Pain Under Shoulder Blades
There are several postural patterns which cause pain in the upper back, pain under shoulder blades, pain between shoulder blades and even pain down arm.
Here is a list of some of the top postural patterns causing these aches and pains, which we have found in the last 10+ years of working with individuals with chronic pain:
1) Poor Ergonomic Posture at Work-a mouse to the side or forward (you should be able to touch your mouse by JUST raising your hand, with your elbow at your side)
2) Driving for Long Periods of Time-arms up, elbows out, holding your arms up high
3) Holding a Child on a Hip, or another Object in Front of Your Body-use support when you will be holding for a long time
4) Holding a Shoulder Bag/Laptop Bag-creates a holding pattern in the shoulder, into the neck and head
5) Side Sleeping-puts pressure on the jaw, neck and shoulders (belly sleeping is WORSE for you, and BOTH cause
6) Lifting Weights for Chest Muscles Without Balancing the Muscles in the Back
The reasons these postures cause pain under shoulder blades is a little confusing to people who focus just on the point of pain. Part of why we have such success with alleviating long time chronic pain with people who have seen other medical and holistic practitioners is because we look at 360 degrees of the body. Essentially, your muscles and bones are a dynamic system of pulleys. When you step back and look at the point of pain, in this case, pain under shoulder blades, you see that the shoulder blades themselves are attached to a number of muscles. Four of the muscles make up the rotator cuff, several more attach the scapula to the spine, up the neck and occiput (lower aspect of your skull), and some attach to the front or upper part of the arm, and the pec minor actually attaches the scapula to the front of the chest, on your ribs! Considering this complicated muscle structure, when a therapist only works on your back, they may be missing a lot of muscles which may be involved in the pattern causing the " pain under shoulder blades "!
SO, the reason why these positions or postures can be primary causes in the pattern causing the pain under, between and around the shoulder blades, is because they cause a muscular imbalance from front to back, or side to side. We have found working with thousands of people with this pain and tension pattern that relieving pressure (tension), by working the muscles in the front of the body the pain diminishes significantly, quickly, with lasting results. The primary culprits are the pectoralis muscles in the upper chest, and secondary, the muscles in the upper part of your arm (your biceps muscles attaches to the same place as the pec minor). This work is not just massage in our office, but the client stretching at home and work, as well as decreasing or eliminating the activity/posture exacerbating the pattern which can also be causing the pain. For instance, moving the mouse on your computer closer to you, so that you don't have to lift your arm forward or out makes a big difference in the pain pattern...or using a sling or wrap to help distribute weight better in carrying a child, or moving your seat position in your car to avoid leaning forward while driving. ALL of these can help alleviate pressure and pain under shoulder blades and pain in the shoulder and neck.
Be aware: frequently when someone with this pain under shoulder blades, or anywhere in the upper back, neck or shoulders, goes to a physical or massage therapist, the practitioner will only work on the 'point of pain'. Working around and under the shoulder blade is great, and of course, necessary. However, these folks are missing the piece of the puzzle that is possibly causing the MOST pressure on the area! All of the postures named above are causing shortening or tightening in the chest, upper shoulder/neck muscles and muscles in the upper arm. One of the experiences you may have if your practitioner is not working the muscles causing the most pressure is that it feels WORSE when you leave your massage than when you arrived, OR the relief is VERY short lived-only hours or a day.
Stretching is one of the ways to alleviate pressure in these muscle groups, including pain under shoulder blades and the good news about that is is doesn't cost anything and you can do it at home!!
In stretching, we learned that the muscle opens up the most when you allow more than 60 seconds for the stretch, and don't ever stretch to the point of pain! Part of the reason we hold stretches for more than 60 seconds, is that that muscles contract, to keep you from stretching into a tear for about a minute. When we hold the stretch for longer, we actually feel the difference in the muscles, since it's actually opening up the fibers and the connective tissue around that muscle. These are gentle stretches we do, and over time, they are more effective. I usually do them two to three times a day when I am feeling most tight, and hold them for at least TWO full minutes. Stretching when the muscles are warm is really beneficial, since it has more blood in the muscle fibers. Take extreme care when stretching, to keep within a comfortable range.
There are stretches specifically to alleviate pressure causing pain under shoulder blades, and pain between the shoulder blades. MOST of them target the FRONT of your body, to alleviate pressure in the upper back and neck. Right-Click here to download the GTS Massage Stretches for Upper Body pdf file. (or just click to view in another window.)
One stretch not displayed on the Upper Body Stretching pdf above is the 'Seated Neck Stretch'. In this stretch, you would start stretching your right side of your neck, by grasping the bottom of the chair with your right hand and allow your head to bend laterally, so your left ear moves closer to your left shoulder. You would repeat on the left side, because you want to work toward releasing the muscles on both sides!
A chiropractor suggested another neck stretch, not only to open up the muscles in the front of the neck, but also open up the curve in the neck a little. In this stretch, I lay on my bed, with my neck bent backward, letting my head rest over the side of the bed. This one in particular can cause a bit of discomfort, since our necks are used to holding in the opposite direction, which means that holding pattern may have caused muscle restriction over time. Generally, any time you stretch a muscle that has been shortened for a while, it's a little uncomfortable.
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