Your Pain Pattern,
What Aggravates It,
The Underlying Anatomy
How to Get relief,
Want to skip ahead?
Here’s a link to my post about
getting relief on your own.
How People Describe This Pain Pattern
People complain of nagging pain in the upper or mid-back, just inside the bottom of the shoulder blade. They have trouble determining what causes it or what to do for relief. They may also complain of sore ribs on that side, just under the armpit or fibrocystic breasts. They usually have a straighter upper back with shoulder blades that wing out instead of laying flatly against the back.
Sometimes, this bothers them while walking or running. That pattern is more common in people who have a rounded upper back. Also, those people are prone to getting a stitch in their side when running or walking.
Often, they have tried many things to take care of it but have not figured out to get relief because the trigger point is not near the site of pain and in a muscle that is seldom addressed.
How You Activate and Intensify This Pain Pattern
This problem is ordinarily caused by forceful or prolonged retraction of the shoulder blade. The most common cause is resting on the elbows while working on a laptop, especially when bent forward or lying on the floor.
There are great examples in this pic. The gal on the right sits up straight. That’s great. But, look at how her shoulders are high and from leaning on her elbows habitually. The guy in the middle is similar but not even trying to sit up straight. On the left, the guy is in the posture that creates this problem. See how he stretches the muscle by leaning on his elbows. The gal by the window does a great job of dropping her shoulders and elbows.
People also get this pattern from a new routine of push-ups or planks during exercise. One client said this started after more vigorous tennis. Another client fell while mountain biking and landed so that it pushed her shoulder back and strained this muscle.
This problem may follow an illness that involves chronic or prolonged coughing. If you have this or other pain from coughing, look at his post. It has simple strategies for relief from different areas of pain that come from chronic coughing.
This muscle helps expand the chest and during labored breathing and may be present during vigorous exercise. It is the same muscle that crates that stitch in your side while running.
The Musculoskeletal Anatomy Behind Your Pain
Anatomy – Throacic Outlet
The anatomy of these structures is important to understand the syndrome. This post walks through the structures one at a time.
Serratus anterior is a fan-shaped muscle that pulls the shoulder blade forward from the back border. It is highly variable. Read more in this post about serratus anterior.
Getting Relief on Your Own
There are stretches and exercises that can help. Look at this post for ideas that are clinically proven to work.
Therapy Notes for Massage and Bodywork
Through Shared Expertise
Review these clinic notes for a more complete approach to treatment.
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Does Your Shoulder Hurt From the Covid-19 Vaccine?
This post offers quick, lasting relief from the pain in your shoulder that came from the vaccine. You will need an ice cube and about 2 minutes.
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.
*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistencies in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.