Shoulder Pain - Pain Between The Shoulder Blades

Author : Jennifer Chu 

Pain and spasm of these muscles give rise to shoulder pain and pain between the shoulder blades. Rhomboid major and minor lie between the shoulder blades and the shoulder pain and pain between the shoulder blades is a combination of tightness and spasm in the middle and lower trapezius muscles in adition to pain from the rhomboid muscles.

The rhomboid minor arises higher from the C7 to T2 levels. The rhomboid major muscle arises from the middle back vertebrae between T2 to T5 levels. They insert along the inner border of the shoulder blade.

These muscles act to bring the shoulder blades together toward the midline. They are also responsible for keeping the shoulder blade flat against the chest wall. They can rotate the shoulder blade in a clockwise direction.

The dorsal scapula nerve supplies them and provides the C5 nerve root fibers. The rhomboid muscles are the only muscles of the body that has only a single nerve root supply. It is difficult to isolate these muscles to contract alone since they are covered by the trapezius muscle. Therefore they are treated in conjunction with the trapezius muscles.

Shoulder pain: The role of teres major as a helper to latissimus dorsi Shoulder pain can occur with pain and spasm in the teres major. This is one of the three muscles that perform shoulder extension, the other two being deltoid and latissimus dorsi muscles. It is therefore exposed to frequent lengthening contractions and prone to injury giving rise to shoulder pain.

Teres major arises from the back of the lower angle of the shoulder blade bone and attaches to the inner lip of the groove on the arm bone along which the tendon of the biceps muscle passes through. This groove is called the bicipital groove and on the outer aspect of this groove is attachment of the pectoralis major muscle. The latissimus dorsi attaches to the floor of the groove.

This muscle is supplied by the subscapular nerve which carries the fibers of the C5 and C6 nerve roots. The function of teres major is exactly similar to that of latissimus dorsi. It brings the arm close to the chest, pulls it backwards and also rolls it inward as in scratching your back or placing your hand into your hip pocket.

Pain in this muscle is felt along the outer edge of the shoulder blade bone and this area is often tender even in those without pain. This muscle is treated together with latissimus dorsi.