"People often associate this sensation of a 'knot' as an area of tightness that must be pounded on, but for many of the people that I see in my practice, it can actually indicate an area lacking stability, especially if stretching [and] massage hasn't helped," Dr. Clare explains. "If an area is lacking stability or strength, the body will try to provide this false stability by 'tightening' things in the area—it's protective in a way." In other words, the more you try to stretch and massage out the knot, the worse it gets. To break that cycle, Dr. Clare recommends strengthening the mid-back area, which will help diminish the tightness and make the "knots" magically disappear. 

So how do you build mid-back strength? Below, Dr. Clare guides us through the top move she recommends adding to your routine.

First, let's explore what causes these faux mid-back knots. Dr. Clare notes that repetitive motions, injuries to the area, and prolonged static postures (i.e., slouching or holding yourself upright for long periods) can all contribute to mid-back discomfort.

This exercise works the scapula stabilizers, which provide stability through the shoulder blade. It also targets the rotator cuff, which supports the arm bone in the shoulder socket, keeping it stable during movement. And this move also helps improve thoracic mobility, which Dr. Clare explains refers to your mid-back mobility, or how much you can move by bending forward and backward or twisting through your mid-back.

Again, the goal is to strengthen the mid-back. "We're trying to provide some extra stability to the area, so the body isn't reactively guarding," Dr. Clare says. You'll need a foam roller for this exercise. Dr. Clare suggests an 18-inch high-density roller, which has lots of versatility, but really, any roller will do the trick. Here's how to do it:

Dr. Clare recommends doing 30 reps three or four times per week. As with most things, consistency is the key to achieving results. Generally, she says after three to four weeks, you should begin to notice changes in functionality or discomfort. 

If kneeling is an issue, you can also do this movement standing up with the foam roller against a wall. Dr. Clare says you can also lay on the ground flat on your stomach and slide your hands along the floor in front of you, no foam roller required. 

Lastly, Dr. Clare encourages listening to your body and seeing an expert if something doesn't feel right. An achy mid-back can also be pain coming from your neck (hence why working with the mid-back doesn't help) or a result of nerve damage or other non-musculoskeletal conditions or illnesses. Better to be sure—and safe—before moving ahead.

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