Why Anatomy Is Important

I’ve had pain in to the left of my spine, a little inferior (below) the scapula and just lateral of the vertebrae, off and on over the last year. It’s often not debilitating, but it will get worse when I sit for long periods of time. I have strained several times where I couldn’t train for a few sessions. I did it in January when I was playing Skyrim, and another time it happened when I was front squatting in Texas (2010, I think). The earliest I ever strained it was before I even did CrossFit, so that must have been in 2007 (I was doing a dumbbell row). I have a slight curve to my thoracic spine which would probably explain why the erector spinae muscles on that side have issues. Most people have a small degree of scoliosis that is hardly noticeable without an x-ray.

I’ve tried a lot of different things from Mobility WOD, and they helped, but the pain still lingers. I used two parts from “5 way shoulder” (specifically a) flexion and external rotation to stretch the lats and b) the cross-chest stretch in external rotation that pulls the scapula away from the spine. They helped, and my thoracic flexibility improved (to the point that those stretches don’t accomplish as much anymore), but I still have the pain. I’ve noticed that sometimes I tend to slightly over extend at my thoracic/lumbar junction and my sacro/lumbar junction in an attempt to not slouch. This could be something that makes it worse. When I laterally flex to my right side, the left side feels stretched and alleviated. Also, if I push my left ribs to the right, and push my right hip to the left, I get an overt stretching sensation along the lower erector muscles.

All of the above is to give you an idea of the data I’ve collected on this injury and how it could help me work on it to improve it. Deep rooted types of pain or injuries will not respond as well to merely stretching them, and there aren’t really any joints to approximate in the spine (like you can do with the shoulder, elbow, hip and knee). This is a long term issue, so if I’m going to penetrate deeper into the tissue, I will need to use a lacrosse ball and at least my own body weight laying on top of it. I can increase the amount of weight by using a weight (plate, dumbbell, dog, etc.) on my chest. However, what I do while on that lacrosse ball is important.

Look at the three muscle groupings that make up the erector spinae. Some are right next to the spine while others fan out and attach on the ribs. By knowing what’s going on under the skin, I can better attack these muscles to alleviate their “deep rooted” problem. It may be that my anatomical assymetry (slightly curved thoracic spine) has helped them get tight, or it might be that they have gotten tight from how I sit at my computer and drive (likely). Someone might look at this and say I have a muscular imbalance. Yes, there’s an imbalance, but not necessarily due to a “weakness”. If there’s a weakness (and I don’t think there is), it’s due to the chronically tight position, not the other way around. Or, there might be some ROM limitations that result in a a weakness (the same way that if your biceps couldn’t move through the full ROM, it’d look or feel like a weakness).

Instead of just laying on a ball and just mashing stuff around, instead I should have a plan. How can I have an effect on these particular muscles to relieve tension, let them slide over one another, or function better? Let’s move along the muscle belly. I hadn’t really focused on moving along the muscle belly of these erectors until last night, and the effect was instantly noticeable. I tried tack and stretching medial to the scap as well as inferior to the scap, but it never really produced the effect. However, after looking at the muscle attachment sites and looking at a trigger point therapy book I have, I realized I hadn’t moved along the muscle belly. I worked from above the pain, towards it, on it, and then below it, and I freed up those tissues and had an instant relief of pain. Neato.

If you are a coach or if you lift alone, improving your anatomy knowledge is important in your ability to prevent and treat injuries or “issues”. Obviously I think anatomical knowledge is important for understanding the lifts themselves, but that’s pretty easy to grasp. To understand injuries and how to rehab and treat them, you need an understanding of the smaller details. Knowing “hamstring” and “quad” isn’t enough; you need to know where those muscles attach (like how the hamstrings wrap around the head of the tibia after crossing the knee).

My little epiphany also brings up the point that if you know the muscular anatomy, then you know how to work on it with a lacrosse ball. Instead of blindly smashing on tissues, work along their muscle bellies. There are instances when feathering over the muscle perpendicular to how the fibers run is necessary (like when working on the TFL after carrying a heavy pack on your back), yet there I bet most instances work better when you move parallel with the fibers — especially when there is a long muscle belly like in the erector spinae group. Think about other muscles that have long bellies: quadriceps, hamstrings, biceps, back muscles, and the forearms. If you have pain in a region, then see what happens if you move “upstream” and “downstream” of that pain with careful, controlled undulations on a lacrosse ball. But before you do, learn the anatomy of the structure so you know where to put that lacrosse ball.

My favorite musculoskeletal anatomy book is the “Trail Guide to the Body”, a book made for PTs and massage therapists. I had to get it in school, and it’s phenomenal. I’ve heard other people cite other anatomy books, but nothing has the detail, muscle action, origin/insertion, and how to palpate every structure like this book. There’s a 4th edition out, but you can find the 3rd edition for pretty cheap (I just bought another copy for $15, which is an absolute steal).

I use this book every time someone asks me an injury question. The good thing is that every time I get a question, I review what I’ve learned in the past by studying the area again. It helps me learn how to rehab things (by getting the muscle to contract) as well as how to mob things (as I described above). Combine this book with “Anatomy Without A Scalpel” and you’re set up to have a good understanding of musculoskeletal anatomy.

I’m surprised to learn how many coaches and lifters do not have a good understanding of anatomy. Make it a point to improve this understanding because it will heighten your understanding of lifting mechanics, but also help with injuries and mobility work.

20 thoughts on “Why Anatomy Is Important

  1. Nice post. Since I have been lifting seriously my understanding and awareness of anatomy and physiology has increased. Through exercise and reading books like you suggest.
    Hopefully you can answer this question. My wife recently started lifting with me using a modified SS program. Evrything was okay for a while then she developed a pretty sharp pain in her lower back, in the sacral area. Dead lifting didn’t seem to aggravate it if she kept her lower back in extension (like everyone should). Squatting really pisses it off though. She now can feel it if she is bent over and twists a bit, unweighted. Let me know if you have any thoughts or directions to figure this thing out.

  2. I’ve probably learned more about anatomy, nutrition, and physics from powerlifting than from high school and college. It’s also important because should you ever have to see a doctor, PT, or chiropractor, they may know what they are talking about in a medical sense but be utterly clueless when it comes to applying that knowledge to lifting which makes it all the more important to inform yourself.

  3. I recently decided to finally get the lingering shoulder/upper back/arm pain I’ve had in my right side looked at. I had considerable tension surrounding the scapulae on my right side, as well as tension in the upper trap on that side and radiating sensation down my right arm.

    The chiro has used Graston to break up scar tissue around the scapulae and in three sessions it has made a marked improvement. He also has found my subscapularis on the right side is very tight, and he is working on breaking up tissue there as well. Both of these are most likely do to throwing as I played football almost weekly for a couple years not too long ago and mainly played QB on offense.

    The chiro is also using Graston and massage to relieve tension in my upper trap and neck as that is the cause of the radiating sensation in my arm as it is impacting the nerves in that area. I am working on improving my posture and scapular retraction as well to help with this.

    He also has me working to improve my thoracic extension, which has already made a difference in my squatting as I am able to rack the bar more comfortable as my shoulders don’t have to excessively externally rotate to make up for the lack of thoracic extension.

    Not sure why I wrote all this, but I guess it could be to say if you can find a good chiro, as well as teach yourself as much as you can, it can make a huge difference.

  4. Anatomy/mobility puzzle time! I wasn’t going to derail an unrelated thread with this. But since Justin seems to like anatomy puzzles, I’ll go ahead and ask.

    Lately, I’ve noticed two strange things. I’ll just describe what I see. (1) If I look up at the mirror while in the bottom position of an RDL, I can see my right hip behind my right shoulder, but not my left hip, as though I’m somehow curving to the right. (2) On my heaviest deadlifts, I tend to twist slightly to the left at lockout.

    I can’t make sense of these two pieces of data together. I don’t have any back pain, but I want to MAKE A BETTER DECISION here. I take good care of my structures — I spend about an hour every night mobbing various things, mostly hips and shoulders. Any ideas?

    Do you have any known anatomical assymetry, specifically in your pelvis?


  5. I really like this article for 2 reasons – first its an important topic for any serious lifter, second it sounds exactly like the problem I’ve dealt with for the last 3 years. Here’s my story, it is very similar so I included lots of details, sorry.

    I first got pain in my thoracic/lumbar area on the left side of my spine about 3 years ago. If I remember correctly it was one of my first times with the yoke. Coincidentally this event is the bane of any competition I do. I don’t think it’s because it was too heavy, but just poor positioning on my upper back and lack of thoracic extension while carrying (which also happened on back squats).

    Later that summer, it got to the point where I would have mid back pain (left side) immediately after I squatted or deadlifted. I worked around it and saw a PT in fall of 09 – his conclusion was thoracic curvature (as you indicated) and he prescribed lots of upper back mobility and eventually some rows and pulldowns. I squatted during this time and avoided heavy pulls. I went another year or so pain free for the most part as I worked my squat back up to a decent number.

    Fall ’10, I get it again while squatting. I see a new PT and he prescribes lots of rowing and IYT sort of movements saying its somewhat of an imbalance between the upper and lower/mid traps. I learned the importance of scapular retraction and how it applies to pretty much everything. I also realized I was very much upper-trap dominant, anytime I’d do a pullup or row I’d shrug “up” instead of retracting the scaps. But this PT did very little to fix the pain. He also recommended I stop squatting. Ok.

    I gave up on that PT and my gym started offering ART/graston services recently. If anyone thinks this is “kinda like massage” you are in for a painful surprise. But this chiro/ART is not only addressing the tight groups (exactly what you indicated), he is also a lifter. He noticed two things – my left side from upper traps down to Illocostalis lumborum & erector group were very tight. He also noticed the upper trap dominance, everytime I retracted the scaps my left upper trap “hiked up.” Its gotten much better over 4-5 visits and he even indicated I can come in intermittently (instead of trying to keep me and pad his pocket I guess).

    Sorry for the long post. But the same problem has basically been the bane of my squat, upper back, and lifting performance/mood. Here’s what I noted:

    1. You are dead on when talking about learning anatomy, other than “oh yea, quads and hams.”

    2. Scapular retraction is effing important. For everything.

    3. Find a good Dr/Chiro/PT, preferably one who understands barbell training.

    4. Rehab and mobility work. Like you said.

  6. I first started thinking about anatomy/physiology after Mobility WOD and places like this site as a way to treat nagging issues and improve mechanics. However, the more you dive in, the cooler it all becomes from a mechanical or structural standpoint. Just ordered Trail Guide. Looking forward to digging in.

    Does anyone have any experience with home ultrasound machines? I’ve been considering buying one to deal with some scar tissues in my elbows.

  7. I’d say with alot of this stuff the first thing to look at would be glute activation. I know I’m going to catch alot of flak for this, but I haven’t seen too many situations where this isn’t the case.

    From an upper body standpoint, I’ve seen very few problems with people who have terrific hip function.

    If your talking about thoracic extension, my first go to move to improve overhead pressing, pushups, or a pulling motion is to get the glutes working with a glute bridge or quadruped activation exercise.

    I’d like to hear what anyone here or the site admin has to say about this article I wrote.


  8. Thank you for this Justin. I’m a kin student so I have some knowledge of the anatomy (they don’t do much application in class) and I was foolishly trying to hit the areas where tightness was (origin of adductors) with a lacrosse ball. This put it into better thinking that it’s more effective to lengthen the muscle at the belly of the muscle where there are fibers to go after rather than connective tissue at attachments to relieve tightness. I’ve had more improvement in a couple days of targeting the belly than I did with weeks of less effective tendon mobilizing. Thanks again for the post.

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