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01.06.2012

Pain below shoulder blade near spine, attractive world - .

Author: admin
Pain between shoulder blades can produce that nagging type of pain that is difficult to reach.
If there has been a past injury to the area or from years of poor posture, a degenerative condition like arthritis can develop in the area between the shoulders causing upper back pain.
While there are many muscles that can cause pain between the shoulder blades, the major muscles often involved are the trapezius and the rhomboid. The use of lumbar support pillows, which help maintain the normal curve of the lower back when sitting, can help to correct rounded shoulder posture, especially when driving a car or working at a desk.
For some, the use of a posture support brace can assist the muscles of the upper back and spine to assume the correct posture. When using armrests on a chair, having them too low can stress the trapezius muscle, too high can cause tension of the neck and shoulder muscles, so try to sit close to your desk with the armrests at desk level. Often, with rounded shoulder posture, the chest muscles (pectorals) can become tight and the in the door stretch can help with tight pectoral muscles and overstretched trapezius and rhomboid muscles. For those who like to sleep on their side and have difficulty finding a comfortable position due to pain between shoulder blades, a pillow can be placed under the affected arm to prevent it from rotating forward and stretching the trapezius and rhomboid muscles. A facet joint problem involving the small joints in the back of the neck may cause pain between shoulder blades. The lower discs in the neck can become herniated, torn or degenerative changes can occur which place pressure on the nerves and this may also cause pain between shoulder blades. Difficult cases involving pain between shoulder blades may require medications and perhaps an orthopedic consultation, however, some home treatments using moist heat, posture changes and traction units may help.
Since these various conditions may occur together, a more comprehensive approach may be required to treat pain between shoulder blades not responding to basic postural modification and conservative therapies.
A 2015 study in the journal Medicine (Baltimore), found coblation technology or nucleoplasty can be an effective, minimally invasive and safe procedure for chronic cervical disc herniation that is producing upper back pain.
The Imbue Pain Relief Patch temporarily relieves minor aches and pains of muscles and joints. The shoulder is a complicated joint, and treating it can sometimes be a complicated process – usually because the pain is so often coming from a place other than where it hurts the most.
Pain of the shoulder, whether it is felt in the back, in the front, at the side, or right in the joint, is usually due to muscular tension in the muscles surrounding and overlying the shoulder blade. Any especially tender region is a good candidate for placement of the Imbue Patch placement, but the areas most likely to yield positive results are those that produce broad, expansive pain patterns – especially when they either alleviate or reproduce the same pain you have been experiencing. In each of the following diagrams, the X’s indicate common sites of trigger points in the muscle, and the red shading shows the pain pattern these trigger points are capable of causing.
Infraspinatus, despite being a very easy muscle to access, is often overlooked, maybe because the bulk of it is on top of the shoulder blade and people either don’t think to press on bone or believe it’s sore just because there’s bone beneath it.
Serratus posterior superior connects the spine of the upper back to the ribs underneath the shoulder blade. To find this trigger point, press firmly on the area just to the outside of the lower tip of the shoulder blade (feel a few inches in all directions).
Subscapularis is a tricky muscle to find and a painful one to work on, but it’s often the key to stubborn shoulder pain. The black X on the left points to the edge of the shoulder blade where it’s possible with some digging to feel a bit of subscapularis.
Massaging these spots is usually unpleasant but if subscapularis is implicated in shoulder pain, releasing tension here can provide almost immediate relief.
Start by pressing just above the middle of your collar bone on the side that you have pain on. Strain or trigger points in the biceps muscle (shown in red in the diagram) can cause shoulder pain, primarily in the front. These muscles, more commonly known as the “pecs,” radiate pain into the chest, shoulder, and arm. Although the muscular causes of shoulder pain listed above are most common, there are other potential sources of pain in the shoulder, which you can investigate with your healthcare practitioner if necessary. This quote was a first clue, but I couldn't understand it at the time, and even if I had, my shoulder blades seemed impossible to control, like wiggling one's ears. If very tight and short, the pectoralis minor may need to be stretched first to allow the shoulder blades to tilt back up. An exception to use of part one of Fix the Shoulder Blades Exercise is a condition called Depressed or Droopy Shoulders Syndrome that is often present in women with low set, steeply sloping shoulders and long necks. A more detailed look at Fix the Shoulder Blades Exercise: It helps to think of the shoulder blades as two rigid, triangular, curved plates lying on and fitting the contour of the posterior rib cage.
And #2—to pull the shoulder blades closer together (only needed if they are usually held more than 4 inches apart in one's usual posture). The muscles that anchor the shoulder blades to the spine, the rhomboids, and middle and lower trapezius are normal length and strength.
Most often it is related to muscle problems, however, a herniated disc or pinched nerve in the neck can cause pain in this area, along with neck joint irritation.
The trapezius is a large muscle, while the rhomboid is a smaller muscle that runs between the spine and the shoulder blades.
The back of the chair should not be pushed forward and should have a slight backward angle. This usually requires no general anesthesia and is more like a spinal injection procedure as an outpatient procedure. In the diagrams below, the X’s show the locations of common trigger points (localized muscle strain), and the colored shading shows the pain pattern each trigger point produces.


Sometimes it comes from the crest of the shoulder (7 – trapezius) or is referred upward from the muscles of the back of the arm (9 – triceps). The first is to study the pain patterns of trigger points in each of these muscles and try to match one of these patterns to the pain you are experiencing. It runs from the upper surface of the shoulder blade through the shoulder joint and attaches to the top of the arm bone (humerus). When it is strained, it produces a dull ache under the shoulder blade, and can also refer pain to the back of the shoulder joint, the tip of the elbow, the outside of the wrist, the pinky side of the hand, the pinky, and even the chest directly in front of the muscle.
This muscle is primarily attached to the front surface of the shoulder blade – the side that faces the back of the rib cage – and it connects to the upper arm. This is easiest when the shoulder blade is made to protrude beyond the side of the rib cage. Pain may also refer to the crease of the elbow and sometimes to the top of the shoulder blade.
Trigger points at the upper inside aspect of the triceps can cause pain that radiates up the back of the arm into the back of the shoulder, and also down to the outer aspect of the elbow, mimicking “tennis elbow.” The X’s in this diagram show common sites of irritability in the triceps where trigger points occur (feel the back of the arm thoroughly, as they may occur elsewhere) and the red shading shows the common pain pattern.
The four rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) hold together and move the shoulder joint, and anything from minor pinching to a complete tear is possible.
You should not use the information on this web site for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. A correction strategy is to have the patient move the coracoid upward and the acromion backwards [which simply means to rotate or tilt the shoulder blade upward so it's more vertical and lies flat on the back.
It strengthened the muscles that anchor the shoulder blades to the thoracic spine, thus insuring that the weight of the arms and the forces generated by the arms in weight-bearing exercise would be transferred to the sturdier spinal column of the back, rather than hanging off the more delicate cervical spine of the neck. Do not do part one, the pull down, of Fix the Shoulder Blades exercise because pain and nerve impingement may result. Similarly, those of us with poor shoulder blade position and function need to be able to see our backs to figure out how to correct the problem. Check slope of collarbones - depressed or horizontal collarbones indicate that the shoulder blades are already set too low in back.
The effort should be felt in the mid to lower back, where muscles from below — the lower trapezius and perhaps lower fibers of serratus anterior (see last illustration below) contract and pull down on the shoulder blades.
Effort should come from between the shoulder blades, not from moving or twisting arms or hands. An over-stretched upper trapezius causes depressed shoulders, which is a potential source of neck pain. May be caused by weakness or paralysis of serratus anterior, especially after traumatic injury to upper shoulder and lower neck area (e.g. But these two muscles aren't adequate for the extra load* and in response they become hyperactive and remain tight, always trying to pull the shoulders up toward the ears. Half of that weight is transmitted to the spinal column in back via the Rhomboids and Trapezius. The usual therapeutic exercises for shoulders, such as seated rows and pull downs that use the arms in pulling or lifting weights, can be painful unless there's already some degree of shoulder blade stabilization. Since arthritic changes and joint problems may occur, this is a common area for careful spinal adjustments.
This pain is often several inches (or more) away from the trigger point at which it originates.
It is somewhat hidden under other layers of muscle, so press deeply to feel all along the region just above a horizontal ridge of bone on the shoulder blade (the spine of the scapula).
The primary serratus posterior superior trigger points occur on top of the ribs, just next to or slightly underneath the shoulder blade. The one implicated in shoulder pain is located near the lower, outside edge of the shoulder blade, on top of the ribs. The red shading in the diagram shows the areas of pain this muscle is capable of producing, which includes the area over the shoulder blade, the back of the shoulder, the shoulder joint itself, the underside of the arm, and the wrist. This can be accomplished by bringing your arm across your chest and then using the thumb of the other hand to feel for the edge of the shoulder blade a bit below the armpit.
If you wish to try, another area to consider is over the back of the shoulder blade (directly behind this muscle) in the regions of the outlined X’s on the right side of this diagram. They are fairly unpleasant to have massaged, but when the scalenes are implicated in pain, getting them to relax can yield profound results. Press methodically in this muscle, especially midway between the shoulder and the elbow, to locate any significantly tender spots. The green shading shows pec major’s pain pattern – primarily into the front of the shoulder and side of the chest. Trigger points in the deltoid are unique in that their pain is felt right at the point, and does not spread much beyond this region. The weight of the arms transfers entirely to the shoulder blade, which houses the shoulder joint. The pinching together of shoulder blades helps strengthen the rhomboids, while lifting the shoulders activates and shortens the upper trapezius.
It is responsible for pulling on and tilting the top of the shoulder blade down, toward the front of the body. The Unilateral Corner Stretch is reported to yield the best pec minor stretch, but there is a risk that the anterior shoulder capsule will be over-stretched.
The shoulder blades are held wider apart because the muscles between them (Rhomboids, Middle and Lower Trapezius) must stretch for the kyphotic spinal curve to bulge out.


The shoulders come back to a more normal position, which allows the chest to expand, and stretches the pectoral muscles underlying the breast area and the intercostal muscles between the ribs, so that they return to a normal length. Otherwise, spasm and pain prevents the effort from going into strengthening the rhomboids, and middle and lower traps, instead of the over-worked default muscles—the upper traps and levator scapula. Pain between the shoulders can also be referred by the heart, stomach and gallbladder or, if you have osteoporosis, a possible compression fracture. The muscles become overstretched and weak, placing abnormal stress on the spinal bones, altered motion and, over time, can develop scar tissues from small tears which develop. Place the ball or release tool on the floor and lay on your back with the ball or tool between the shoulder blades. A neck pillow designed for side sleeping can add the final touch to a comfortable night’s sleep that reduces pain between shoulder blades. If application of the Imbue Patch directly to the knee does not significantly improve your pain, applying the Imbue Pain Relief Patch at the site of strain in nearby muscles sometimes yields better results.
I prefer the second approach, because even if you correctly identify a muscle with trigger points that is producing your pain, there are often other muscles that are also implicated, and you won’t know this until you discover them.
Trigger points in supraspinatus can cause aching in the shoulder, sometimes extending to the outside of the upper arm, forearm, and even wrist; raising the arm may be difficult and painful.
The infraspinatus joins the back of the shoulder blade to the top of the arm bone (humerus) and when it’s irritated, it usually sends pain deep into the joint and into the front of the shoulder, sometimes also inhibiting shoulder movement (“frozen shoulder”). The red shading shows pec minor’s pain pattern – more broadly in the chest, and also the shoulder, and sometimes down the inside of the arm to the palm and fingers. Also, while many other muscles refer pain into the deltoid area, the deltoid is somewhat less likely to be the primary source of pain here.
At the shoulder joint, the upper arm bone (the humerus) inserts into the glenoid cavity of the shoulder blade.
Both the rhomboids and upper trapezius are over-stretched when shoulder blades are depressed, and the lower trapezius is too short and tight.
The results should be that the kephotic curve of the thoracic spine flattens (if flexible), and the neck and head come back into line with the spinal column.) Very importantly, the movement takes place in back and not directly on top of the shoulders. Focal points of hyperactivity are felt as tender knots at the levator scapulas' points of attachment to the shoulder blade (red X in illustration above and at left). I wasn't able to activate the correct muscles during my 4 plus courses of Physical Therapy for neck and shoulders. You can control the pressure and when you find a tender area, hold it until the pain gradually fades – about 20 to 30 seconds, although it may take a minute.
This pain is typically felt at the lower portion of the shoulder blade and back of the shoulder, but it can also spread down the back and inside of the upper arm and forearm, and even into the ring finger and pinky. If you find one (or more), and especially if they produce pain that radiates upward, place the Imbue Patch here.
Rather than hunting for trigger points of one muscle or the other, methodically feel this whole region, searching for tenderness and broad pain into the shoulder. Doing a high shrug with shoulders up as high as they will go, also stretches the lower trapezius and helps the shoulder blades rise higher. Currently, with my neck pain resolved, I may do one rep a day in the course of correcting my posture, especially when sitting. If slouched posture is habitual, the Rhomboids, and Upper and Lower Trapezius muscles, which anchor the shoulder blades to the long thoracic spinal column of the back, stay elongated and weaken (stretch weakness and atrophy).
Unfortunately in slouched posture, the levator scapula and the upper trapezius are also stretched—their points of attachment on the shoulder blade having moved further away.
I knew the effort was supposed to be coming from the shoulder blades area and not the arms, but that was next to impossible when one's back and shoulder blades are like an unknown territory. With the other hand, you can get your fingers or thumb into the tight space between the edge of your shoulder blade and the rib cage.
Pay special attention to points that produce an unpleasant painful or nervy sensation that may travel to other areas.
The X’s in the diagram indicate common sites of trigger points, but you should methodically press on the muscle in vertical lines, starting at the front and gradually making your way to the back. I absolutely needed them; the touch of the physical therapist guiding me through the shoulder blade pull-down exercise was not enough, neither was someone telling me what my shoulder blades were doing. Without a good way to see what should be activated, there is lack of innate body feel for what is really going on back there.
Trigger points in infraspinatus may weaken the shoulder and make it difficult to reach behind the back.
If you find any spots with significant tenderness, massage them and apply the Imbue Pain Relief Patch.
It was much later that I discovered that it was possible to learn to contract and strengthen the muscles that control shoulder blade movements without using the arms, but mirrors were needed for visual feedback. Part 2, Pinch the Shoulder Blades is still useful for depressed shoulders if the shoulder blades with arms at sides are held more than 5 inches apart. However, if you have the common problem of *Upper Trapezius Dominant with weak lower trapezius, upward sloping collar bones, and shoulder blades that ride too high on the back and tilt forward to to the front of body, then Olderman's book won't help as much.



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