Shoulders, Mid-Back and Headaches
Hikers are particularly prone to problems in the mid-back that can result in headaches and shoulder muscle pain. Contributors to this discomfort are posture, pack fit issues and even improper trekking pole height. We will take a look at all three with plenty of pictures to help clarify.
To revisit our earlier graphic, the thoracic spine or mid-back is meant to be a mobile section of your spine. The chart doesn’t show it, but the scapula, or shoulder blade, is a stable joint and the shoulder joint (glenohumeral) is mobile.
You have a lot of motion in your neck, which is still a stable segment, but higher up near where the skull and the spine meet is the more mobile portion.
With cell phones and computer work, our shoulders tend to round forward. The same adopted posture happens with hiking.
When the shoulders round forward, they stretch out the muscles between the shoulder blades and shorten the muscles on the front of the chest. This reduces your ability to fully inhale and also causes tension in the muscles that attach from the shoulder blades to your head and neck. This is what causes tension headaches and those knots in your shoulders.
Take a good look at where the muscles of the upper back, notice where they attach to the bones.
- Levator Scapulae attaches to the top of the shoulder blade and the bones of the neck. Where that muscle attaches to the shoulder blade is the prime spot for knots.
- Trapezius is huge, from your skull down to the start of your lower back!
- Finally, the Rhomboids which attach from the shoulder blade to the spine. These guys along with the middle and lower traps get stretched out and have a hard time doing what they are supposed to do.
- Many of these muscles attach to the spine, so positioning or posture is important.
The Posture Piece
When the head is forward, meaning the ears are in front of the shoulders, muscles like Levator and Upper Traps will tighten up to help pull the head back to where it belongs. This can compress nerves leading to tension headaches or even tingling in the arms.
Now, on the front side, the Pec Minor gets short and tight with all of the muscles being stretched out in the back.
Ever get that burning feeling during a workout? When those muscles contract to help pull your head back, they start to feel that same burning feeling. Because they are contracting and strained constantly, they become irritated.
Sometimes, if the weight of the pack sits too much on the shoulders, the body will instinctively engage the upper traps and levator, which raises your shoulders. A trekking pole height to hight can have a similar effect for some. (Me!)
Poor posture can do more than make you look like a turtle, it can also cause some more serious disc problems in your neck. Think about having a long, tall spine at all times. Make sure you have a pack that allows the weight to largely be placed on the hips, not the shoulders. Everyone has a different percentage or theory, I like around 75-80% on the hips, the rest on the shoulder straps.
In the picture on the left, I’m standing tall, arms are resting at my side (my right hand is holding the camera remote). This is an ideal posture for hiking.
On the right image, my shoulders are rounded forward, my mid-back is arched and you’ll see that causes my hands to land more to the front rather than the side. My gaze naturally moves downward. Similar to starting your day, and ending your day. Fatigue sets in and posture goes right out the window.
This is the same posture, just from the side. In the left image, my ear is over the shoulder and my spine is tall. Note my hand is also at my side.
On the right image, the head is forward and the ear is in front of the shoulder. This strains the muscles in the back of the neck which can cause tension headaches. You’ll also see that with my shoulders rounded forward, the hands also land more to the front of my legs. That’s an easy clue that your shoulders are rounded.
Now looking at the same posture just with a trekking pole. See how much lower my head is in the right image? That’s due to the rounded shoulders and mid-back.
My *personal* preference is to use a trekking pole height a little shorter than normal. If I raise the trekking pole height to create a 90 degree bend in my elbow I started to feel shoulder discomfort. I do not with the lowered height. It takes some practice and miles to figure out what height will work best for you.
This final series will show how trekking pole height can affect elbow and wrist position. This can lead to unnecessary elbow strain or wrist discomfort.
In the top image, the pole is adjusted to low. It might be a suitable height for going up hills though.
The middle image is my usual trekking pole height and the final image is the recommended height with a 90 degree elbow bend.
Note how the wrist position changed in each photo. This is where the ergonomic trekking pole handles would be a nice upgrade.
As a rule, if I am facing a long climb or descent, I will adjust the poles accordingly. Uphill would be a shorter height, downhill requires a longer pole for proper support. If it’s a shorter up and down, I’ll leave the poles alone.
We touched on pack fit already so let us move onto massage and stretching techniques. Remember in the earlier post about knee, we mentioned a lacrosse ball? Here’s another great place to use it! This will help to release the tightness in the Levator and Upper Traps.
I really like how they place the ball between the shoulder blade and the spine; work that area from the top of the shoulder blade to the bottom of the shoulder blade. This is ground zero for discomfort so remember that you are doing something good!
Here’s a great stretch to follow the ball work with, it’s a silent film, so I’ll narrate:
- *chair is optional and increases the stretch, can also be done standing*
- To stretch the right Levator, point your nose to your left armpit
- Raise your left arm resting your left hand on your head
- GENTLY pull with your left hand until a stretch is felt
- Hold for no less than 30 seconds, but no longer than 2 minutes
- Repeat as needed throughout the day
This Pectoralis Minor release will complement the work you have done to the Levator and Upper Trap areas. As mentioned earlier, this muscle will become short and can also compress nerves that feed the arm. If the levator is tender and painful, you can bet pec minor is too.
These are quick easy techniques that you can do while on the trail. Having a lacrosse ball with you is well worth its weight when it comes to caring for sore, tender muscles. Tennis balls are too soft and compress too much. Lacrosse balls offer better stiffness and grip better.
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You can reach me email@example.com with any injury issues, past or present that you feel will impact your hike. Training questions are also welcome – I am happy to help!