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Massage Therapy Notes – Rhomboid Major and Minor

Pain between the shoulder blades is seldom rhomboids. At times, the client has trapped and arrgraveted the rhomboid muscles against a hard surface and they need direct calming. More often, they have extreme imbalances between the extrinsic back and extrinsic chest muscles. When the problem is postural, Imbalances are usually easy to see. The shoulders and upper back are notably rounded, or the upper back is very straight, and the shoulder blades are winged out.

People often believe that pressing on the point of pain is the solution. Because of this, rhomboid muscles are often over-treated. I would go with the common bodywork maxim, “He who starts at the point of pain is lost.”

First, know your shoulder patterns. If this is not rhomboid muscles, don’t waste your time diligently digging through the upper back, especially if they have rounded shoulders.

Rhomboids produce achy trigger points just along the border of the scapula. These trigger points are sensitive and need prep with ice or joint works to get a good release.

This is one of those life lessons like the one I talk about in The Godfather of Organized Pain. I’ve witnessed as Dr. Pruitt reached out and pressed those sensitive rhomboid trigger points. Then he mobilized the upper thoracic vertebrae. After that, he pressed on the same spots with little or no tenderness. Rhomboid muscles will not release with any lasting effect unless the facet joints and costovertebral joints along the upper thoracic vertebrae are mobile.

Treatment Sequencing

Rhomboids act more like a rubber band that controls tension. On the other hand, bigger extrinsic muscles like the trapezius, latissimus dorsi, and chest muscles are the prime movers of the scapula. If you are doing additional structural work to correct posture, do that before you treat the rhomboid muscles directly.

This NMT protocol is great for mobilizing vertebrae and melting down the lamina. It starts with the sub-occipital area, which helps with Forward-Head Posture.

Next, treat the rhomboids with this protocol to get rid of local trigger points and further mobilize local joints.

Unless there is some acute injury to the rhomboids, lasting relief is all about rebalancing the shoulder girdle. Evaluate their posture, then use the wall push-ups, chest stretches and other techniques in this post.

The neck stretches for Forward Head Posture in this post are also very helpful.

This site is undergoing changes. Starting in early 2020, we began improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.

Weekly Featured Post

This post shows you how to press out the trigger points and stretch the infraspinatus muscle. It’s a small muscle on the back of the shoulder but creates a number of problems, including:

  • shoulder pain when sleeping
  • loss of grip strength
  • upper neck pain
  • pain along the inside edge of the shoulder blade

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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