Upper back pain - rehab intensity advice?

[h3nr1que]

Hi all,

I'm looking for any advice on the pace/intensity of upper back (rhomboid & trap) rehab exercises. My situation is below. Any pointers would be really appreciated!

Problem:

- Pain for last 6 months following weightlifting strain.
- Pain is right between the shoulder blades, and extends down to mid-back/erector spinae
- Pain tends to be worse first thing in the morning
- Initially I left it untreated for about 3/4 months and then had an ongoing illness for 2 months, so I've only started active rehab in the last two weeks.
- Left scapula has tendency to click (no pain) when pulled back.

Current plan:

- I'm pretty sure issue is rhomboid/trap related and that these muscles have lengthened during inactivity and been pull out of whack by my pecs which were still relatively strong after the initial injury.
- I do have fairly rounded shoulders as well.
- Therefore i've started stretching my pecs out twice a day and doing upper back squeezes (3x10) twice a day. Have been doing this for two weeks.
- I'm now starting to do resistance band pull backs (3x10) and overhead resistance band presses (3x10) once every two/three days.
- The resistance band work is pain free when I do it but is currently making me quite sore on the following day, mostly an ache but occasionally a bit sharper too. I try generally to make the affected muscles work, going at about 60% of what my 'max' intensity might be. In general, the overall muscle pain is yet to improve.

So I suppose the question is

a) Does this sound like a sensible approach for now?
b) Is the intensity about right, and if so is the soreness/slight pain afterwards normal? How long might I expect it to continue after this long out of action?
c) Any other tips for this area? I'm trying hard to work on posture etc.

Any help would be really appreciated. PS the exercise band stuff was recommended by a physio so I'm confident the technique is right but for financial reasons I can't keep going back. I've also had an MRI scan which showed no issues with the bones, ie it's entirely musclar apparently.

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[StatesPT]

Hi - Is the back pain you experience currently the same as the initial pain 6 months ago? What was the exercise that hurt you in the first place?
You could try dropping a set of 10 reps and see if you feel any different later. If it is better later then start there and slowly progress sets, reps and add other exercises. If not any better then consider holding off on resistance exercise and do more cardio.
As an aside I wouldn't get too worked up over your posture and muscle imbalance. The evidence is a bit murky as far as poor posture causing pain or good posture relieving pain. Just keep moving, eat healthy, get full sleep cycles and decrease stress!

[h3nr1que]

Hi and thank you for the response,

The initial injury happened during barbell squats if I remember correctly. The pain definitely isn't quite as bad as it was when it first happened and indeed has improved a little even since my initial post.

I'm now starting to add in some shoulder mobilisation stuff as I've noticed various clicks and snaps starting to occur. Thanks for the info re. posture etc, that's good to know.

Thanks again for the response.

Henry

[StatesPT]

Glad to hear things are better. Cracks/snaps without sharp pain are normal and may come and go. Just progress moderately and keep the discomfort manageable. - Regards