Why do I get upper back pain when I run?

You may expect some aching in your legs for a day or two after a run. This is usually a normal reaction to exercise and is known as Delayed Onset Muscle Soreness (DOMS). But upper back pain? How is that linked to running at all? We discuss what may be causing pain in this area, and what you can do about it.

Upper back pain when running is actually a reasonably common problem, and especially affects people who are new to running, or have been out of practice for a while. This is because our running position tends to change as our muscles get tired and lose strength. This can happen in a number of ways:

• You may start slouching with your upper back

• Your shoulders may begin to rise with tension in the muscles around your neck

• You may hold your arms with increased stiffness as you feel tired

This can lead to an aching feeling in your neck, or around your shoulder blades and upper back. Sometimes this can worsen to a sharp, stabbing pain in these areas, and can stop you from running completely.

What causes upper back pain when running?

The most common cause of upper back pain when running is due to poor posture. The middle section of your spine (between your neck and your lower back) is known as your thoracic spine.

If you sit at a desk for long periods of time in the day, you are likely to be stiff in the joints in this area. People tend to sit with rounded shoulders and a curved upper back. We call this a flexed position.

This leads to tightness in the chest muscles (pectorals) and weakness in the muscles of your upper back (mid/lower trapezius and rhomboids).

Even if you don’t work at a desk, driving, watching TV, eating, texting, cooking, cleaning all tend to be in a flexed position too!

What can I do about it?

1. Improve your posture

The first thing to think about is to reduce the amount of time you spend sitting. The longer you sit without a break, the more tired your muscles become and your posture will gradually deteriorate.

Try and move every 30-60 minutes and break up prolonged positions. The best thing to do is stand up and walk around your desk or chair for 30 seconds. Standing and stretching is helpful, as is simply doing some stretches in the chair. ANYTHING where you have moved out of that posture!

Shoulder blade squeeze

Stand up, bring your hands together behind your back and squeeze your shoulder blades together.

This should bring your shoulders right back and stretch your chest out.

Sometimes this can be more effective if you raise your arms up slightly away from your bum.

Hold this for 15-30 seconds, then release.

Repeat 3 times.

We talk more about other stretches and things you can do when working from home in our previous blog.

2. Improve thoracic mobility

Rotation - sitting

Sitting on a chair. Keeping your hips facing forwards slowly turn with your upper body to one side.

Holding on to the chair with one hand, use it to help you twist a little further.

Hold for 5 seconds, then release and do the same on the other side.

Repeat 5 times on each side.

Rotation - lying

Lying on one side on the floor, with your knees bent and your arms both straight out in front of you on the floor.

Slowly bring your top arm over your body and rest it on the floor on the other side of your body. Keep your knees and your other arm on the other side of your body.

Hold for 20 seconds.

Repeat 5 times on each side.

Extension with a foam roller

Lying on your back with a foam roller just below your shoulder blades. Bend your knees and keep your bum on the floor.

Place your hands behind your neck with your elbows pointing toward the ceiling to help support your neck.

Slowly extend your upper back over the foam roller. Think about this a bit like a reverse sit up.

Pause for 1-2 seconds, then slowly return to the starting position.

This should not cause any neck, lower back or shoulder pain. Make sure you don’t force the movement.

Repeat 10 times.

If you don’t already have one, we recommend the Edge Sports 2 in 1 Foam Roller and ball. This is a great set as it comes with one hollow design rumble roller and one softer smooth foam roller. The softer one may be a good place to start if you are very stiff as this can be a little sore to start with!

3. Consider your arm swing

Think about your arm swing when you are running. Are they swinging too much? Or not enough? Try and focus on your fist being close to your hip as you swing your arm backwards, and then as your swing your arm forwards, your elbow being close to your hip. There will be some slight variance with this from person to person but any large differences may contribute to pain. Are your arms crossing over your body as you swing them or are they parallel to each other?

You may even find that after a few weeks of doing these exercises, your breathing during running may improve. Sometimes improving posture can actually help our lung capacity, meaning you can take deeper breaths and make the most of every one!

4. Trapezius and rhomboid strengthening programme

Another thing that can be really helpful is strengthening your lower trapezius and rhomboid muscles. Often the upper portion of the trapezius muscle is tight and overactive, and the mid-lower part can become underused and weak.

It is best to see a physiotherapist for exercises for this, as they can assess weakness in this area and which exercises are required. They can also decide which level to start you on and progress you through a programme to make sure you are getting the most from your exercises.

Your physio may also provide you with taping techniques around this area to relieve tension through your upper trapezius and support this area to help the pain.

Tape can also serve as a gentle reminder about your posture, by providing feedback when you slouch or bring your body into a flexed position.

This is absolutely not written to substitute medical advice and it is always important to see a qualified health care professional for a formal diagnosis. If any of the exercises cause pain during or after the exercise, discontinue and consult a physiotherapist.

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