Self Care – Can’t Reach Pain Under the Shoulder Blade

Once in a while, this problem starts by awkwardly reaching up and back, but usually, this is a chronic problem.  The muscle tightens because the upper ribs have become chronically elevated. Also, there is the issue of chronic Forward Head Posture and, usually, a bit of a hook in the upper back. You can get relief and make steady progress toward correcting your posture and releasing the compression of those upper ribs and the base of the neck. 

This pattern not usually bothersome enough to be addressed until the rib heads have become chronically fixated. They can be difficult to release with lasting results. You need to correct some structural issues like Forward Head posture. See your trigger point specialist for more help with this.

This muscle acts like a 5th scalene muscle and many of the same exercises and ideas apply. Serratus Posterior Superior is often the in league with tight scalenes and the squeaky wheel of Forward Head Posture.



Here are several suggestions, starting with the easy ones that you can do without a lot of preparation or time. You can do them at your desk or in the coffee shop. The exercises at the end need to be done in the gym or at home where you have some equipment or some ice.


Sit up straight. Postures that bend forward, like working on your laptop, compresses your abdomen and force you to breathe by pulling up on your ribs with these muscles. As this first post notes, coffee shops and cars are made to accommodate our slumping posture and tight shoulders, so you’re going to need to have an attitude about this until you get your back muscles rebuilt. The exercises that I suggest below help to rebuild your erectors and extrinsic back muscles so that sitting up straight is natural, not something you have to think about.


The exercise in this post is really great for releasing tension in the head, neck and upper back. It is particularly good at strengthening the muscle that lower shoulders and releasing the muscles that keep them high and tight.

Camel Pose by yogabycandace.com

If you’re a yoga practitioner focus on those chest openers, like camel pose and backbends. Observe the tension in the base of your neck as you take your head back. Watch how many people miss this important part of opening their shoulders.



For longer-lasting relief:

Build your extrinsic back muscles. This means that you should do exercises that drive your elbow up and back. Shoulder presses, upright rows, posterior flys, etc. Start with moderate work, every other day. after about 3 weeks, you can go up in weight and intensity.

Do you use an elliptical trainer? You can help by keeping your head back, your chin down and slightly exaggerate the shoulder movement as you move your arms front to back.

The exercise in this post takes a little time, a place to lay down and, probably, some peace and quiet. It also comes later, after you’ve taken the hook out of your upper back and it is better at mobilizing rib heads.

and some related posts…

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.

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