Recently I had a day where I was doing a lot of evaluation on clients. I do that a lot. People come to me with aches or pains and are trying to figure out where it comes from. One of the favourite parts of my job is trying to figure out the actual source of the issue rather than where the pain is coming from. If you’re not assessing, you’re guessing.

I’ve been doing this for twenty years. Thankfully over that time I literally have hundred of examples of where pain comes from, and many of the places are common sources. So I’m writing this article as a starting point to where I often find the major source of an ache or problem is in the three main parts of the body. It might not be where you think it is!

As I’ve said before, pain is just a signal. There’s something wrong with the body or it’s alignment or movement that needs attention. And with most people when it comes to aches and pains, there are three areas they manifest most. Those parts are:  

Shoulders or upper arms

Lower Back

Feet and ankles

Pretty common, right? I’d say the majority of people I see have one of these areas affected. Which is why it’s been so easy over the years to figure out what could be going on.

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I almost labelled this article as “Most of the time it’s BLANK” because that is absolutely what happens. Ninety percent of the time pain in one of these areas comes down to one main muscle. So if you’re having pain in one of these areas, read on and I’ll be able to give you some insight.

As I’ve said before, this is not a diagnostic process. These are simply the first locations I will go to when discussing pain in a particular area, and through my years of experience I find that they are most often the culprit towards stiffness, pain, or dysfunction. There are over six hundred muscles in the body, and it is incredibly complex. So what you’re experiencing could be from somewhere else. These are good places to start checking.

What I’m going to do is go through all three areas, the muscle involved and then what you can do about it. The next part of this article will deal with the solutions and what you can do to help yourself if one of these areas is affected. Let’s get started:

AREA OF THE BODY THAT HURTS: Shoulder or upper arm, sometimes when rotating or lifting.  

MOST OF THE TIME IT’S: Latissimus Dorsi, most commonly called the lats.

This muscle is one of the largest in the upper body, and originates in several different places. The reason that this is on the list is because it directly affects several different areas of the body in movement. This list includes the shoulder blade, rib cage, upper arm and even the lower back. It is even assisted in some movements by other muscles.

When working with people pain will most often manifest underneath the shoulder blade or mimic rotator cuff issues where pain will travel from the upper back down the upper arm. This is because of the way the lat helps to stabilize the shoulder blade along with some of the muscles of the rotator cuff. It is also the prime mover for a ton of physical movements that require pulling.

If you’re doing a lot of things like rows, pullups, deadlifts in the gym it can become an issue. For regular people, doing externally rotated movements and having them loaded or even things like sitting with your shoulders around your ears can cause this muscle to become overactive (trying to pull your shoulders down) and painful. So desk workers, take note.

I always advocate that people emphasize pulling movements over pushing movements, especially if they are recovering from postural issues. This is a massive part of addressing these problems.

AREA OF THE BODY THAT HURTS: Lower back or hips.

MOST OF THE TIME IT’S: Quadratus Lumborum

This muscle in my world is called the QL, and is part of a system of deep abdominal muscles, even deeper than ones like your abs and your TVA. And it does a lot of stuff. Not only is it a muscle that affects inspiration because of attachment to the diaphragm, but it is used when laterally flexing (ie bending sideways) and extending the spine (ie leaning back).

It also greatly helps with stabilizing your pelvis and when it is affected, has trigger points that hit the back outside of the hips and also the middle of the lower back just above your butt. So when you’re experiencing lower back pain, it’s a big player and very common for me to see in pain when people are having problems bending, rotating and sitting.  

Because it is a very deep muscle it gets used a lot in combination with your other trunk and core muscles, especially because it attaches to your lower lumbar spine. Now, your “core” (or trunk muscles) have not only many layers but they all work together to create movement and protect your spine and hips. So isolating one muscle is difficult, but it is possible to address it while dealing with a few other areas.

If a physio has told you to “strengthen your core” then odds are they meant this muscle.

AREA OF THE BODY THAT HURTS: Ankles or Feet.

MOST OF THE TIME IT’S: Soleus

The soleus I like to call the forgotten stepchild of the calf. Many people know about the big meaty gastroc at the top of the calf just below the knee. However, the soleus is below it. It ties directly into the ankle because it inserts as part of the Achilles tendon and it travels all the way up the lower leg on the outside.

It is a massive contributor to things like walking, running, jumping and even climbing stairs. Part of the reason for this is because it takes load off the larger calf muscle when the knees are bent. In fact, at a 90 degree bend (ie sitting down) the soleus takes over completely.

The issue here is that most people don’t strengthen this muscle properly. So you end up with a very strong gastroc and then when the soleus needs to work, it can’t as effectively. This can lead to ankle pain and even lower limb issues through the knee. Remember that your feet and ankles take an incredible pounding if you are active, and it is easy to have one part slightly out of alignment or weak.

Many people forget about calf strength and foot strength, and for any athlete or lifter it is important to take care of these areas. They are your link to the ground!

SO WHAT DO I DO?

In my next article I will discuss the solutions to these areas and what you can do to help yourself with stubborn tissue and chronic problems. Until then, do a quick self assessment of these areas. Are they tender when massaged? When you’re stretching them, do you feel a restriction (especially on one side)? Is there a movement I’ve described that gives you pain?

As I mentioned, this isn’t a definitive list. It’s a good starting point. These three muscles are incredibly common for contributing to pain and stiffness, which is why I call them the Big Three. I could probably have called this article the Big Ten, but there’s only so much room. These are the top.

Remember that finding the source of the problem by isolating it should always be a first step towards recovery. As always, if you need any help, or have any questions feel free to reach out. I hope that you found this useful and stay tuned for my next article!