Upper back pain, which involves the middle section of the spine (the thoracic spine), can disrupt a runner’s routine. Whether you can run depends heavily on the specific nature and intensity of your discomfort. Self-assessment is necessary to determine if continuing your activity will be harmless or potentially harmful. This evaluation helps distinguish between minor muscle tension and symptoms that demand immediate rest and professional guidance.
Immediate Triage: Determining the Safety of Running
The decision to stop, rest, or modify your run should be based on a clear triage process evaluating the pain’s characteristics. Use the 0-10 pain scale, where 0 is no pain and 10 is the worst imaginable. If the pain is a mild ache rated 3 or less and does not worsen while running, modification may be possible.
If the pain begins at level 4 or higher, or if mild pain quickly escalates, stop running immediately. The type of pain is also telling: a dull, general ache often indicates muscular fatigue or tension, which may allow for a modified run. Sharp, stabbing, or electrical pain, especially if localized to a joint or feeling like a “catch,” suggests a potential joint or nerve issue requiring immediate cessation of activity.
Pain location and spread are additional indicators of severity. Discomfort localized strictly to the muscles between the shoulder blades is less concerning than pain that radiates. Radiating pain, particularly if it travels into your arms or hands, indicates nerve irritation and signals the need to stop and seek advice. If the pain persists after you stop running, or if it significantly changes your running form, your body requires rest.
Mechanical Factors Causing Upper Back Pain While Running
The repetitive impact of running often exposes mechanical issues originating from daily posture. Prolonged sitting can lead to a flexed, or rounded, position in the thoracic spine. This posture encourages tightness in the chest muscles and weakness in the mid-back muscles, such as the rhomboids and trapezius.
During a run, this muscle imbalance manifests as slouching, where the upper back rounds and the shoulders hunch forward. This poor form forces the weaker upper back muscles to work harder to stabilize the torso against running forces, leading to fatigue and pain. Improper arm swing also contributes to strain; arms that cross the body’s midline introduce excessive rotational stress to the thoracic spine.
Running gear can introduce mechanical strain if not properly fitted. Heavy or ill-fitting hydration vests or backpack straps can pull the shoulders forward, exaggerating compromised posture. Simple habits like clenching the fists or shrugging the shoulders also create excessive tension in the upper trapezius muscles. This muscle overuse, especially over long distances as fatigue sets in, is a common precursor to upper back discomfort.
Practical Adjustments for Running with Mild Pain
If your pain assessment indicates a mild, muscular ache (level 3 or below), several adjustments can help you continue running safely. Focus on form correction by adopting the cue “running tall,” which involves gently lifting the chest and looking straight ahead. This helps achieve a more neutral spinal alignment without forcing an overly rigid posture.
Consciously manage your shoulder position by retracting them slightly (pulling them back and down) to engage the mid-back muscles and relieve tension. Ensure your elbows pump straight backward and forward, parallel to your body, instead of crossing the midline. This minimizes unnecessary rotation in the thoracic spine.
A dynamic warm-up that includes gentle movements for the thoracic spine can improve mobility before starting. Simple exercises like arm circles or torso twists help prepare the area. Post-run, gentle stretching and foam rolling of the upper back can release muscle tension and stiffness, preventing the mild ache from becoming persistent.
Warning Signs That Require Professional Consultation
While most running-related back pain is muscular, certain symptoms are red flags requiring immediate medical or physical therapy evaluation. Consult a professional if the pain persists for more than two to three weeks despite rest and self-care. Accompanying neurological symptoms, such as numbness, tingling, or weakness in the arms or hands, signal nerve compression and must be assessed.
Pain accompanied by systemic symptoms like fever, chills, or unexplained weight loss could indicate an underlying infection or serious condition. Pain that interferes with breathing or is accompanied by chest pain requires prompt attention to rule out issues related to the ribs, heart, or lungs. If the pain is severe, sudden, and follows a traumatic event, seek professional advice for proper diagnosis and treatment.