Hi everyone, I’m Ian Harvey, massage therapist. This is my friend Kristyna. Today, we’re going to be talking about painful rhomboids. That pain between the shoulder blades, or even up higher, on the upper back, that people really want you to work out. They want you to work out these knots. Well, we’re going to talk about why the rhomboids may not be the issue. We’re also going to talk about the anatomy of the rhomboids, and some strategies for working with this pain that might not create that soreness the next day. If you’d.
Like to skip ahead, you can use the time codes in the description. So the rhomboids are actually two muscles We have rhomboid major, which is the bigger portion, and rhomboid minor, which is more superior, it’s kind of tiny, sometimes the two muscles are joined together. So we’re going to talk about these as if they were one muscle because they pretty much act as one unit. The rhomboids originate from C7T1, so if you can palpate this larger spinous process that’s at the base of the neck, then that is C7T1. Rhomboids also originate from.
All the way down onto T5, so 1, 2, 3, 4, 5. So this is the origin of the rhomboids, and they come down, diagonally down if you think of both sides, they look like a Christmas tree, they come diagonally down, and they attach to the medial border of the scapula. This upper portion attaches right near the spine of the scapula, which you can outline with your fingers here. Come to this medial border, that’s where this insertion site of the upper portion of the rhomboids is. And it goes all the way down, this insertion goes.
Massage Tutorial Rhomboids myofascial release, pain between shoulder blades
All the way down to this inferior angle. So, this is the origin, this is the insertion, and if you bring those two together, that’s the action of the rhomboids. It retracts the scapula, bringing the scapula closer to the spinous processes. At the same time, it also rotates the scapula downward. It changes it this way. It angles it this way. So, there’s retraction and downward rotation. But that’s not really the full story of rhomboids. The rhomboids are mainly a stabilizer. They keep the scapula glued to the rib cage, and they.
Act as a posture muscle. They keep the scapula at a set distance from the spine as you go through your work day, as you slouch, as you stand, as you do different activities. Now something very important to know about the rhomboids is that they are mostly covered by trapezius. So if you can’t palpate lower trapezius, then you’ll never quite know whether you’re on rhomboids, or whether you’re working through trapezius. You’ll never know if that lump you’re feeling is part of trapezius, or if it’s part of rhomboids. If you feel.
A lot of knots down here, you may be mistaking this inferolateral border of trapezius for something that it’s not. So, let’s find this lower border of trapezius. To find lower trapezius, we’re going to be starting from about T12, don’t worry about the exact location of T12, and we’re going to be coming up toward this spine of the scapula. It’s the lower edge of a kite, so it’s going to be shaped like this. So bring your fingers in about that direction, coming from this spine of the scapula down, and strum toward the spine, superiorly.
And medially, and you’ll strum across some bands of tissue that are going in this direction. If those bands of tissue are going in this direction, they can’t be rhomboids, they have to be trapezius, which is superficial to rhomboids. So I’m plucking up that inferolateral border of trapezius right now. Look how little real estate there is to work just on rhomboids. Pretty much right here. And I’m not going to get a lot of work done if I just concentrate on that point. So, realize how relatively unavailable rhomboids is for direct work.
Any work you do on it will have to be through trapezius, and you’ll have to know whether you’re palpating trapezius fibers or rhomboid fibers. Or, you could just not worry about it so much. I don’t do a lot of specific work on rhomboids. I don’t do a lot of trigger point work up in this region, I don’t work toward these spinous processes, though that can be good work, it can feel nice, but it can be easily overdone. I don’t work on this medial border too much, I don’t specifically try to friction it or anything like that.
Because rhomboids are the victim in this scenario. They’re getting yanked on all day be our rounded shoulder postures that we tend to develop in the workplace and in school. And they’re being kept long while having to be strong. They’re keeping our shoulders in place while they’re being lengthened, and that can cause spasm, and that can cause pain. So instead of attacking these rhomboids, which are already stressed out, I’m going to try to reduce some of the things tugging on those rhomboids. Now, that’s not to say that I’m going to ignore.
The rhomboids, because they are irritated, they are upset. So it can feel good to do some nice steamrolling moves over the rhomboids, and over that trapezius. You can be specific, but definitely start broad, start slow. And think soothing, you want to soothe these irritated tissues. We can do some specific work following this inferolateral border of trapezius. All of the knots and trigger points that you’re likely to find in this region, if you find that inferolateral border, I’m betting that they will track with it. They’ll follow that trapezius. Trapezius may be more ticked off than rhomboids. And you.
May find some in this belly right here, which could be trapezius or rhomboids, and you can work directly with those. All I ask is that you, at least for your first few sessions, limit that work. Now you may be saying, well when I work in this area, they get relief. Yes, it does help to desensitize these rhomboids by doing this deeper work, but by doing work that be sensitizing, that might be causing further nervous system irritation, you can, over time, create more sensitivity in this area. You might be doing the opposite of what.
You mean to do. So, instead of trying to work out knots or do any digging, after all this nice steamrolling, we can start working on everything that’s pulling against rhomboids and trapezius. Namely, the rotator cuff, serratus anterior, and the pecs. So for rotator cuff, I like to do a nice steamrolling move down this scapula. If you’d like to see more rotator cuff work, you can click that little bubble in the corner there. That’ll take you to my rotator cuff tutorial. If all four of these rotator cuff muscles are working hard at the same.
Time, if they’re all hypertonic, they’re going to be keeping this humerus glued to the scapula. They’re going to be yanking this head of the humerus into the glenoid fossa, which is also going to be yanking the scapula outward. So if you can soothe and calm these rotator cuff muscles, the the scapula will be able to travel inward a bit, it will be able to retract without rhomboids and mid and lowertrapezius having to pull so hard. The same thing with the serratus anterior. Serratus anterior comes from the same insertion site as rhomboids, but it pulls.
In the opposite direction. It attaches to these ribs over here. So, if we work on these rib attachments, that can cause serratus anterior to lose some of its tone, and again rhomboids doesn’t need to pull so hard. So, for me, that looks kind of like this. I’ll start in this lower thoracic region, I’m here on this lateral portion, I’ve got my elbow tucked into my side so this power is coming from my hips and from my stance. And then, as I deepen this lunge, or shuffle my feet that way, I’m able to create some nice compressive.
Traction of all this fascia on the lateral thoracic region northward, up superiorly. So I’m steamrolling all of these attachment sites of serratus anterior while giving it a bit of a stretch. This also works into the teres muscles. And finally, finish with some nice work on the pecs. I’ll have a more complete tutorial on pecs some time in the future. Just spread them, give them some nice fascial traction as you move this arm, and just think opening up. Think warming this anterior tissue and working with it in such a way that it will.