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Writer's pictureRain Green

Understanding Shoulder Blade Pain: Common Causes and Treatments

Updated: Nov 8

The shoulder blade, or scapula, is a triangular, flat bone at the back of your shoulder girdle. It plays a crucial role in connecting the collarbone to the upper arm, allowing for a wide range of shoulder movement. But when discomfort arises in or around this area, it can affect everything from your mobility to your daily activities.

Shoulder Blade Pain

There are many potential reasons for pain around the shoulder blade, which can vary in type and intensity. It may be sharp, burning, or radiate into surrounding muscles, or it may present as a tender ache that spreads across the upper back. Let’s explore some common causes and approaches to managing shoulder blade pain.

 

1.    Poor Posture and Muscle Strain

Poor posture is a frequent culprit behind shoulder blade discomfort, as prolonged slouching weakens back muscles, putting pressure on the structures around the shoulder blade.

  • Text Neck: Spending extended time looking down at a phone or tablet strains neck and shoulder muscles, resulting in “text neck.”

  • Side Sleeping: Side sleepers who sleep with their lower arm in front may push the scapula outward, leading to "winged scapula" or scapular dyskinesis, a condition where the shoulder blade juts out.

  • Slouching at a Desk: Sitting hunched over a desk weakens upper back muscles and can strain ligaments and spinal discs, particularly if you work on a laptop without ergonomic support.

 

2.    Injury from Overhead Lifting or Reaching

Lifting heavy objects overhead, or repetitively reaching up without proper form, strains the muscles surrounding the shoulder blade. Situations that may cause this include:

  • Lifting Luggage: Raising heavy bags into overhead compartments can pull on shoulder muscles.

  • Overhead Exercises: Weightlifting exercises, such as the overhead press, can stress the shoulder if done with poor form or excessive weight.

  • Repetitive Overhead Sports: Sports like swimming, which require repetitive overhead movement, can lead to overuse injuries and even rotator cuff tears.


3.    Overuse Injuries

When shoulder muscles and ligaments are overused, such as during sudden increases in activity, they can become strained and painful. Common scenarios include:

  • Repetitive Gardening: Extended or repetitive motions, like trimming hedges or planting, put excess strain on shoulder muscles.

  • Racket Sports: Playing sports like tennis without adequate training can overstress the shoulder blade, especially for beginners or those who play intensely after a break.

In overuse injuries, inflammation of the bursa near the shoulder blade can occur, leading to painful conditions like scapulothoracic bursitis, sometimes called “snapping scapula syndrome.”

 

4.    Cervical or Thoracic Disc Herniation

A herniated disc in the neck (cervical spine) can press on nerves that radiate pain to the shoulder blade area. Commonly, cervical disc herniations cause a nerve-related pain described as burning, stinging, or tingling near the shoulder blade. If a thoracic disc is affected, such as in the C7-T1 vertebrae, pain typically radiates to the area below the shoulder blade and may be sharp or electric-like.

 

5.    Facet Joint Arthritis

Facet joints are small, jointed areas in the spine. When these joints in the lower cervical spine become arthritic, they can refer pain to the shoulder blade area. Pain from facet joint arthritis is often a dull ache but can feel sharper when turning your neck or looking over the shoulder on the affected side.

 

6.    Dislocated Rib

A dislocated rib may occur from trauma, repetitive strain, or lifting movements that cause the rib to misalign. This can create a sharp pain near the shoulder blade, often exacerbated when reaching overhead.

 

7.    Compression Fracture

A compression fracture, especially in people with osteoporosis, occurs when one of the spine’s vertebrae collapses under pressure. This condition can cause sudden, sharp pain in the shoulder blade region, particularly if pressure is applied to the affected area.

 

8.    Underlying Health Conditions

In some cases, shoulder blade pain may signal more serious health concerns, such as:

  • Heart Conditions: Conditions like aortic dissection or even a heart attack can cause upper back pain, which may radiate to the shoulder blade area.

  • Lung Conditions: Although rare, lung issues such as a pulmonary embolism can cause pain under the shoulder blade, especially when breathing deeply.

 

Red Flags:

Pain that persists or worsens over time, affects your ability to perform daily tasks, or is accompanied by symptoms such as headache, tingling, weakness, or nausea warrants medical evaluation. Certain symptoms, including fever, unexplained weight loss, or respiratory issues, may also suggest an underlying systemic condition.

 

Therapy Relief Options:

Addressing shoulder blade pain often involves a combination of lifestyle changes, posture improvements, and strengthening exercises. However, in some cases, medical or surgical treatment may be necessary to relieve persistent pain and restore function. Here’s an overview of therapy approaches

 

1. Physical Therapy and Exercise

  • Physical therapists design exercises to strengthen muscles that stabilize the shoulder blade and improve postural alignment, which prevents future pain and relieves existing discomfort. Specific exercises targeting the rotator cuff, rhomboids, and trapezius muscles are often included.

  • Stretching routines for the upper back, neck, and shoulders are also emphasized to reduce stiffness around the shoulder blade and alleviate pressure on nerves, which can relieve pain from conditions like cervical spine issues or facet joint arthritis​.

2. Posture Correction and Ergonomic Changes

  • Correcting posture is crucial for alleviating shoulder blade pain, especially when it’s exacerbated by long hours of sitting or improper ergonomics. Adjusting the height of screens, using supportive chairs, and maintaining a neutral spine while seated can all help reduce strain on muscles around the shoulder blade. Improved posture also prevents the development of new trigger points​.

3. Manual Therapy for Joint and Nerve-Related Pain

  • For cases where shoulder blade pain is related to spinal issues, such as a cervical herniated disc or facet joint arthritis, manual therapy, such as gentle spinal mobilization, may be beneficial. Physical therapists or chiropractors may apply manual adjustments to alleviate pressure on nerves and reduce referred pain around the shoulder blade.

4. Strength and Conditioning Exercises

  • Strengthening exercises, particularly for the muscles in the upper back and shoulders, provide long-term benefits by enhancing stability and reducing strain. Exercises like rows, shoulder rotations, and scapular squeezes strengthen the muscles that support the shoulder blade, helping to prevent pain from recurring or worsening.

5. Trigger Point Therapy

  • Relieving Tension and Knots: Trigger point therapy can be especially effective for shoulder blade pain stemming from muscle strain, tension, or prolonged posture-related stress, particularly for pain originating from the rhomboid, trapezius, levator scapulae, and infraspinatus muscles. This therapy helps release “knots” or sensitive points within these muscles that commonly refer pain to the shoulder blade area, often causing aching, tightness, or stiffness. For example, trigger points in the rhomboids frequently lead to pain between the shoulder blades, often presenting as a superficial ache that can be relieved through targeted release techniques.

  • Improving Range of Motion: In cases where shoulder blade pain is caused by poor posture, repetitive strain, or muscle overload (such as prolonged sitting or lifting overhead), trigger point therapy aims to relax these tightened muscles, reducing inflammation and improving mobility.

 

For recurring pain, self-massage tools like LittleMum Shoulder Deep Tissue Massager allow individuals to release trigger points on their own, which can help with ongoing pain management, particularly when posture or repetitive motions are a factor.


In the instructions below we will show you what areas you shall work to achieve relief with LittleMum Shoulder Deep Tissue Massager. It is important to work all areas of the scapula so that tension in one area isn’t released at the expense of another. You will need reposition the massager up and down the middle back as instructed below.


Firstly, lie back on the floor with your knees bent. Position LittleMum Massager on deep tissue side under your neck or back. The massager curve is intended to stretch out a bent-forward upper and middle back. Start your massage at the upper border of your shoulder blade.

Shoulder Blade Pain Release

Here is your levator scapulae and your upper trapezius located. You can feel the upper border, which is also called angulus superior, by moving the massager until the bottom line hits the upper bony landmark of shoulder blade.

Slowly move your arms away from your body. Pausing when you feel slight resistance, so that it stretches the pectoral muscles and you’re getting a complete stretch.

Afterwards, massage the whole area between the inner border of your shoulder blade, also called Margo Medialis. The muscles that you are going to work here, are your rhomboids, and your trapezius.

Shoulder Blade Pain

When you are doing with this area, you want to concentrate exclusively on the upper half of the inner border of your shoulder blade. This time you can cross the arm of the affected side in front of your body and keep it there. This way, your shoulder blade will rotate and set free the fibers of your serratus posterior superior, which are usually hidden underneath your shoulder blade.

Shoulder Blade Pain Massage

Last there is only one area left, which is directly on the lower border/angle of your shoulder blade. Here, some fibres of your latissimus dorsi attach. Lay on your back and place the LittleMum Deep Tissue massage’s lower angle (trigger point side) in the soft tissue area between your 12th rib and the top of your pelvis. Bend your knees and place your feet flat on the floor. Stay here, for more pressure open your knees and lay it on the floor. Then, either lay still or push into your left foot to hover your hips and move your pelvis forward and back.

latissimus dorsi

The massager can be also used on a chair or on your car seat to give your back a real trigger point massage. Place the trigger point side pointing to your back . It features a patented design and is constructed of high-strength aluminum alloy core and food-grade silicone impregnated. It is weighted for precise placement and comes with a silicone coating for comfort, along with a 15-year warranty against defects. It is FSA or HSA eligible when purchased through Amazon, you can purchase it on Amazon using the link below.

However, If you prefer using leverage to apply targeted pressure to knots and trigger points, reaching the levator scapulae and areas between your shoulder blades, the LittleMum Cane Massager is an excellent choice. The LittleMum Cane Massager is engineered for superior precision compared to lightweight plastic massage canes. Its thumb-like knob delivers firm pressure to shoulder blade trigger points without being sharp or rigid, offering effective myofascial release akin to that of a massage therapist's thumb. Crafted from high-quality, durable materials like 304-grade stainless steel and food-grade silicone, the LittleMum Cane Massager is FSA or HSA eligible when purchased through Amazon using the link below.

References:

  • Wang, S. M., et al. (2010). "Effect of Myofascial Trigger Point Release on Muscle Strength and Function in Patients with Myofascial Pain Syndrome." Journal of Rehabilitation Medicine, 42(3), 236-241. doi:10.2340/16501977-0412.

    • This study highlights the effects of trigger point therapy on muscle function, which includes the levator scapulae, showing improvement in strength and pain reduction.

  • Kase, K., et al. (2013). "Effectiveness of myofascial trigger point therapy on muscle pain: a meta-analysis." The Clinical Journal of Pain, 29(5), 479-487. doi:10.1097/AJP.0b013e31826f6b6c.

    • This meta-analysis reviews various studies on trigger point therapy's effectiveness, including its role in alleviating pain in specific muscle groups such as the levator scapulae.

  • Schmid, A. B., et al. (2012). "Treatment of myofascial trigger points in the upper trapezius muscle: a randomized controlled trial." Physiotherapy Research International, 17(4), 223-230. doi:10.1002/pri.1441.

    • This randomized controlled trial examines trigger point therapy for the upper trapezius, which is closely related to the levator scapulae, showing significant pain relief.

  • Nagrale, A. V., et al. (2015). "Effect of trigger point release technique on pain and range of motion in patients with myofascial pain syndrome of the upper trapezius: A randomized controlled trial." Journal of Back and Musculoskeletal Rehabilitation, 28(3), 543-550. doi:10.3233/BMR-150591.

    • This trial specifically evaluates the efficacy of trigger point release techniques on the upper trapezius and adjacent muscles, including the levator scapulae, demonstrating effective pain relief.


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