Why does my upper back hurt after running?

 

Have you ever asked yourself why does my upper back hurt after running? Have you recently added running to your daily routine? Do you know running also need special techniques? Can you imagine if these techniques are not followed, running casually may cause more harm to your body than providing benefits?

A large number of health enthusiasts around the world are fond of running. They run to keep themselves physically as well as mentally fit. Anyone who wishes to join the health squad and leave behind his/her unhealthy lifestyle, usually begins the journey to healthy life by running as it is the simplest of all exercises, or is it?

The process of running is not as simple as we consider it. Running needs more than a pair of comfortable shoes and will. It needs proper technique or instead of becoming Usain Bolt, running will give you severe body pain and you may no longer feel like running at all. But once you know the basics of running properly, from big marathons to running for your life, you can run like Flash!

It may also be the case that we are running properly and still our upper back hurts. This will need further assessment and evaluation as upper back pain may also result from certain pathological conditions and may not always be because of a simple problem such as a bad posture. Diseases which can give upper back pain are Vertebral discopathy, facet joint arthritis, osteoporosis, vertebral infections, behçets disease, ankylosing spondilitis and others. We'll be discussing all of these later in this article.

 

What is upper back?

How does upper back pain feel like?

Why my upper back hurts after running?

Risk factors

How to prevent upper back pain?

Management of upper back pain

 

What is upper back?

The upper back starts from the base of the neck, involves the shoulder blades and the region between them until the end of rib cage. “Thoracic spine” is the medical term used to define the upper back.

 

How does upper back pain feel like?

While muscle tenderness after a physical activity is normal, upper back pain presents itself as a feeling of stiffness or tightness around the shoulder area or it may appear as a sharp stabbing pain.

 

Why my upper back hurts after running?

Slouching or improper drooping posture while running is the most common cause of upper back pain after running. Running long distances with improper posture, strains the upper back muscles which include trapezius, lattisimus dorsi and rhomboid muscle. These muscles are responsible for maintaining a straight and proper posture. When a runner is tired, his/her posture changes in a way that his/her head droops forward creating tension on back muscles. If this tension continues for longer duration, it strains the muscles causing upper back pain. Constant slouching and muscle strains, weakens posterior muscles of back further increasing the slouch and hence, continuing the vicious cycle.

This process can eventually worsen the mobility of ribs and thoracic vertebrae, making it difficult to use the lungs to their full capacity.

Running on hard surfaces like asphalt for longer periods can also increase neck and upper back pain. This pain which initially is mild and achy can change into sharp pain causing one to lose focus or even put an end to the training day.

Swinging too much or too less while running can also lead to upper back pain.

Even though muscle strain because of a bad posture is the most common cause of upper back pain, some underlying health conditions can also be responsible for pain in the upper back. These include:

1.Muscular imbalance

Movements in our bodies are products of simultaneous contraction as well as relaxation of antagonist muscles. For example,  when you pick something in your hand, your bicep mucles will contract while triceps will relax in order to perform this action.

Certain actions such as a bad posture, sedentary lifestyle, imbalanced exercise or even abnormal development of muscles that may  present in the form of asymmetry, cause muscular imbalance i.e., while one muscle that is overused tighens too much; its antagonist muscle is underused and  becomes weak.This leads to limited range of motion and pain

2. Facet joint arthritis

This may present as chronic neck pain. Facet joint is formed between two spinal bones or vertebrae with a cartillagenous surface in between them. Degeneration of this cartillage in the facet joint can cause pain and stiffness, every time one moves this joint.

Facet joint arthritis occurs mostly due to aging that speeds up the degenerative process. It may also occur following a trauma to the spine, causing severe inflammation, pain and thus limited motion.

3. Ankylosing spondilitis

It is a chronic inflammatory, autoimmune disease of spine. AS is more common among young men and has the tendency of genetic inheritance. Pain in this disease can start from lower back and eventually involve the upper back too. Chronic inflammation of spine causes the vertebral bones to fuse together, process known as ankylosis, making the spine stiff and motionless.

4. Behçet disease

It is a multisystem disease caused due to inflammation of vessels or vasculitis. What causes this vasculitis is still unknown. BD causes recurrent oral and genital ulcers, uveitis, gastrointestinal, rheumatologic, vascular and other manifestations.

Since, we're talking about back pain, we'll discuss the rheumatologic manifestations of BD. Most BD patients have joint pain or arthralgia and inflamed joints or arthrits. These inflammed joints can include spine too. Also the chronic vasculitis in BD is associated with a negative impact on bone metabolism causing bone loss and thus osteoporosis in these patients.

5. Osteoporosis

It is defined as the loss of bone mass that makes bone weak, fragile and prone to fracture. Osteoporosis can occur independently or may be a result of some other condition such as Behcet disease. The osteoporotic weak bones especially in the vertebrae are prone to compression fractures that cause the vertebrae to collapse leading to pain, deformity and even decrease in height that can affect a person's self confidence too.

6. Lumbar discopathy

Discopathy means the " disease of disc". Our spine is made up of a number vertebrae, between these vertebrae a cushion like cartillagenous structure, intervertebral disc is present. The job of this disc is to support the back as it bears the weight of our body while we are sitting or standing. These discs when healthy, are hydrated but with passing age the water content in them reduces and they become dry, weary and full of cracks. This marks the beginning of disc degeneration. These dry discs can no longer support the back as before, and certain activities such as carrying heavy weights, standing or sitting for too long, trauma, jerky movements etc put them at risk of herniation.

In disc herniation, the central part of the disc, or nucleus pulposus, herniates out from the cracks in the peripheral part of disc. Herniated disc compresses the adjacent nerve causing severe back pain. Physical activity can further agravate the back pain.

7. Lumbar vertebrae infection

Invasion of lumbar vertebrae by bacteria such as Staphylococcus aureus or E.coli, causes lumbar infection. These microbes usually find their way towards the spine via bloodstream following a surgery or in drug abusers. Infected vertebrae is at risk of developing fractures, and fractured spines is unstable and thus cannot bear the body weight, such that it may cause hunchback or kyphosis.

Symptoms of lumbar vertebrae infection may involve back pain or neck stiffness, fever and chills, sweats at night, back pain which doesn't reduce despite taking rest, discharge of pus at the site of surgical wound etc.

8. Seronegative sacroiliatis

Sacroiliitis or inflammation of sacro-iliac joint is associated with and is the initial symptom of seronegative spondyloarthropathies (SpA). Other causes may involve infection, trauma, IV drug abuse etc.

SpA is a group inflammatory diseases (Ankylosing spondilitis, psoriatic arthritis, reactive arthritis etc) that cause arthritis of the spine and nearby joints. Sacroiliitis manifests as pain above the buttocks, on either side of the lower back, fever, back pain that increases when resting and decreases with activity,

 

Risk factors

Upper back pain after running is mostly experienced by those who are either new to running or have started to run after a long break. Improper techniques while running and running on hard surface also increase the risk of upper back pain. Other risk factors include:

  • Lack of exercise and weak back muscles

Sedentary lifestyle and not using the muscles causes their deconditioning, weakens the muscles and makes them prone to easy straining after a physical activity.

 

  • Too much exercise and muscle overuse especially if done in poor posture

Prolonged use of back muscles, for example sitting, standing or running for too long, especially in bad posture increases the tension on muscles, making these muscles achy and weak.

You can test for yourself if your posture is bad by standing straight against a wall such that you touch the wall with back of your palms, knees, lower back and head at the same time. Then move a step forward and try to stand in the same position for 30 seconds. Notice the areas of maximum tension while you maintain this position. Areas of maximum tension are actually the areas which are weak and where you need to work harder to maintain an upright position.

  • Excess weight also increases the strain on back as back is responsible for supporting the weight of body (torso). Studies suggest that losing weight helps in reducing back pain.
  • Psychological condition

It is unknown how a psychological problem is involved in causing upper back pain, however it is seen that people who suffer from depression experience more pain than people who are psychologically healthy.

  • Smoking

Smoking halts proper blood circulation to body organs including muscles and spine. This can impair the natural process of muscle repair after a strenuous physical activity, increasing the period of muscle fatigue and strain and thus muscle injury. Smoking can also cause degeneration of vertebral disc in the same way.

 

How to prevent upper back pain?

  1. Improvising your posture while sitting as well as standing helps in reducing the stress on posterior back muscles ( trapezius, rhomboid, latisimus dorsi). We slump the most while sitting and hence it is important that we take utmost care of our posture while sitting.
  • Do not sit for long. Make sure to walk or change your posture every 20 minutes to reduce the tension on back muscles.
  • Adopt a correct sitting posture

While sitting,

  • make sure your shoulders a relaxed
  • look straight and do not bend your neck
  • keep your feet flat on floor
  • keep your back supported with a cushion or backrest
  • position hips slightly above from the knees

 

  1. Know proper running technique
  • Do not let your head bend and strain your neck. While running keep your neck straight and look forward.
  • Keep your shoulders relaxed and your shoulder blades in a position as if you are holding something in between them. This will prevent the hunching of shoulders.
  • Keep your posture straight and erect with your head and back straight and shoulder leveled. Maintained proper posture helps fight fatigue while running
  • Clenched fist while running is not appropriate as it creates pressure in the neck and shoulder as well. Keep your arms and hands relaxed.
  • Arms at 90 degree angle with shoulders and hands at waist level
  • Swinging must not be at the level of elbow. Arms should swing at the level shoulder joint. Arm swing should not cross over chest but should be maintained along the side of the body.
  • Some may feel bouncing helps to run better however this is not the case. Bouncing wastes energy and causes legs to fatigue faster. Don’t bounce when you run. Take light steps and land your feet softly on the ground so your body don’t have to absorb too much shock.
  1. Perform exercises to strengthen your postural muscles

This involves a diverse range of exercises. Exercise to correct slumping posture:

  • Bridges: Lie down on a plane surface. With your arms and hand positioned straight on the floor, bend your knees and bring your ankle close to the hips, with feet still flat on floor. Now raise your thighs up such that the knee and the shoulder fall in a straight imaginary line. Lower your thighs slowly to the initial position. Repeat 9-10 times.
  • Back extensions: These include a number of back stretches such as knee to chest, kneeling stretch, torso stretch etc
  • Plank: Lie down in a prone position. Raise your body up such that forearms and toes are carrying all the weight. Legs must be kept straight and don’t allow hips to sink lower. Maintain a straight line from head to toe. Stay in this position for around 10 seconds. Repeat for 5 to 6 times.

 

Management of upper back pain

Initial treatment is to observe proper rest until the pain fades away.

Home remedies include:

  • Gentle stretches
  • Cold or warm packs to reduce pain and stiffness due to inflammation
  • Over the counter drugs such as Ibuprofen or acetaminophen, to reduce the pain.

If the pain is too much to tolerate and does not reduce by any of the above mentioned methods then one must seek medical help.

A physician, based on the patient’s proper history and need, may prescribe anti inflammatory drug or a muscle relaxant.

If patient has an underlying condition such as depression, the doctor may give anti depressants or opiods, if the pain is too severe.

Also, medication can be directly injected to the site of pain if topical medications are not helpful.

This must be noted that none of these drugs should be taken as self medication and should only be used after a proper professional medical counseling.

 

Running can be a remedy if only one knows how to perform this most ancient form of exercise in a proper manner. It is true that it does not need equipment and anyone can do it but if not done as it is supposed to be, running can get real annoying if associated with upper back pain.

It is important to keep in mind that even simpler things like running need adequate knowledge and training, and when we ignore proper trainings, these simple things bring complications in our lives. Hence, it is important to gain enough knowledge about everything around us, talk to the professionals in that particular area, and use their advice to make your life better and healthy.

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