This post is intended for those who have irritation or discomfort near the shoulder blade without a clear cause (such as posture from being sedentary). If there has been trauma to the back or shoulder, or very sharp pain, I highly recommend contacting a professional. This post will have a few tips for things you can do for self-maintenance at home, from quick pain relief to more long-term techniques to keep the discomfort at bay. I must add extra stress on the long term techniques, especially for those who often are at the computer or looking down at their phone a lot. This pain pattern might also be explained by something called Upper Crossed Syndrome if you are interested in more information.
To see what may be causing the pain at the shoulder blades, I recommend looking over my first post on the topic.
This post is in no way meant to replace professional advice, and please be very mindful that you do not have other conditions going on (such as osteoporosis) before following any of this advice, and for heck's sake get an actual evaluation from a Physiotherapist if the pain is really bothering you. With that being said, here are some things you can do at home to help with mild discomfort of the inner shoulder blade.
1. Topical Analgesics
One of the easiest ways to deal with aching muscle pain is to just cover it up for a little bit. Of course this won't help in the long run but if it's driving you crazy, or just needs some time to heal, topical analgesics can help.
Some common recommendations:
and a host of others. Some people find pain relief from simple peppermint essential oil. Try one or two out, and see how you respond.
2. Hot/cold pack
The next simple thing to do is add some heat and cold to the back.
Prepare an ice pack in the freezer (or a bag of iced peas) and use a dry towel so the ice does not make direct contact with the skin (and also to hold it in place easier).
For heat, soak a towel in hot water, wring it out, and toss it in the microwave for a minute or until hot.
To alternate heat/cold, simply leave the cold on for 3 minutes, then put the heat on for 3 minutes, and repeat alternating a few times.
The idea behind this: heat causes expansion of blood vessels, cold causes contraction of blood vessels. By alternating them you are expanding and shrinking the blood vessels, and for some this can create a relief from pain.
3. Self-massage and Stretch
You can work on your own back and shoulder blade using a tool such a tennis ball. I have also used a theracane, a curved tool that you hold onto, with good results.
The Painotopia website has as great guide on how to locate the muscles you want to massage.
First you can try some trigger point therapy on yourself. This may provide temporary pain relief but I caution against using this method long term. Since the rhomboids are already elongated, you are effectively making a long muscle even longer. Actually, for most people, the better, longer lasting treatment (that nobody wants to hear), is building the strength of the muscle. (ref: J Phys Ther Sci. 2016 May; 28(5): 1636–1639) Which we will get to later.
Place a tennis ball on the wall and lean your back against it to hold the ball on the wall. Adjust the location of the ball so that it is right at the shoulder blade where the rhomboids attach (as shown in the picture), and check for any tender spots. When you locate the tender spot, lean into the ball to create a deep pressure and hold that pressure for 30 seconds. You want to feel a deep radiating 'ache' but it should not really be painful (if it is, stop). You need to make the distinction between good ache versus burning stabbing pain, the latter meaning you should stop immediately.
Now do the same thing for the spot at the infraspinatus, moving the ball onto the shoulder blade. This one can take your breath away, trust me I know. It can also really help to release this trigger point for a number of issues. You'll look for a really sensitive spot and lean into it for 15 to 30 seconds. The possible locations are marked as X's on the image below.
Next, do the same for the teres major/minor muscles (you'll be hitting part of the latissimus dorsi muscle as well). For this one place the ball on the wall and lift your arm overhead. The ball will almost be in your armpit but don't let it go in the actual pit, keep it on that muscle that makes the back border of the armpit. You might have to roll up and down the muscle slowly til you find that tender spot, then press and hold on it.
Next we will work the front of the shoulder. Go to a wall corner or door frame, place the ball on the upper pectoral near the shoulder, and lean forward. Let your arm hang next to you so that you're not activating or straining it, just relax into the pressure (the area marked by the X below). The reason we use a wall corner here is so you can lean past the wall. This works well in a door frame, so your torso leans forward while your shoulder stays on the frame. Next, remove the ball and position your arm fingers pointing up on the door frame, and lean forward slowly to stretch the pec muscle.
Lastly you can try a self massage for the scalenes. In order to do this safely, start with very light pressure, and if you don't know how to apply a lot of pressure with the finger tips, you will simply use friction (moving the fingers back and forth over the muscle) to help loosen up the area. I highly recommend finding a professional massage therapist or physiotherapist to work on this area for you.
Using the opposite hand, put the fingers on your collar bone (right hand if touching your left collar bone) and move back just a bit so your fingers sink into the groove. Press down slightly, then move your finger tips left to right (not too rapidly) for about 30 seconds. Tilt your head back, your chin going in the opposite direction from your collar bone, to stretch the scalene muscles.
You can also add a passive stretch by simply laying back with something under your back. Use a foam roller or thick pillow, lay flat on the floor with the pillow under your mid-back parallel with your spine, and allow your shoulders to fall back, and lay in this position for 10 minutes or so.
4. Exercise for the shoulder
Using exercise for shoulder mobility is going to be the best way to stabilize the shoulder, keep it toned, and keep it from aching from posture. In my experience, the mid back pain most often comes from being immobile or sedentary.
In this section I will recommend a couple different types of exercise, one of which is resistance exercise. The reason this is important is that it helps to cue the muscles to contract against some kind of resistance, which will be important for it to hold that shoulder in place without pain down the road.
What a lot of people don't realize is that you can use a personal trainer for a sort of check-up, like you would a dentist. It is really helpful to have someone there to make sure you're doing the movements correctly, that your mind-to-muscle connection is happening, and that you're using the right progression in exercise. So I recommend finding a good personal trainer who knows the importance of these things to do a session or two with, even if you are a self-motivated person.
These exercises will target the muscles around the shoulder blade using body weight or resistance. There are all sorts of machines you can use for adding resistance, and if those interest you I recommend hiring a personal trainer for a session or two to learn how to use the machines properly, or ensure that you are targeting the correct muscles. For home use, I recommend dumbbells or a resistance band. Either way, start off light and gradually increase the resistance you are using.
Rows are any movement that pull your shoulder blades back together. You can use a resistance band around your feet, you can put the resistance band in the door, or you can lean forward and use a dumbbell. You can adjust your arms to change which muscles you are targeting. For this particular target, keep your arms about shoulder height and pull the elbows back, focusing on pinching the shoulder blades together. It may help to have someone behind you touching your rhomboids- this will help your brain to make sure you feel the contraction occurring in the rhomboids and not just the rotator cuff. It is a common mistake to only rotate the arms instead of pulling the shoulder blades back (the latter is our goal here). While this will target the rhomboids and part of the trapezius muscle, other shoulder stabilization exercises that you might learn from a person trainer will benefit you in many ways to have a well-rounded and stable shoulder.
2. Super man
Lying on the floor, lift your arms up and pinch the shoulder blades together, hold for two seconds, then return to the floor. Don't let your head come back, focus on just pulling your shoulder blades together. Repeat 8 to 12 times and rest.
3. Scapula Push-up
This one is a fantastic shoulder isolation exercise. I have found it to be very useful, just follow the video.
These are just 3 ideas for waking up the rhomboids and trapezius in your back, and if that is the source of your pain, the exercises will really help more than anything in reducing your pain, and helping you to feel like your shoulders and back are more supported.
For more exercise ideas, have a look at a few of these links:
What's going on with me, research articles, interesting little blurbs. This blog is an attempt to consolidate research into an easily digestible format.
Alex Moon has been a Licensed Massage Therapist since 2012, did his undergraduate studies at Utah State, and is currently working on his Doctorate in Physical Therapy.