Rhomboid Major and Rhomboid Minor Muscles: Trigger Point Pain

The rhomboids are two separate muscles, the rhomboid major and the rhomboid minor. The muscles are located in the upper back and connect the shoulder blades to the neck and upper back vertebrae.

Rhomboid trigger points (TrPs) pain is felt around the inner edge of the shoulder blade.

Contents Of Article:

Rhomboids Referred Pain Pattern

Where are the rhomboid muscles?

  • The rhomboid major connects the upper back vertebrae (T2-T5) to the shoulder blade (scapula).
  • The rhomboid minor attaches to the bottom neck vertebra (C7)  and the first upper back vertebra (T1) to the shoulder blade (scapula).

What movements does it control?

  • Pulls the shoulder blade toward the spine
  • Stabilizes the shoulder blade
  • Raises the shoulder blade
  • Pulls the arm down from overhead position

 

Looking for detailed muscle anatomy? The Rhomboid Major and Rhomboid Minor Anatomy Page has origin, insertion, innervation, and blood supply information. It also lists agonists and antagonists for each muscle action.

The Rhomboid Muscles

 

Rhomboids Muscle Trigger Points Symptoms:

TrPs in the rhomboids cause aching pain around the inner edge of the shoulder blade. You may notice the pain more when you are resting.

They also contribute to slumping in the upper body. Your shoulders will round forward and you may feel stiffness and some pain when you try to pull the shoulders back and straighten your back.

The symptoms:

  • Pain around the inside of the shoulder blade especially noticeable at rest.
  • Popping and/or grinding noise when moving the shoulder blade
  • Difficulty or inability to straighten the upper body out of a slumped position
Trigger Points Information

Trigger points are small knots found in the muscle that when pressed increase pain in the area or send referred pain to another area of the body. To learn more about trigger points read Muscle Trigger Points and How They Contribute To Muscle and Joint Pain.

TWD Recommends:
Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

Biofreeze Professional Gel is what I recommend for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain. Recommended by medical professionals and trainers. 

What Causes Trigger Points To Develop?

The biggest contributor to TrPs in the rhomboids is short and tight pectoralis major and pectoralis minor muscles.  Short tight pec muscles put constant strain on the rhomboids which overstretches the muscles causing tightness, pain, and the development of trigger points. Eliminate TrPs in the pecs before working on the rhomboids.

Stress and other activities that have you holding your shoulders up or holding the arms overhead are very stressful for the rhomboids. Motions that require sudden, hard, and repetitive downward motion of the arm will contribute to the development of trigger points.

Some examples:

  • Painting a ceiling
  • Hanging wallpaper
  • Rowing
  • Throwing a ball
  • Pull-Ups
  • Extended work at the computer
  • Military posture: standing with extremely straight posture with shoulders pulled back, chest thrust forward.

TWD Recommends:

Doctors and physical therapists often recommend TENS to relax the muscles and ease pain. The Belifu TENS Unit Muscle Stimulator is highly recommended and can be used on most areas of the body.

If you have or are buying a TENS unit, Doctor Jos' book Maximum Pain Relief with Your TENS Unit will help you use your TENS unit to achieve maximum results. Highly recommended!

How To Avoid Development of Trigger Points

  • The first thing to do is to check the pec muscles and the subclavius muscles for TrPs. Eliminate those then work on the rhomboids.
  • If you have rounded shoulder or forward head posture work on your posture. Slumping overstretches the rhomboids and will contribute to soreness and pain as well as the development of trigger points.
  • If you are doing activities such as painting overhead use a ladder or other tools so you don't have to constantly reach up with your arms.
  • Exercise and Sports- be sure to do a good warm-up and cool-down. 'When your muscles start feeling weak and shaky take a break or stop.
  • If you work at a desk sit closer to the desktop to ensure that you are not over-reaching to type or work. Have a chair with armrests that properly support your elbows and forearms.
  • Don't overcorrect your posture by forcibly holding your shoulders back and keeping your back perfectly straight. Be correct and relaxed, not stiff and stressed.
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Rhomboid Trigger Point Treatment

The rhomboid muscles are easy to self-treat using massage balls while leaning against a wall.

If you have balance or mobility issues the Thera Cane Massager is recommended.

The Trigger Point Therapy Workbook is an excellent book with diagrams that will teach you the location of trigger points and how to use the treatment methods. A recommended resource to learn about TrPs and treatment.

The best resource to learn how to treat small painful knots is The Trigger Point Therapy Workbook. The authors explain trigger points and their effects in everyday language, not medical speak. I recommend this book to anyone interested in learning to treat their own muscle pain.

How Long Before I Feel A Reduction In Pain?

Trigger points in the rhomboids deactivate quickly and you will usually feel relief in a few days. If you are not feeling any change or if you feel better but the pain quickly returns you will need to check the pectoralis major and minor, subclavius, and scalene muscles in the neck and deactivate trigger points in those muscles. Then come back to the rhomboids trigger points and work on them. You will then feel better.

Another requirement for successful treatment is to keep treating until the trigger points are deactivated (gone), and can no longer be felt. Deactivated TrPs do not produce any pain or symptoms when pressure is applied to the area. It is tempting to stop treating when you feel better but if the trigger point(s) are still there, the pain and symptoms will return.

If you are buying the Trigger Point Workbook to self-treat the rhomboid muscles you will need a hardball for treatment. The Kieba Massage Lacrosse Balls are a good choice to use on the rhomboids as well as other areas throughout the body.

The Thera Cane is the other tool recommended by the TrP Workbook. This tool is easy for most people to use. You do not have to contort your body or have a lot of hand strength. You can easily reach most areas of the body including the glutes, upper and low back, and back of the thighs.

Interesting Facts

  • 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 muscles) become short and tight pulling the shoulders forward (rounded shoulder posture). This overstretches the rhomboid muscles in the back making the rhomboids painful. Treating and elongating the pectoral 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 that looks like a Christmas tree on muscle diagrams.

Rhomboid pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

  • Scapulocostal syndrome
  • Degenerative disc disease
  • Stenosis
  • Pleurisy
  • C4, C5,  C6,  C7,  C8,  T1, T2 radiculopathy
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Satellite trigger points associated with the rhomboid muscles:

If you have developed TrPs in the muscle there is a chance that you will find satellite trigger points in these muscles.  To ensure complete treatment check and treat the following muscles:

  • Levator scapulae
  • Infraspinatus
  • Pectoralis major
  • Latissimus dorsi
  • Serratus anterior
  • Scalenes

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Other muscles that have similar pain patterns:

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