As a massage therapist, it is a rare occasion when a client comes to us without a knot or tightness between the scapula (shoulder blades). Not only do clients suffer this common complaint, but many massage therapists have this same issue. What can we do to help our clients and ourselves suffer less from this malady?
Understanding where the muscles are located and the purpose of their movement will give us a start. The rhomboids are made up of rhomboid minor and rhomboid major. Minor is located above major, both attach from the vertebrae to the scapula at the medial border of both scapula. Their purpose is to move the shoulder blades toward the spine while maintaining shoulder posture and also to help raise the shoulder blades.
Sitting or standing with rounded shoulders for long periods of time stretches the rhomboids constantly and at the same time shortens the chest muscles, making them tight, which causes the chest muscles to pull on the rhomboids at rest. Pain is usually reported as an achy soreness, or a common description is, “it feels like a hot poker” in between the shoulder blades. Pain may be felt at rest.
To massage the rhomboids:
Start just above the vertebral prominens (when you bend your head forward, it is the most prominent bump on the spine between the neck and shoulders) and press deeply following the grain of the muscle to the scapula. Move down a strip and repeat, continuing the stripping of the muscle to the bottom of the scapula.
Another method of massage for the rhomboids is to have the client lie face down, place the free hand under the shoulder, and lift. This will aid in inserting the fingertips just under the edge of the scapula to use compression.
Always give your client homework. Listed below are two stretches that you can give your client to do at home, per PhysioAdvisor.
- Shoulder Blade Squeeze
Begin this exercise standing or sitting with your back straight. Your chin should be tucked in slightly and your shoulders should be back slightly. Slowly tighten your rhomboids by squeezing your shoulder blades together as hard and far as possible provided the exercise is pain free. Hold for 5 seconds and repeat 10 times.
- Resistance Band Pull-Backs
Begin this exercise in standing or kneeling with your back straight and holding a resistance band. Slowly pull your arms backwards, tightening your rhomboids by squeezing your shoulder blades together as shown. Hold for 2 seconds and then slowly return to the starting position. Perform 3 sets of 10 repetitions provided the exercise is pain free.
Rolling a tennis ball on the offending knot against the floor or wall is a common exercise. Also, foam rolling is a good technique.
Hopefully, these techniques will help ease the common complaint of rhomboid pain for both your clients and yourself!