These days, pain and tension between the shoulder blades is a condition commonly seen in desk jockeys regardless of their age. Even children as young as elementary school-age doing school work on their digital devices have similar complaints. The first step to relieving the pain between your shoulder blades, is to understand what’s causing it. That way the pain not only goes away but stays away.
In this blog we will cover:
- What causes pain between the shoulder blades
- How the neck plays a role in pain between the shoulder blades
- The impact of ergonomics on pain between the shoulder blades
- Pain between the shoulder blades when breathing
- Best stretches and exercises for pain between the shoulder blades
What Causes Pain Between the Shoulder Blades?
Musculoskeletal conditions stem from both your muscles and bones which is exactly what pain between the shoulder blades is. To understand why you’re experiencing this pain let’s go over a few key points.
- Your muscles have 2 main functions. One is to stabilize a joint or part of your body. And the other is to actually move that joint or body part. This is how we move!
- Your brain is in charge of every function in your body, including telling your muscles what to do and when to do it. You see, there is a right order in signaling, contracting muscles, and moving the body parts. Any deviation from that order means dysfunction. This translates into insufficiency, pain, and discomfort.
- Your body parts never function in isolation. The different parts work together to perform movements and this is coordinated by the brain. The brain has to figure out what to do given what you throw at it. That plays a huge role in not only pain but the resolution of it.
Rhomboid and Serratus posterior muscles
Now I want you to know that pain between your shoulder blades, is not necessarily an issue in that area. So looking at just the spot of pain/discomfort to resolve any issue is simply a partial solution.
The picture to the right highlights where your pain may be. But the muscles highlighted are not necessarily the root cause of that pain. Massaging this area, though it may feel good for a short while, won’t do much long-term. The question that needs to be asked is why you’re feeling pain in those muscles. And the answer is in your posture and how you go about your days.
What is Your Posture Like?
The majority of people today have what is called a forward head posture accompanied by rolled forward shoulders. We can thank our computers and other mobile devices for that! With prolonged sitting we see:
- Collapsing into your chair
- Shoulder rolling forward
- The neck going forward
- The head over the neck look looking
While the body is fully capable of doing all those movements, it is the length of time it stays in that position that is the problem. Along with all of this, you collapse over your diaphragm! Which means your breathing apparatus is compromised! So you’re working on low oxygen with no core support. This means EVERY FUNCTION of your body is impacted.
Resuming this posture daily ends up with:
- The muscles in the back of the neck and shoulders becoming overstretched and weak.
- In the front, muscles become short, overly contracted, and weak!
- The shoulder blades no longer lay nicely against the body (winged scapula).
- The shoulder (ball inside the socket) sits too far forward within the joint.
This is not only the case when you’re sitting behind your desk, but affects every movement when you’re at home, driving, at the gym, running on the weekend, etc. This is why devices and gadgets that ‘zap’ or remind you to sit upright are not going to work! Your lifestyle has modified the blueprint of movement (Homunculus) so unless you work on bringing it back to how it was, your posture is NOT going to change. I will tell you more about this below but first, watch this video to understand what exactly is happening without you realizing it!!
How to Change the Blueprint of Movement?
You are born with a blueprint of movement and sensation called Homunculus at birth. And in the first 2 years of your life, it gets detailed just like the ‘software’ dictates!! This is why all babies on the planet regardless of the many differences follow the same patterns of movement and movement development. We all are designed the same way.
This blueprint gets modified based on our injuries, lifestyle, habits, and choices we make. While that is a beautiful thing that allows adaptability, it can work against us. That is because we now no longer moving based on the map of movement and sensation.
Through Postural Neurology, we are able to test the brain to see what the map of posture and balance looks like. Then with positive neuroplasticity, we can change the map to reset to the original blueprint. This is what Developmental Kinesiology like DNS is all about.
Your Ergonomics Matter
If you work behind a desk, ergonomic modifications are absolutely necessary. If this crucial lifestyle adjustment is skipped, the feeders of the problem are never addressed and the pain will eventually return because the cause is still being supported elsewhere. I suggest you read my blog named: How to Achieve the Best Ergonomics to assess your work or study environment.
Here are some simple changes you can make:
- You want the middle of your monitor to be eye level.
- Sit on a 95 cm minimum exercise ball vs a chair to work out your PMRF.
- If you do not use the side numbers on your keyboard, get a keyboard that has the numbers up on the top only.
- Make sure you are centered to the keyboard letters – and your keyboard is as wide as your shoulders are!
Having the right ergonomics makes such a difference that I have a whole Ergonomic Playlist on Youtube, and an Ergonomic Checklist to make sure all stones are turned.
Breathing and Pain Between Shoulder Blades
Your breathing reinforces your posture and when done wrong, it reinforces the wrong patterns of movement and posture. In the case of pain between shoulder blades, let’s look at this more in detail but first, let’s see how babies breathe because if they all do the same type of breathing, then that must be how the ‘software’ reads!
When it comes to pain between shoulder blades, many describe finding themselves not breathing deep or feeling pain when breathing.
Intercostal muscles
In the pictures to the right, you see highlighted muscles called intercostals. These muscles are between all your ribs and go all the way around your ribcage. When breathing correctly, these muscles expand as the ribs expand with inhalation. When you’re not breathing properly these muscles don’t get to expand as they were designed to do, and with lack of movement comes stiffness and soreness. So now when you try to take a deep breath, it may feel like a sharp pain or cramp between your shoulder blades and chest.
The result of improper breathing mechanics may even make you feel like you have anxiety, all from wrong breathing and bad posture, but that can be a whole other blog itself!
Improper breathing is a contributor to almost all musculoskeletal conditions I see in my clinic, and correcting the breathing is a vital component of treatment.
Stretches and Exercises for Shoulder Blades
The muscles on the backside of your neck and shoulders are overstretched and weak. The pecs and neck muscles on the front end are shortened and tight. Sounds like a simple fix, just strengthen and stretch, right?
Brace yourself because I am probably going to make a paradigm shift here! Why do we isolate an area to strengthen and stretch when no part of our body ever does any work by itself? This is the number one mistake we make when rehabilitating an injured or pained part.
Stretching your neck, shoulders, and arms, working them out with weight, bands, and straps do not do anything. When the body part in question is not put to work with the rest of the body with keen eyes looking for the quality and timing of the movement, the treatment will be ineffectual.
With Dynamic Neuromuscular Stabilization (DNS) all different parts of the body do their part while the spotlight is on a specific part. The exercise below is a great exercise for strengthening the shoulder stabilizers while also engaging the core, correcting the neck posture, and addressing how all the muscles in the arm and shoulders work together.
While mechanically duplicating this is easy to do, functional performance of it may not come so easy and yet, we all did this at age 5 months! All we need to do is re-walk the path we all walked when we were babies, not to add anything new, but to reestablish the proper way of moving that we are all hardwired with. The concepts of DNS can be applied to every movement to make what is dysfunctional now functional.
The exercise below for example is not something you will see a baby do but applies the proper breathing, the neutral spine, and the correct muscles doing the job and what we prescribe to undo some of the restrictions caused by our sedentary lifestyle.
Healthier Shoulders and a Posture Are Just One Step Away
I hope you’ve found this information helpful and realize that the goal is to not only get out of pain but correcting the dysfunctional movement and posture to stay out of pain. If you’ve liked what you read and want more information and functional exercises I suggest you check out my Youtube Channel with 100’s of videos made with you in mind; contact me if you need help with your pain in between shoulder blades or your posture.
-Dr.Shakib