+Donna Martin
Nov 212012

What pain and symptoms are associated with the rhomboid major and minor muscles?

Pain caused by the rhomboid muscles

Pain around the shoulder blade indicates rhomboid muscle dysfunction.

  • Pain along the inside of the shoulder blade.
  • Popping and/or grinding noise when moving the shoulder blade
  • Inability to stand up straight

Where are the rhomboid major and minor muscle located?

The rhomboid major connects the upper back vertebrae to the shoulder blade.

The rhomboid minor connects the shoulder blade to the  bottom neck vertebra and the first upper back vertebra.

What movements do the rhomboid muscles control?

  • Pulls the shoulder blade toward the spine
  • Stabilizes the shoulder blade
  • Raises the shoulder blade

Activities that can cause rhomboid muscle pain:

  • Activities that require continuously or repeatedly raising the shoulders
  • Hanging wallpaper
  • Rowing
  • Throwing a ball
  • Extended work at the computer

Interesting facts about the rhomboid muscles:

  • Pain in the upper back is often contributed to the rhomboid muscles. However many times it is actually the pectoralis major and minor which actually causes the pain in the rhomboids. The pectoral muscles (upper chest muscle) shortens pulling the shoulders forward (rounded shoulder posture) which over stretches the rhomboid muscles in the back making the rhomboids painful. Treating and elongating the pectorial  muscles will often reduce or eliminate upper back pain.
  • The rhomboids are often called the Christmas tree muscles. Their connections on the lower neck and upper back extending to the shoulder blade give them a distinct triangular shape which looks like a Christmas tree on muscle diagrams.

Clinical diagnoses to which this muscle symptoms may contribute:

  • Scapulocostal syndrome
  • Sprain/Strain syndrome

Other muscles that should be considered and examined in conjunction with the rhomboid major and minor:

Help with Rhomboid Muscle Pain and Symptoms

Sombra Warm Therapy Gel provides pain relief.

Warm Therapy Gel for Rhomboid Muscle Upper Back Pain

Sombra Warm Therapy Pain Relieving Gel is a pain relieving gel that I use both personally and professionally in my massage therapy practice. Unlike other over the counter heating creams, it provides warmth without burning heat.  If your upper back pain is caused from arthritis in the upper back and shoulder area, or if there has been a recent strain / sprain to the rhomboid apply Sombra to the upper back area for pain relieve. If you are dealing with constant chronic upper back pain and have a slumping upper body posture or rounded shoulder posture, then also treat  the chest muscles and up into the  front of the shoulders. I recommend Sombra for chronic pain and chronically sore tight muscles.

Cold Therapy Gel For Rhomboid Muscle Injury and Pain

Biofreeze is recommended for recent muscle injury

Biofreeze Pain Relieving Gel is an excellent pain relieving gel that I use on clients with recent injuries and muscles and joints that are swollen. Cold therapy gel works  like ice  and does not promote swelling. A recent study showed that Biofreeze decreased pain 2 times more than ice and the pain relief lasts 9 – 10 longer. If  your pain is from a recently strained rhomboid  muscle I would recommend Biofreeze.

Hot Cold Pack For Pain and Relaxation


SofTouch Large Hot Cold Pack  is a large pack that can be used for hot or cold treatment. The pack is large enough to cover most of the back. It can also be laid across the to relax chest pectoral muscles which can also help relieve upper back pain.

The inside of the pack contains a clay like substance that remains soft and pliable so you can mold the pack to your body. The outside of the pack is wrapped with soft suede like material that does not shock the skin when touched. My clients love this pack and it is now the only hot and cold pack that I use in my massage therapy practice.

Relax and Stretch The Pectoral and Neck Muscles To Help Rhomboid Upper Back and Shoulder Pain


Soothe-a-ciser: Relief for neck and shoulder pain helps relieve pressure and pain in the neck and shoulders.  10 – 15 minutes laying on the pillow allows muscles in the neck, chest, shoulders and upper back to relax. It can relieve or even stop some headaches. It can work especially well for those with tight painful rhomboid muscles, pectoral (chest)  muscles, and people who have slumping upper posture or rounded shoulders. A great pillow for people who work at desks and computers!

Braces and Support for Rhomboid Muscles


Rounded shoulders and slumping upper body posture are often caused by shortened tight pectoralis muscles which over stretches upper back muscles causing sore and painful upper back muscles.

ShouldersBack Posture Support gently pulls your shoulders back helping you maintain straight correct posture while stretching and elongating the chest muscles.

I use this brace myself when I begin to feel twinges of pain in my shoulders and upper back. I have recommended it to family, friends and clients who have pain due to slumping upper body and rounded shoulder posture. If you have rounded shoulders, begin using the brace slowly for short periods of time. As your body adjusts, you can tighten the support and use it for longer time periods. This brace is not a rigid support, you can still move comfortably and freely, it does not forcibly hold your shoulders down and back.

Self Treatment Help For Upper Back Muscle Pain Caused By Rhomboid Major and Minor Muscles

The Trigger Point Workbook can help you resolve muscle pain throughout your body.

Do you know that the rhomboid muscles contribute to pain in the upper back around the shoulder blade? They are also often the cause of a grinding feel and popping noise when the shoulder blade moves.

If you are suffering with unresolved pain around or under the shoulder blade consider purchasing Claire Davies  The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. Mr. Davies explains the trigger point phenomenon and muscle pain in everyday language.  But what makes this book worth its weight in gold are the individual muscle trigger point treatments that Davies has compiled. His diagrams and step by step instructions help you locate which muscles are contributing to your pain,  how to find the trigger point and treat it. He also provides stretching and strengthening exercises for each muscle. It takes time and practice to master finding trigger points, but once you learn you have a tool and method to help relieve muscle pain throughout the body.If you are suffering from unrelenting shoulder and upper back pain  treating the trigger points in the rhomboids and  pectoral muscles can help reduce or eliminate your pain.  This book is a must have for anyone interested in finding the cause and treating muscle pain.


The Theracane Massager is a self treatment massage tool for use on those hard to reach areas on the neck, shoulders, back, hips and legs. If you are considering buying the book The Trigger Point Therapy Workbook, you will need to buy the Theracane to use the treatment methods for the back detailed in the book.

Anatomy Study: Origin, Insertion, Action and Innervation of the Rhomboid Major and Minor Muscles

Rhomboid Major Christmas Tree Muscle

The rhomboid major muscle connects the shoulder blade to the upper back vertebrae.

Rhomboid Major

Origin: Spinous processes of T2 – T5
Insertion: Vertebral border of the scapula, from inferior to the scapular spine to the inferior angle
Action: Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Innervation: Dorsal scapular nerve C5
Primary Actions:
1. Retraction of the scapula

  • Agonists:  Trapezius (middle fibers), Rhomboid Minor
  • Antagonists: Serratus Anterior, Pectoralis Minor

2. Downward rotation of the scapula

  • Agonists: Levator Scapulae, Serratus Anterior (upper fibers), Rhomboids Minor, Pectoralis Minor, Trapezius (middle fibers)
  • Antagonists: Trapezius (upper fibers), Trapezius (lower fibers), Serratus anterior (lower fibers)

Satellite Trigger Points: Levator scapulae, Infraspinatus, Pectoralis major, Latissimus dorsi, Serratus anterior

Rhomboid Minor

The rhomboid minor muscle connects the shoulder blade to the upper back vertebrae and lower neck vertebrae.

Origin: Ligamentum Nuchae and the spinous processes of C7 and T1
Insertion: Vertebral border of the scapula, adjacent to the scapular spine.
Action: Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Innervation: Dorsal scapular nerve C5

Primary Actions:

1. Retraction of the scapula

  • Agonists:  Trapezius (middle fibers), Rhomboideus Major
  • Antagonists: Serratus Anterior, Pectoralis Minor

2. Downward rotation of the scapula

  • Agonists: Levator Scapulae, Serratus Anterior (upper fibers), Rhomboids Major, Pectoralis Minor, Trapezius (middle fibers)
  • Antagonists: Trapezius (upper fibers), Trapezius (lower fibers), Serratus anterior (lower fiber)

3.      Stabilizer: Trapezius (middle part)

Satellite Trigger Points: Levator scapulae, Infraspinatus, Pectoralis major, Latissimus dorsi, Serratus anterior, Scalenes

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