How a Stiff Upper Back Can Spiral into More Issues and What to Do About It

As we grow from infancy to adulthood, we develop our movement patterns. We combine static posture, mobility and stability to create movement. We practiced all day limited only by what our developing musculoskeletal system could handle. (“Movement, Functional Movement Systems: Screening, Assessment and Corrective Strategies. Gray Cook, 2010)

As adults our movement patterns change due to adaptation to our habitual activities, demands of sport or due to injury.

We have become more sedentary; we are involved in jobs that required prolonged sitting times or are used to spending many hours using electronic devices. With these sustained positions come changes to our movement patterns – often detrimental ones.

Example of the upper limb spiralling into other areas:

  • We develop an increased kyphosis (round back position), with associated stiffness of the upper back
  • As our backs are rounded and stiff our necks adopt a poked neck position, placing an increased load in the joints
  • Increased load causes stiffness in the upper cervical joints and that can lead to headaches
  • As our backs are rounded and stiff our big muscles in the upper limb, like the pectorals become tight and shortened and therefore we start using smaller muscles in our arms to cope with our work load
  • This change can lead to problems like lateral and medial epicondylalgia
  • As our thoracic spine is stiff our shoulder blade muscles don’t have the capacity to work efficiently to give the dynamic stability needed for the rotator cuff to function
  • We now start developing sub-acromial impingements, rotator cuff tendinopathies and tears

So, functional movement is a combination of static and dynamic interplay. Meaning that when assessing a patient, we do not consider only the injured area, but the movement patterns relating to that injured area, and in our example, the whole upper limb.

Without addressing the movement pattern dysfunctions, the injury most likely will return as the relationship between all structures of the upper limb and upper back have not been addressed.

Regardless of the cause, changes to our movement patterns can result in painful issues and the best way to address this is by starting with an assessment of the movement pattern involving the whole kinetic chain.

At Precision Physio in Sydney, our Physiotherapists are trained and well-practiced in not only relieving the pain of an injury, but assessing patients in their entirety, to be able to provide real strategies and treatment plans to ensure positive changes for the long run.

Book an appointment

If you would like to have an assessment of your movement patterns, or find out more, you can contact us on 02 8607 4000 or request a call by completing this form.

This blog was written by Maria Quispe – Physiotherapist at Precision Physio St Marys. If you would like more information, or to work specifically with Maria, you can contact her through the Precision Physio St Marys clinic: 02 9623 2220 or book in online.

Jon Perkins

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