Remedial Massage Therapist is deep

By far one of the most common complaints I hear as a Remedial Massage Therapist is deep, dull pain located between the medial border of your shoulder blade and spine, and after a little overview of the muscular system it’s easy to identify the rhomboids as the dysfunctional muscles. You may get temporary relief from stretching or releasing a few trigger points in the rhomboids with a lacrosse ball, but that’s all it is – temporary. In order for longevity, it’s best to take a holistic approach to this symptom.

As numerous research papers* suggest, strong links between dysfunctional muscle, joint and nerves of the neck can often trigger pain in this intrascapula area. A study by Ralph B. Cloword (1959) applied stimuli to the cervical region to conscious patients, who reported exactly where they experienced any pain and discomfort. This is illustrated in the images below:

Evidently irritation of the lower cervical nerves (C4-C7) can trigger discomfort in this instrascapula area. Other studies have replicated these results with relation to dysfunction in the lower cervical region. Such as, Slipman et. al (2005) Provocative Cervical Discography Symptom Mapping* and Dwyer et. al (1976) Cervical Zygapophyseal Joint Pain Patterns 1*

Generally, this dysfunction can also be associated with tingling or numbness sensation down the arm and neck pain. However, Tanaka et al (2006), found that intrascapular region discomfort is often the initial symptom in radiculopathy and can be present long before any tingling is felt down the arm. So although you may be experiencing pain in the rhomboids, it may be more of a secondary response to a dysfunction in the neck region.

In order to reduce the likelihood of recurring rhomboid pain, lifestyle modifications need to be taken into consideration. Of course, it’s difficult to alter every aspect of your life, a general rule of thumb here is to change what you can, don’t worry about what you can’t.

1. STRESS

Increases the sensitivity of nerves, try to alter your situation or your response to stress triggering events.

Stepping away from these events, taking deep breaths for a minute or two or redirecting your attention to something else are key to avoid triggering your sympathetic nervous system.

2. SLEEP

Poor sleep quality and quantity will increase the likelihood of lingering symptomatic pains.

Avoid artificial lighting emitted through your phone, laptop or tv while trying to sleep. Set up a nightly routine to help you wind down after the day is done, leaving an hour or so before bed without the use of any electronics.

Caffeine can also have a detrimental effect on your sleep. Be cautious of consumption time as it can linger within your system which can in-turn disrupt your sleeping pattern.

3. INACTIVITY

This isn’t just from laying in bed all day, physical inactivity due to hours spent working or studying at your desk without any active breaks like walking or stretching in-between will lead to pain in your upper back. Moreover, trying to keep up with a “perfect posture” will also amplify symptoms. Try finding positions that are most comfortable for you and move into those positions often.

Give the exercises below a try to help with any stiffness or discomfort felt in your upper back region.

EXERCISES

SCATTER THESE MOVEMENTS THROUGHOUT THE DAY, EVERY COUPLE OF HOURS, TO BREAK UP ANY STATIONARY POSITIONS.

Try not to aim for a specific set/rep scheme, instead opt for 30-60 seconds of each movement and repeat as many times as you feel necessary throughout the day.

1. THORACIC EXTENSION WITH FOAM ROLLER

(2 – 5 SETS X 6 – 15)

2. HALF KNEELING THORACIC ROTATION

(2 – 5 SETS X 6 – 15)

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3. SCAPULAR PUSH UP

(2 – 5 SETS X 6 – 15)