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Often referred to as the rhomboids, the rhomboid major and rhomboid minor are two different muscles located in the upper back. The muscles connect the shoulder blades to the neck and upper back vertebrae. The rhomboids contribute to pain between the shoulder blade and the spine.

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    Where Are The Rhomboid Muscles?

    Rhomboid Muscles

    The rhomboid major is the largest of the two muscles. It connects the upper back vertebrae (T2-T5) to the shoulder blade (scapula).

    The rhomboid minor is the smaller muscle that lies above the rhomboid major. It connects the bottom neck vertebra (C7) and the first upper back vertebra (T1) to the shoulder blade (scapula).

    What Movements Do The Rhomboids Control?

    The rhomboids affect the movement of the shoulder blade. When you pull your shoulders back, the rhomboids pull the shoulder blades toward the spine. The muscles also pull the shoulder blades up when you shrug your shoulders. The muscles also help pull your arm down when it is lifted overhead or to the front of the body.

    Another vital role of the rhomboids is stabilizing the shoulder blade, helping to keep the shoulder blades in place, and providing support while they move.

    Visit the Rhomboid Anatomy Page for detailed muscle anatomy information.

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    Rhomboid Muscles Pain

    Rhomboid Muscles Referred Pain

    The symptoms:

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

    Activities in which you hold your shoulders up with your arms overhead are very stressful for the rhomboids. Motions that require sudden, hard, and repetitive downward motion of the arm will also overwork the rhomboids. Stress is also a contributing factor as most people tend to hold their shoulders up when they are tense.

    Activities that contribute to pain in the rhomboid muscles

    • 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 The Best Pain Relieving Gel In The Market

    Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. Rub Sombra into the lower neck and upper back to relieve rhomboid pain. You can use the gel 2-3 times a day for hours of pain relief. (Not sold in stores)

    Poor Posture and Trigger Points

    The primary cause of trigger points in the rhomboid muscles is the shortened tight muscles in the chest, namely the pectoral muscles. When the pectoral muscles become short, they pull the shoulders forward, causing a rounded shoulder posture. The rhomboids are then in a sustained stretch, which causes tightness, pain, and the development of trigger points. Trigger points are small hard knots or bands in the muscle that you must deactivate to eliminate pain.

    The first step is to eliminate TrPs in the pecs before working on the rhomboids. You will also need stretching exercises for the pecs and strength exercises for the rhomboids. The pec muscles need to become more flexible, while the rhomboids need to become stronger to hold the upper back and shoulders in their correct upright posture.

    Rhomboid Major and Minor Anatomy Showing Trigger Point Locations

    Rhomboid Muscles Trigger Point Treatment

    If you are interested in self-treatment but are unsure how to do so, 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. The workbook is recommended resource to learn about TrPs and treatment.

    The rhomboid muscles are easily self-treated with the help of one of these two tools to reach the muscles.

    The first tool is a massage ball. You use the ball by leaning against a wall applying pressure to the muscles. You roll the ball to massage the area.

    If you have balance or mobility issues, then consider Thera Cane Massager. The cane can be used sitting or standing without requiring balance to treat the muscle.

    TWD Recommends

    Doctors and physical therapists often recommend TENS to relax muscles and ease the pain. The Belifu TENS Unit Muscle Stimulator an excellent choice for treating shoulder, upper back, and arm pain.

    How Long Before I Feel A Reduction In Pain?

    Trigger points in the rhomboids deactivate quickly, and you will usually experience relief after a few treatments. If you are not feeling any change or the pain soon returns, check the pectoral muscles, the subclavius, and scalene muscles in the neck. Deactivate trigger points in those muscles, then come back to the rhomboid.

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

    How To Avoid Development of Trigger Points In The Rhomboid Muscles

    • 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 a rounded shoulder or forward head posture, work on your posture. Slumping overstretches the rhomboids and will contribute to soreness and pain and the development of trigger points.
    • If painting overhead, use a ladder or other tools so you don’t have to constantly reach overhead with your arms.
    • 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.
    • Exercise and Sports Enthusiasts- be sure to do a good warm-up and cool-down. ‘When your muscles start feeling tired and weak, take a break or stop.
    • 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.

    TWD Recommends

    A warm pack will provide quick, soothing relief if you are stressed out with tense, tight muscles. TWD uses the Cureve Hot Cold Pack. The pack can be popped into the microwave for heat treatments or placed in a freezer for cold treatments.

    Interesting facts:

    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 muscle 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

    Other muscles that should be considered and examined:

    Satellite trigger points associated with the rhomboid muscles:

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

    Find additional muscles that may contribute to these symptoms:

    The rhomboid muscles and other muscles can be affected and contribute to the conditions listed.

    Muscles with similar pain patterns

    If you are experiencing pain in the upper back around the shoulder blades, these muscles may be contributors to your pain.

    Infraspinatus Muscle
    Serratus Anterior
    Trapezius Muscle