T Nation

Back Pain Between Spine/Scapula


The problem:
I've had back pain in the area between the scapula and spine (red lines in attached pic) for a long time, maybe 10 years. Typically it only hurts noticeably when I have been standing still a while (5 minutes doing dishes) or sitting on the ground (like hunched over applying painter's tape last night). There is a constant feeling of tightness in this area and over the years I've developed a sort of tick with stretching these muscles (spinae erectors?) by pulling my scapula up or stretching my head forward and to the side or simply fast jerky torso twists.

The pain has become more pronounced as I've just started strength focused lifting. After doing squats the area is very tight, has a random tingling sensation, and prone to pain (the same day as well as next). Recently I noticed that my squat form is not so great. I sort of twist my spine to the side when fatigued. Imagine doing squats with all the weight on your left shoulder, you'd twist your spine slight and lift your left shoulder higher, I do this when fatigued and so far it's been impossible to stop doing without racking the weight. This may or may not be related. I also have some issues with my knee caving in on the left side which I've read (on this forum) is probably because of weak glutes (my quads are very disproportionate in size to the rest of my leg muscles).

I'm very interested in continuing powerlifting (and never going back to a bodybuilding approach to weight training) so I'd like to remedy this before I start conjugated training (ordering power rack this week for my garage!).

What I've tried:
Soft tissue work (foam rolling) helps for around 5 minutes but I don't think it's really helped with the problem (just the symptoms).
Aggressive stretching of the area tends to make it worse. There have been times where I stretch and it makes my back hurt all day.
SLDL and good mornings were a stab at hitting that area and although I've got stronger in the lifts the back pain has been unaffected (incidentally good morning form I'm fine with unlike squats).

Random background bits:
I vaguely remember pulling (or something) a muscle in that area when I was in high school wrestling (10 years ago), I remember a loud pop and pain in that area and sitting out of live wrestling for a week. It could be unrelated though.

I have an office job and am sitting 8 hours a day. I never have any back pain at work (or while sitting in any backed chair) though.

My posterior chain is fairly weak still. For years I have loathed any sort of ab work as my lower back fatigues before my abs even with simple crunches (my lower back, not the part described above, aches immensely after 20 or so crunches).

Any suggestions or words of wisdom?


Lol, this sounds like how I used to be.

Start doing front and side planks. There's a picture of someone doing side planks girly style in this article


The front plank is just a pushup position, but on your elbows. Keep your torso as straight and tight as possible, and fire the glutes the whole time.

The foam roller may not be enough to loosen up your T-spine. Tape 2 tennis balls together and roll on that. The stimulus is more concentrated. You can also use 1 ball on trigger points on your back. Occasionally I'll lay down with the ball near the bottom of my r. scapula and move my arm up and down.

When deadlifting, ALWAYS keep your shoulder blades retracted and your back as straight as possible. Finish the movement with your hips.

Be mindful of keeping proper posture throughout the day.


I've had the same pain. The two tennis balls definitely help loosen up the t-spine. I read somewhere that a lot of pain is referred into that area with forward head posture, which I definitely get with 8 hours at a computer. One thing that also works is rolling the neck and base of your skull with either the foam roller or the tennis balls up against a wall. Also, doing neck strengthening exercises and face pulls have seemed to strengthen some of the imbalances that I've built up.

If the rest of your posterior chain is tight, try rolling the bottom of your foot on a tennis or lacrosse ball throughout the day. It amazed me how much of the tightness in the PC can be relieved by loosening up the ends, ie your foot and the top of your neck. Hope it helps.


Is there any chance a chiropractor could help? My company's health insurance covers it so I could give it a try.

Did a few things last night although I can't find my foam roller -- just moved into new house. I did a few sets of planks and noticed that doing a side plank on my left side is a lot harder than right side (I bet I could go 2x the time on the right side). I also did a bunch of glute activation/strength work as I found an old Cressey article here that said poor glute firing could overtax the hamstrings, lower back, and T-spine muscles so figured it was worth a shot. I also found a thoracic extension exercise that Cosgrove had Dave Tate do. You sit in a low back chair and basically lean backwards, it felt like I was going to break my back and I'm still a little tingly back there from it -- I won't be doing it again.


Definitely. I would really call foam rolling soft tissue work or therapy. A hands on practitioner is light years better.


An update, I did 3 sets of 20 facepulls yesterday and today I've yet to have any pain or tingling. Thanks for the recommendations tom63, ajcook99, and Doug Adams.


Hi, sorry for digging up this old thread.

I have similar problems with my scapula I believe. I've been working out for about 2.5 months and I've been constantly having neck/shoulder blade pain.

When I turn my head to the left side, over my left shoulder, I feel a sharp pain under my left shoulder blade. Before I had the same symptoms on my right side, but it went away and now I have it on the left side. The pain is not exruciating, but it's still there and causes me problems during driving for example.

I don't experience pain during any particular excercise, only when I turn my head to look over my shoulder. The pain goes through the lower part of my neck, down to my shoulder blade. It's getting really annoying.

This is my back routine, I workout a 3 day split:
5.Seated Row
6.Lying T-Bar rows
7.Lever Shrug

Everything about 3 sets, 10-12 reps.

Lately I've started to do scap push-ups in hope it will improve my condition. I also do those shoulder dislocates with a dowel stick. Any other stretches, excercises you can recommend? Would face pulls help?


I would not hesitate to see someone about the pain. My pain started in the same place. I was underdiagnosed by an orthopeadic doctor and it wasn't until half my triceps disappeared on my right arm that we finally did an MRI and found out that I had a herniated disk in cervical spine. All of the pain was being referred down from there.

My only point being, it's better to rule out all possibilities and be able to progress rather than unknowingly put yourself in position to worsen the underlying problem. I will say that of anyone, it was good sports chiropractor that has done provided all the benefit for me: from ordering the MRI to providing temporary pain relief to actually understanding that I was an athlete and sending me to a physical therapist that specializes with athletes. Best of luck.