One of the most debilitating, painful and downright annoying muscular injuries I see presenting into my clinic is pain between, or above the shoulder blades. Shoulder blades are also known as scapulae. People always describe this condition as an irritating and constant gnawing pain. Most people struggle to sleep at night because of the pain. It can be sore when driving, sitting at a desk or even lying out on the couch! Does this sound like your situation? Well, invariably the pain is simply caused by a muscle that has gone into spasm. A spasm is defined as the following - “a sudden involuntary muscular contraction or convulsive movement”. There are 2 main reasons for this to happen - A muscle is either overworking because other muscles are weak and they are not doing what they are supposed to do, hence some or one particular muscle has to do ‘extra’ to compensate, or the other reason is the muscle is just weak and it cannot handle the load or movements being placed upon it. Think of it this way - a muscle should act like a spring or an elastic band, it should stretch and shorten, unfortunately when one is in spasm or not functioning, it can’t do this and it becomes “stuck”. Sometimes muscles can be ‘stuck’ long or ‘stuck’ short, either way, this can lead to pain.
There are several reasons why this might happen with regards to muscles between the shoulder blades. Firstly, we have to understand the shoulder joint is a very complicated joint, it is the only joint that can rotate through a full 360 degrees of motion, which in turn means there are many muscles to contend with. But, in my experience, one muscle above all else needs to be working efficiently for the rest on the muscles around the shoulder blade to work efficiently. That muscle is called the serratus anterior.The serratus anterior is a very large muscle that runs from the back or underside of the shoulder blade all the way around to several attachment points on the rib cage (see below) and its job is to keep the shoulder blade sliding forward effectively on the rib cage. If this does not happen, and this muscle is weak we sometimes see scapular winging. We often see this presented where one or both shoulder blades stick out from the rib cage and don’t move in sync as we lift our arms up and down repeatedly. We also see the shoulder loses its ability to internally and externally rotate. When all this happens, other muscles cannot do what they are supposed to do and they either stop functioning or they are overworking, either way, the muscle will go into spasm and cause pain. When people experience pain between their shoulder blades it is usually their rhomboids, mid traps or levator scapulae that are affected.It is worth noting this can happen without the shoulder blade winging, but people who get this type of pain regularly tend to have some sort of scapular dyskinesis or dysfunction. It can be easily diagnosed by a trained professional and knowing the specific exercises required to strengthen specific muscles will get you right along with some hands on treatment!Try this exercise below and get your Serratus muscles working efficiently!
Wall Slide exercise:-
1. Place a band or towel between your hands
2. Rest forearms on wall at 90͒͒° and round your upper back while tilting your pelvis upwards
3. Slide your forearms up along the wall as far as you can as you pull apart the towel or band
4. Repeat 10 times and do 3 sets