A Physical Therapist’s Analysis of Ryan Braun’s Middle-Back Pain

By: David Tranchita, PT

Lately, one of our hometown heroes, Ryan Braun, from the Milwaukee Brewers, has been sidelined due to a middle-back strain. While middle-back pain is often completely dismissed, it can relate to myofascial pain or inflammation with knots called trigger points in the muscle surrounding the thoracic region of the spine. Running from the base of your neck to the bottom of your rib cage, the thoracic spine doesn’t move very much and doesn’t contort quite the way the upper and lower spine does. This is actually a good thing because it means less stress will be put on your body and your thoracic discs won’t be subject to the same amount of wear and tear. However, because of this lack of movement and postural issues, strains can develop in the back muscles, causing middle-back pain. This is especially common if you are compensating for a weakness or limitation in rib or thoracic joints mobility from a lifting or repetitive movement like throwing a baseball or swinging a bat like Ryan Braun.

Here are five ways to relieve the pain and to keep it from coming back:


1. Perfect your posture.

As with most back pain, poor posture plays a big role in middle-back pain. When you spend hours sitting at work (i.e. computer work station) with rounded shoulders or lift a lot of boxes with poor form, the muscles in your back are forced to work overtime. This extra work needed to support your shoulders and neck can cause strains. Having a good, adjustable, ergonomic chair is important if you have a sedentary job. It is also important to use correct body and lifting mechanics when reaching and lifting objects.











 2. Stretch your chest.

Sitting up straight might not be as easy as it sounds. If your back muscles are perpetually stretched and your shoulders have been rounded for months or years on end, the muscles in your chest are most likely incredibly tight, which forces you into an even more hunched position. It’s important to get up from your desk every hour and move to get circulation into your muscles.

A good stretch for your chest muscles is a doorway stretch. Stand in a doorway with your forearms braced against its sides with your upper arms parallel to the floor. Step forward with one foot as if lunching and bring your hips and chest forward until you feel a gentle stretch in your chest. Hold for 30 seconds and repeat.








3. Work out knots.

Tired middle-back muscles and pain in the stabilizing muscles of your shoulders/shoulder blades go hand in hand. Myofascial release therapies, such as massage, Dry Needling or self release (using a tennis ball and/or foam rolling sensitive spots) can help loosen up muscle tissue, thus giving some pain relief.




4. Talk to a physical therapist.

If at-home therapies aren’t relieving your pain, contact your physical therapist to see if you have any other underlying issues (i.e. Scoliosis, Osteoporosis), because these issues can cause pain, particularly middle-back pain, if not treated properly. Physical therapists in Wisconsin can prescribe X-rays if needed to rule-out any compression fractures and/or scoliosis. If you do have myofascial trigger points that are not going away, some licensed physical therapists are certified in Dry Needling, which helps reduce the nods by using a filament needle similar to acupuncture.


5. Strengthen your back muscles.

Most middle-back pain comes from other muscles being weak and fatigued during an activity, causing compensatory patterns. Starting a gentle middle-back strengthening program can further help you correct your posture and eliminate your pain.

Particularly helpful exercises that strengthen middle-back muscles (middle and lower trapezius and periscapular muscles, which support and stabilize your spine and shoulder blades), are scapular squeezes at your workstation and resisted rows at your health club or home with light weights.


Hopefully these five tips not only relieve your middle-back pain but also get Ryan Braun back out on the field again. Go Brewers!