Many patients have presented to me with neck pain, shoulder pain, or both during activities like overhead reaching or even turning their head. When I start working on muscles around their shoulder blade there is a lot of tight, tender spots. So, why is there pain in the shoulder or neck if there is dysfunctional muscles around the shoulder blade. I like to picture the shoulder blade as the connection from the shoulder (glenohumeral joint) to the core. In the case of putting a heavy dish onto a top shelf, if there is a break in the chain from our powerful core muscles to our arms, then it puts a lot of strain on the smaller shoulder muscles (rotator cuff). Therefore movement of the shoulder blade is essential to safely transfer loads from the arm to the rest of the body or even transfer loads from the hips and core to the arm.
Think about watching a baseball pitch, a basketball shot, a golf swing, etc. All of these movements have just as much lower body and leg movement as upper body and arm movement. The more efficiently a pitcher can transfer a load through the legs and hips to his shoulder, the more powerful the pitch. The problem is when that shoulder blade doesn’t move or can’t stabilize then power is lost.
One of the reasons for shoulder blade dysfunction is postural. Everything we do today is in front of us, like computer work and driving, which often causes our shoulders to round forward. Certain muscles tighten up reflexively in response to these postures. The one cue I give all my patients for posture whether in my gym or at their desk is think tall spine. What I mean by this is; picture a rope attached to the top of your head and it is being pulled straight up. The chin may tuck slightly, the top of the shoulders should feel relaxed, but the midback and low back may feel a little tight, in order to loosen them take a few deep breaths trying to relax those areas. This should allow the shoulder blades to assume a better position.
Improper movement patterns of the shoulder blade can also contribute to shoulder or neck pain. These movement patterns can be evaluated by a physical therapist, trainer, or chiropractor. Treatment usually includes modalities to relieve muscle tension and exercises to promote better movement patterns. Although not all neck and shoulder pain is generated from the shoulder blade, it is something that should be evaluated in most cases of neck, mid back, and especially shoulder pain.
