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 aching along the inside of the shoulder blade while slouching. Also, it is annoyingly tender along the edge of the shoulder blade. The pain in the upper back usually begins when they are slumped forward at a desk for a while. This position lets the shoulder blades spread and the chest close.
The onset of this problem is slow, usually over a long period. For example, it may have suddenly gotten worse after an extended period of reaching up and forward the put things on a shelf. This muscle usually hangs freely but develops this problem when chronically overstretched.
Some people have a chronic problem with this pattern. When you look at the back of these people, they tend to have very straight or hunched upper backs. For these people, either their shoulder blades are close together and wing out, or their shoulder blades are spread far apart and lay close to the ribs. As a result, there is a substantial imbalance between the chest and back muscles. Usually, the chest is short and tight. Conversely, the back stretches open with rounded shoulders.
This pattern typically bothers them when they are in this position for long periods. However, when they stand and move, this goes away quickly.
How You Activate and Intensify This Pain Pattern
The classic pain occurs when you slump forward for long periods. For me, this happens when I slump over my desk. I get a little tired. Usually, I sit a little too far from the keyboard, and my shoulders pull forward. Sometimes, I’m just not maintaining the curve in my low back because the seat is too low. Or, I’m leaning in to look at the fine print. It is worse when I twist to one side, like the picture. And, it radiates from that green point on my shoulder blade.
Hips & Head Forward
It also happens when you lean back and pull your head forward. As the edge of your shoulder blade presses into the hard surface of the chair, this will start to ache. This pain tends to be sharper and more painful at the point of contact. Those tender trigger points along the inside edge of the shoulder blade will activate, and the pattern flares up.
Pain between the shoulder blades while slouching is a common problem in industrialized cultures. Indeed, there is a transition to sedentary work that promotes seated tasks. As a result, the rhomboid muscles, which produce this pattern, are over-stretched as the shoulders drift forward.
Overstretching also might occur when the shoulder extends too far or too much. For example, this posture happens while painting overhead with a short brush so that the shoulder blade stretches up and forward. The same extension may happen when spending a long time stocking a high shelf.
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.
These muscles are flat strips that strap the inside of the shoulder blade to the spine. You can read more about the anatomy in this post about rhomboid muscles.
Very Similar Pain Pattern, Different Muscle
Pain between the shoulder blades is usually some other trigger point that refers to the rhomboid muscles.
Rhomboids get over-treated because the pain is there. The pain here is usually referred from another muscle. Take a serious look at these other posts for the right pattern and associated self-care to get lasting relief.
Getting Relief on Your Own
This post has strategies for getting relief on your own. Explore how to change your activities, stretch and other strategies that relieve the pain associated with this trigger point.
Therapy Notes for Massage and Bodywork
Through Shared Expertise
This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.
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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.