. The therapist, using more towels (smaller) as a barrier, places smaller stones on the legs, thighs, in between the fingers and palms of the hands and in between the toes. While these stones are warming the body, warm or cool stones are used to massage the face. Then the neck and shoulders get massaged with two stones on either side. As the stones cool on the body, they are replaced by warmer stones which are used to massage the arms, legs and feet. The therapist then has the client turn over on their back, the larger stones are picked up from the table, and replaced with warmed stones and placed on the back, on top of the towel. The same procedure is done as the front, except stones are placed on the thighs and calves. While they are cooling, more massaging is done on the soles of the feet, and then working up toward the back, stones are used to massage the calves and thighs. The back is the last area to be massaged. All the previous stones that were on the body are collected and placed in the bath towel which is used as a pack, and placed on the tailbone area of the back, and warmer stones are used to massage the back. Then the therapist perfoms some finishing strokes while the client basks in the most wonder hot stone treatment she/he ever had!

Be prepared to spend about an hour and fifteen minutes with your massage therapist.