Question
I've been training as a powerlifter for a year and a half now.  I'm 21, 195lbs, and bench, squat, and deadlift 255, 325, and 405 respectively.  Last winter I started having back pain, not in my lower back but more between the shoulderblades.  My doctor couldn't tell me what it was, so I took about a month off.  It didn't get any better, so I started lifting again.  By the time I maxed out in the spring it was really bad so I took another month off, still no change so again I started lifting but kept poundages lighter.  By the fall it was better but still not perfect, but it was not improving much so I started training heavy again.  Since then it has not gotten better or worse, except on a day to day basis.  More recently, within a few months, I think I have been able to somewhat determine the problem.  On days when it is bad, my back constantly feels misaligned, and I am always trying to adjust it, sometimes every few minutes, but i always goes right back.  I have also noticed that my right lat feels sore on these days.  A few days ago it was so bad I decided to try and use massage on my lat.  The first thing I noticed was that my left lat felt normal, like a piece of muscle.  But my right lat felt swollen, and instead of being a solid piece it was almost as if the fibers were separated; it felt sort of stringy.  I did the best I could to massage my lat with my opposite hand as deep as possible.  Almost immediately, I noticed less back discomfort (although still not perfect) and I noticed that the consistency of my right lat was more similar to my left.  

Now I am fairly certain that my lat is the problem.  However, I do not know exactly what is wrong or how to fix it.  I know my right lat is bigger than the left so an imbalance is possible, or maybe I somehow injured it without realizing it.  This problem is frustrating and is the only reason I sometimes don't want to lift.  I hope I have given enough information that someone with more knowledge than me can make an educated guess as to my problem, and suggest some possible rehabilitation options.  I would get an MRI but neither I or my family can afford the copay, so anything I could do to try and treat it for free would be my first choice, although if that didn't work I would be willing to try other methods.  Thanks in advance for your help.

Jim


Answer
Dear Jim,

The first problem here is that this has been an ongoing issue for about a year now...obviously what you have been doing has not fixed the problem, and may have actually made it worse.  Whatever the offending tissue is, it is chronic now and will take longer to heal.  Second problem, you cannot adjust the spine or massage your back by yourself...no matter what anyone else has told you.  You need to have the issue addressed by a professional.  Third problem, continual weight lifting without resolution of the original problem will only exacerbate the condition or make it worse.  So what now?

Well, I don't think you need an MRI from what you have described...even though MRI's are the gold standard for soft tissue imaging, it is an advanced imaging technique, and really is more specific for deeper pathology such as disk issues, nerves, tumors, internal joint structures like ligaments, tendons, cartilage, meniscus, etc...
They are used for muscle pathology sometimes, but usually in higher level athletes.

First Priority is to limit the weight tanning you are doing, and possibly hire a certified strength and conditioning coach to evaluate your form. (NSCA-National Strength and Conditioning Association or ACE-American Council on Exercise) I often see athletes in the gym performing lifts inappropriately even though they had prior tanning.  This will always lead to injury eventually.

Second, I would suggest that you get to a chiropractic physician for an spinal and muscular system exam....a sports injury certified chiropractor would be the best choice (American Chiropractic Board of Sports physicians-ACBSP).  If the chiropractor has additional training in soft tissue mobilization techniques such as Active Release Therapy (ART) or Graston technique, this is a plus, or if a massage therapist is on staff, deep tissue would be beneficial.  You need to actually find out what the main problem is to address it correctly, and a proper orthopedic evaluation is the best way to determine this.

Below you will find links to the above mentioned organizations...it can help you find qualified professionals, and additional information.  Good Luck Jim.

www.acbsp.com
www.nsca-lift.org
www.acefitness.org
www.activerelease.com
www.grastontechnique.com

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net