Help me solve my weird back pain, please

[Sinatra]

Hi! Don't let this wall of text discourage you, because I've included absolutely everything for you to get as clear a picture as possible, but I'll write a short summary in the end for the lazy people. And english is my second language so I'm sorry for any misspelling.

About me: Male, 23 years, 184 cm, 77 kg, started working out in early 2010, but not with heavy compound exercises until the end of the year. I ate Roaccutane from June 2010 to June 2011 (if it has something to do with it).
My father have had back problems throughout his life and my mother has rheumatoid arthritis and another painful disease (which I always forget the name of).

The pains origination: I worked as an industrial carpenter (fairly active job) when I started training with heavy compound exercises. The pain started to come sometime during the late spring of 2011, when I began to reach relatively big weights. (Also worth mentioning is that I became unemployed in March, so I spent quite a lot of time in front of my computer.) Squatted around 5x80 kg and around 100 kg in deadlift. I progressed very quickly, as SS & SL5x5 say that beginners should do, and as I felt I could handle.

The pain: The pain comes immediately after a finished set when I stand up and slowly bend forward and bend the thoracic spine. It's a weird aching pain, almost as if you stretch a muscle to far but more painful than normally and almost tingly. It's somewhere around here: http://img545.imageshack.us/img545/9246/rygg1.jpg
It feels as if it is between the m. erector spinae and the spine. The pain disappears after a few minutes.

This is the exercises that provoke the pain (the worst is first):
1. Front squat
2. Press
3. Squat
4. Deadlift/bench press
5. Almost every free weight exercise

It does not hurt after bodyweight exercises such as pull-ups, chins and dips.

I have recently also started to have sensations there when I sit and twist my upper body all the way to right and left, all day, even if I didn't work out that day.

Treatments: I have never taken any medication for this as it does not directly hinder my daily life.
I have tried rest, both a weeks active rest och months passive rest. It has become almost as intervals, with two months of training, a month's rest, and so on.
At first I thought it was because I was weak, and thus tried to train through it, but it only got worse.

As it never passed but only worsen, I made an appointment with a physiotherapist around August / September, but she had no idea what it was. I received heat treatment and a little massage on my first visit. The week after I got some more heat treatment and acupuncture. Since she had no idea what it was I decided to book an appointment with a doctor instead, and perhaps require an x-ray.

The doctor said it was because the tendons/ligaments/whatever had fallen behind when I progressed so quickly, so my back could not stabilize itself properly. He estimated that the radiation from an X-ray would be more dangerous than a possible misdiagnosis, so that was it. He recommended me to reduce the working weight and increase the number of repetitions.

I rested for a while until mid-October, and then I increased the number of reps to around 10-12 and reduced weights tremendously.

The pain came back after one week of training so then I decided to book an appointment with a naprapath.
He said it was due to my extremely bad posture, as my forward rotated shoulders forced the spine to stabilize with the help of the small muscles (multifidus?) Instead of the correct muscles.
He did fix my posture a lot, but there is a little work left. He also massaged the thoracic spine to check for deadlocks, but it never cracked once. He also massaged the muscle along the spine (erector spinae) and he said it was unusually tense (I almost screamed in pain). This was after two treatments and the latest was this Friday 12/9/11.
He said I could not do any flat bench presses, but only inclined, and otherwise I would continue training as usual.

Today I trained, but the pain/feeling came back again, following the incline bench press, but as usual most intense after the press.

I have filmed myself to study the performance, but I see no problem at all (I have really studied your technique videos). I did ask for an assessment on my front squat on a Swedish training forum though, but the only complaint was a minimal "butt wink" at the bottom (which is not unusual, as far as I know).

I do have intra-abdominal pressure when I perform the exercises.

tl;dr: Weird pain in thoracic spine after sets and I've tried talking to doctor/naprapath/physiotherapist.

Any ideas at all? I want to get big and strong!

[Mark Rippetoe]

I don't know what it is. Can't tell from here. But this is funny:

The doctor said it was because the tendons/ligaments/whatever had fallen behind when I progressed so quickly, so my back could not stabilize itself properly. He estimated that the radiation from an X-ray would be more dangerous than a possible misdiagnosis, so that was it. He recommended me to reduce the working weight and increase the number of repetitions.

Everywhere, all over the earth, doctors are perfectly willing to pull diagnoses out of their asses.

I used to have periodic mid-back spasms until I started doing high-volume chins. Went away after these, and hasn't bothered me since.

[cpbellavia]

6 ft 170 is pretty effing light. Is this one of those cases where the issue goes away at better bodyweights?

[Sinatra]

I don't know what it is. Can't tell from here. But this is funny:

Everywhere, all over the earth, doctors are perfectly willing to pull diagnoses out of their asses.

I used to have periodic mid-back spasms until I started doing high-volume chins. Went away after these, and hasn't bothered me since.

Might be worth a shot. Since it doesn't hurt during bodyweight exercises, I'm thinking something must be weak or hard for me to flex/tighten.
Thanks for moving the thread btw!

6 ft 170 is pretty effing light. Is this one of those cases where the issue goes away at better bodyweights?

I was even lighter when I started to train (154 lbs), but I've always been "skinny fat". Now I'm just a bit more muscular skinny fat.

[Eyzteinn]

I'm a physiotherapist and got into the business because of severe back pain. So I've been where you are now. Exactly where you have marked your pain, is where I had pain for a while, though not as you described it. For me it hurt all the time, but less. For me it was a blockage, which nobody managed to unblock.

Doing pull-ups, the strong latissimus dorsi does most of the work. It probably wont hurt (as much). Doing all the other exercise you've mentioned, stresses the lower and middle trapezius, the rhomboids major and minor, the infraspinatus as well as the serratus anterior, and if any of these muscles develop trigger points, muscles lying underneath their area of referred pain, will probably also develop triggerpoints, which includes the supraspinatus, levator scapulae, teres minor and major, upper trapezius, most of the erector spinae muscles, multifidi and rotatores and so forth and mayhap also the posterior serratus inferior and superior (but that rarely happens). I see from the picture that your latissimus dorsi is highly visible, indicating it is very active. I think your latissimus dorsi does a lot of the work that the muscles attached to your scapulae are supposed to do.

I'd work on activating these muscles. In a couple of months time, see the naprapat, and have him assess your thoracic spine anew. He maight be able to unlock it then.

[Sinatra]

I'm a physiotherapist and got into the business because of severe back pain. So I've been where you are now. Exactly where you have marked your pain, is where I had pain for a while, though not as you described it. For me it hurt all the time, but less. For me it was a blockage, which nobody managed to unblock.

Doing pull-ups, the strong latissimus dorsi does most of the work. It probably wont hurt (as much). Doing all the other exercise you've mentioned, stresses the lower and middle trapezius, the rhomboids major and minor, the infraspinatus as well as the serratus anterior, and if any of these muscles develop trigger points, muscles lying underneath their area of referred pain, will probably also develop triggerpoints, which includes the supraspinatus, levator scapulae, teres minor and major, upper trapezius, most of the erector spinae muscles, multifidi and rotatores and so forth and mayhap also the posterior serratus inferior and superior (but that rarely happens). I see from the picture that your latissimus dorsi is highly visible, indicating it is very active. I think your latissimus dorsi does a lot of the work that the muscles attached to your scapulae are supposed to do.

I'd work on activating these muscles. In a couple of months time, see the naprapat, and have him assess your thoracic spine anew. He maight be able to unlock it then.

I do feel my lats working very much in upper body exercises, and I've thought about it, but dismissed the thought because I figured it was meant to be stabilizing.
You mentioned a lot of muscles; exactly which ones do you recommend me to activate? Teres minor/major and infraspinatus?
Thank you for this answer!

[Eyzteinn]

Putting the knuckle-side of your hand at your lower back, and tracing your knuckles upwards towards your shoulder blades, does that hurt? If so; probably infraspinatus. Do you have a deep pain within the shoulder joint? Probably teres (I always forget if it's minor or major).

Anyway, this is the case: If your latissimus dorsi is strained and/or has trigger points in it, it'll activate satelite trigger points in all the muscles lying underneath it, and these muscles will in turn activate satelite trigger points around them. A vicious circle, for sure. Search you tube for an exercise called Wall Angle. Do it. It works wonders for trapezius instability. Fixing that instability, will go a long way in fixing the rest of the muscles. So focus on trapezius, especially lower and middle fibers.

[Dan H]

I have had a similar problem, albeit more chronic, with my mid back. Although I'm not sure if its the same issue Sinatra is dealing with I would certainly like to know more.

A little over 2 years ago I developed some acute pain around my thoracic spine (if I had to guess its around T7). I don't feel it specifically in my spine, but to the left side somewhat under the scapula. I have a hunch its from continued poor technique squatting and deadlifting, specifically rounding of the upper back during the squat or front squat.

I saw to PT's each for a few months with the first one thinking it was curvature of the spine (thus I did a lot of mobility work) and the second saying it was an imbalance between my upper and lower traps (did a lot of IYT's and scapular retraction to engage lower traps). Both helped somewhat, but I still get the pain after I squat heavy. I did notice my traps were imbalanced - I was always shrugging up but never retracted my scapulae during a lift. I've gotten somewhat better at it but I still find my shoulder blades (specifically the left one) getting lazy and not retracting.

Eyzteinn, I am intersted in what you had to say about the lower-mid traps, rhomboids, etc - do you think they could be causing the pain? I try and do plenty of warmup for scap retraction as well as band pullaparts, IYT's, etc but they don't always want to do what they're supposed to. I'm also toying with the idea of massage therapy. Any input you have would be great.

Sinatra - not sure if I have the same problem or not, but always try and keep your lats engaged, pull your scaps down and together and keep your chest up when you squat/DL.

Hope to learn more. Thanks.

[Sinatra]

Putting the knuckle-side of your hand at your lower back, and tracing your knuckles upwards towards your shoulder blades, does that hurt? If so; probably infraspinatus. Do you have a deep pain within the shoulder joint? Probably teres (I always forget if it's minor or major).

Anyway, this is the case: If your latissimus dorsi is strained and/or has trigger points in it, it'll activate satelite trigger points in all the muscles lying underneath it, and these muscles will in turn activate satelite trigger points around them. A vicious circle, for sure. Search you tube for an exercise called Wall Angle. Do it. It works wonders for trapezius instability. Fixing that instability, will go a long way in fixing the rest of the muscles. So focus on trapezius, especially lower and middle fibers.

Both of them hurts actually, and I think you mean teres minor. I've always known that I have bad rotator cuffs and I did internal and external rotations a while back until they stopped hurting and then I started doing turkish get-ups instead (cause it's way way more fun). I haven't had any problems with them until the naprapath stretched my shoulders to minimize my forward rotation. I guess I have to go back to doing the rotations again.

I used this video for the "wall angle": http://www.youtube.com/watch?v=LMb2jOE3t_Y
and it gave a really good burn in my deltoid posterior (I think, or maybe it was one of those small thingies) and scapulae area. I wasn't even able to put my arms flat against the wall, so I guess you really found the root to my problem.

So, I'll start doing the wall angle every morning and really focus on rowing exercises for my trapezius and rhomboids, and hopefully that will make the pain go away.
I can't really thank you enough for you help, but thank you! And if I need to visit a physiotherapist again I'll definitely go to Trondheim!

Sinatra - not sure if I have the same problem or not, but always try and keep your lats engaged, pull your scaps down and together and keep your chest up when you squat/DL.

Hope to learn more. Thanks.

I have really bad mobility in my scaps, but hopefully the wall angle will fix them. Thanks for the tip!

[Dan H]

Yea scap mobility is one of those little things you never really here of when you start training, but can cause huge issues down the road if its ignored.

I'll give the wall angels a try and see what happens.