[Muscle Monday] Nagging Shoulder Blade Pain Got You Down? - Consider the Rhomboid Major and Minor
Have you ever wondered why you may be getting pain between your shoulder blade and spine?
For the second installment of our posture series, we will be discussing the Rhomboid Major and Minor. While they are two muscles, they almost always work together. Over the next few posts, we will be exploring some of the major muscles related to posture and how they work together. If you'd like to read our previous posts about posture, click here.
Let's get things started. Allow me to present to you the Rhomboid Major and Minor:
This dynamic duo attaches to from the spinous process of the last cervical segment (C7) and upper thoracic spine (T1-5) to the medial border of the shoulder blade. It sits one layer underneath the trapezius muscle, which we discussed in a previous post. The rhomboid minor is located superior/above the larger, broader rhomboid major muscle. Both work together to pull the shoulder blade towards the spine, otherwise known as "scapular retraction."
Image source: Complete Anatomy
This muscle is essential to the stability of the whole shoulder complex as it works to keep the shoulder blade supported during arm movements in all directions.
The rhomboids can be a common source of pain in the area between the spine and your shoulder blade. Often times people will report pain, dull, aching or occasionally sharp pain to that region. This pain is very common in people who do a lot of prolonged work at a computer (particularly in the mousing hand), as well as musicians who have to hold their instruments in one position for long durations (flutists, violinists)
One thing that should be acknowledged is that people can feel pain in other areas aside from the actual tissue source. The picture below demonstrates some common referral patterns where people may experience symptoms when there is a trigger point on the rhomboid ('X' marks the spot).
It is imperative that I warn you that 'trigger points' are not the only source of pain that can refer in this location or pattern. For example, there are joint-related pain that can also refer pain to similar areas. One of the most common ways that cues clinicians like me to suspect muscle-related/trigger point pain (other than palpating the muscle) is if patients often describe the pain as coming on after a prolonged period of time and they have to fidget around or change positions frequently to find a more comfortable posture. If you are unsure, be sure to seek out help from your friendly Physical Therapist (including us) to help you navigate this issue and help steer you back onto the right path.
We will discuss trigger points and what they actually are in an upcoming post.
When looking at overall posture, these muscles are significant because when in a slouched posture, these muscles are commonly in a stretched position. This makes it more difficult for them to generate the amount of force needed to help hold the scapula in place. Remember this image?
The harder these muscles have to work, the less time it takes for them to start to fatigue, which can be interpreted by your brain as that dull, aching sensation that you may feel.
The best way to avoid this fatigue is to make sure that you have enough flexibility in the opposing muscles, such as the pectorals and the upper trapezius, and enough strength in the supporting muscles.
Check out our post on Instagram for some ideas of some simple exercises you can do to get things moving in the right direction.
Can't wait to share more about posture next week
Until next time, stay happy and healthy!
Exercise? Say What?
As a physical therapist, one of the most common phrases that I hear when meeting new patients is "I don't work out as much as I want to." Ok, fine. Are you saying that because you mean it, or are you saying it because you have a health professional sitting in front of you and you feel that you need to say that to us?
You hear it all the time. One of the top New Year's Resolution every year is to "lose weight" and "get in shape", and gyms all around the nation make a KILLING in the beginning of every year of people full of hope and promise of starting the new year off on the right foot.
As a performing artist, it is especially important that you try and have some sort of regular cardiovascular or strength training program set into place. Like I mentioned in my last article, the large majority of musicians spend a large portion of their day either sitting at a desk job or practicing/rehearsing/performing.
You tell me: Same or different?
The Center of Disease Control currently recommends that a minimum of TWO types of physical activity is needed to improve overall health
You can read more about the CDC's recommendation HERE
Now, I am not recommending that everyone go out and jump into these high-intensity programs. What I AM suggesting is that start at a level that you are comfortable with and gradually work your way up to these recommended durations, especially if you are currently leading a sedentary lifestyle. This is something that needs to be built into your daily routine. It will be a struggle at first, but soon enough it will become second nature, just like picking up and dinking around on your axe.
I'm hoping that in the near future, I can talk about specific exercise programs (ie. Insanity, Crossfit, CardioBarre, Piloxing - the newest rage here in LA), but honestly, there is so much stuff out there I would need a separate blog to cover it all.
Long story short, get out, move around, even if it is 'just' walking.
Stop talking and start doing.
Until next time, stay happy and healthy!
Dr. Janice Ying is a Los Angeles-based Physical Therapist. She is board-certified Orthopedic Physical Therapy Specialist and is regarded as a leading expert in the field of Performing Arts Medicine and the development of cutting edge injury prevention and rehabilitation programs for musicians.
The information on this website is intended for educational purposes and should NOT be construed as medical advice. If you have or think you have a health-related issue which needs to be addressed, please seek the help from your local licensed medical professional.