Trigger Points – Radiating Pain Under the Base of the Shoulder-Blade

Client’s Description

referral - iliocostalis thoracis - R6 - posteriorPeople complain of achy, nagging pain that is focused near the base of the shoulder-blade. It may radiate upward along the edge of the shoulder-blade and toward the spine. If there was some sort recent event that started this, it may be a sharper sensation.

referral - iliocostalis thoracis - R6 - anteriorPain in the middle or the left side of the chest can be cardiac related and should be cleared by a medical doctor before bodywork is sought as relief.

They may also complain of pain that radiates through their rib cage to the front of their chest. It is often confused with heart related symptoms, even thought the focus of pain is in the back.

When this is chronic, clients are usually not aware of the onset of symptoms. When it is acute, it is caused by some activity that unexpectedly twists the torso like a car accident, roller coaster ride or slipping on a slick floor.

This pattern can bother them during many daily activities, especially when they are bent slightly forward. One client was a corporate negotiator that spent a great time at a conference table. This posture had given him short powerful pecs that constantly overworked these muscles in his upper back.

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Self Care

breathing on magazines - vid capThe breathing exercise in this post is quite useful for immediate relief of this problem. I usually have to walk clients through this exercise for a full 10 minutes. Without support many of them quit this too quickly or loose focus. They often fail to breath all the way in, until they feel tension in their back and all the way out until they feel tension in their back as well. When done well, this breathing exercise is consistent offering relief. A hot shower or ice-massage before the exercise helps.

If the problem is rounded shoulders and tight pectoral muscles, the doorway stretches in this post are helpful for taking pressure off of these stressed back muscles. Do those stretches with the elbows above the shoulders, even with the shoulders and below the shoulders to release the all sections of the chest.

Postural corrections by a therapist is usually needed for long-term relief, especially when this has become chronic.

Therapy Notes

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Iliocostalis binds ribs together. Trigger points are strongly related to fixations at the costovertebral joints. This trigger point, near the lateral angle of the 6th rib, responds to the release of fixations around T4-T8.

Many clients wouldn’t complain of this chest pain as they think it is a heart issue or they aren’t interested in massage there. In my practice, they usually tell me of pain and sensation in unusual areas as they realize that the pain and the trigger point are usually in different places. They also realize that it may the parasympathetic referral of a distal trigger point. Educating the client on trigger points can be very useful for more effective treatment.

Similar Patterns

Click on these categories to see if there is a referral pattern that better describes your concerns.

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Tony Preston has a practice in Atlanta, Georgia where he sees clients.

He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

Question? Comment? Typo?
The Body Guild.org
(404) 226-1363
tony@thebodyguild.org


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