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These days, more than ever before pain and tension between the shoulder blades is a condition commonly seen in desk jockeys regardless of their age; these days, 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, and other musculoskeletal conditions, is to understand what’s causing it so 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 are those stemming 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.

  1. Your muscles have 2 main functions. One is to stabilize a joint or part of your body and another is to actually move that joint or body part. This is how we move!
  2. 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 and any deviation from that order means dysfunction which translates into insufficiency, pain, and discomfort.
  3. Your body parts never function in isolation, but the different parts work together to perform movements and this is, of course, coordinated by the brain. The brain has to figure out what to do given what you throw at it and THAT plays a huge role in not only pain but the resolution of it.
pain between the shoulder blades

Rhomboid and Serratus posterior muscles

Now keeping that in mind, I want you to know that the pain between your shoulder blades, or anywhere else in your body, 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 with 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, you start collapsing into your chair with the shoulder rolling forward, the neck going forward, and head over neck look looking up a bit. Your eyes have to be parallel to the ground and that is why the head looks up and causes the nagging pain at the top of your neck.

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 are working on low oxygen which then means EVERY FUNCTION of your body is impacted.

The part of your brain called Ponto-Medullary-Reticular-Formation or PMRF which tells your body to go upright against gravity does not really get to practice because your posture does not require it to do so. It starts shrinking thus the term Digitial Dementia bear in mind that dementia means shrinkage of the brain. The good news is with the right exercises, this reverses itself and the shrunken PMRF comes back to the original size and function as long as all other is intact.

Resuming this daily posture, the muscles in the back of the neck and shoulders become overstretched and weak, and the ones in the front become short, overly contracted and weak; the shoulder blades no longer lay nicely against the body (winged scapula), and the shoulder (ball inside the socket) sits too far forward within the joint. This is why you keep wanting to pull your arms back and stick your chest out simultaneously to ‘stretch’ it that way. 

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 the blueprint of movement and sensation called Homunculus at birth and 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 and while that is a beautiful thing that allows adaptability, it can work against us because we now are not moving based on the map of movement and sensation we were best fitted to.

Through Postural Neurology, we are able to test the brain to see what the map of posture and balance looks like and with positive neuroplasticity, change the map to resume the original blueprint.

Movement is like a concert with the brain being the conductor, the blueprint of movement or Homunculus is the notes in front of the conductor and the body parts are the musicians. The musicians not only need to know their parts but need to know when to chime in and when to phase out. The lack of synchrony in all of this is what dysfunction is all about.

Once through Postural Neurology we find out what part of the ‘map’ needs attention, then we need to play the concert so all parts practice to work together- just like a mock concert. This is what Developmental Kinesiology like DNS is all about.

So to properly address your posture, all movement issues including shoulder blades, mid-back, neck, and shoulders, we need to check the neurology behind the posture and the quality of movement. 

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.

One of the most important and easiest ergonomic fixes is your computer monitor height! 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 (remember that?). If you do not use the numbers on your keyboard that much, get the type of keyboard that has the numbers up on the top vs off to the right. Make sure you are centered to the keyboard letters – not with the numbers on the right side and your keyboard is as wide as your shoulders are! This is a huge thing since too small of a keyboard means your arms will be pressed against your body and make one of the heads of your triceps less active throughout the day. That head is the one that supports your shoulder blade in keeping it upright and against the ribcage at rest.

Triceps and Scapula

Triceps and Shoulder Blade

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.

intercostals

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, and the Pecs and neck muscles on the front end are shortened and tight. Sounds like a simple fix, 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. In the concert example I gave earlier, no matter how well the ‘violinists’ play if they don’t do their part at the right time and phase out at the right time, the concert still won’t be good, right?

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.

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.