Rhomboid Pain: Causes, Treatment and Prevention

The rhomboid muscles are found in the upper back under the shoulder blades, they link the shoulder blade to the spine.

These muscles are responsible for:

  • Pulling the shoulder blades towards each other
  • Correcting our posture
  • Assisting in pulling and overhead arm movements

Rhomboid pain is felt at the upper back close to the shoulder blades.


What Causes Rhomboid Muscle Pain?

  • Awkward positioning of the upper back such as slouching over a laptop for a long period of time without going on breaks.
  • Carrying a heavy bag pack especially on one shoulder
  • Not warming up properly before a sporting activity
  • Upper back deformities such as scoliosis or hyperkyphosis.
  • Overuse of the rhomboid muscle.
  • Strain to the rhomboid muscles which can occur from poor lifting.
  • Muscle spasm.
  • Muscle Weakness

Associated Symptoms

  • Pain at the upper back
  • Swelling
  • Tenderness
  • Muscle tightness or knots
  • Occasional pain while moving the neck
  • Pain in the arms which might be due to a nerve being pinched at the upper back
  • Pain while moving the shoulder
  • Discomfort while slouching or trying to stand erect

When To See A Doctor

Most times, rhomboid pain should resolve in a few days. However, if the pain is persistent, severe or has additional symptoms like a deformity or difficulty moving your arm or shoulder, you should see your doctor.


1. Rest

The first form of treatment for rhomboid muscle pain is rest. Resting will involve reducing activities that cause or increase pain at the upper back or arms such as heavy lifting or slouching.

2. Ice

Place ice in a damp towel and place it on your back for 20 minutes. If you already have an ice pack, placing an ice pack on the painful area can help relax the muscles and relieve pain.

3. Heat Treatment

Ice is usually done for the first 3 to 5 days. After the 5 days, heat therapy can be commenced by your physiotherapist, especially if ice has not been helping with the pain. Heat increases blood flow which will help speed up the healing process.

4. Medications

Muscle relaxants are usually prescribed to relax the muscles which, in turn, relieves pain. Pain relievers can also be given to help relieve pain. These medications are prescribed by the doctor so it is necessary to see the doctor before taking any medications


5. Rehabilitation

The rehabilitation process is taken up by the physiotherapist. Depending on the doctor’s assessment, a referral will be written to physiotherapy for rehab.

The physiotherapist will assess you and look out for any associated symptoms or causes of pain. After assessing, a treatment plan will be designed to help relieve pain, prevent deformities, prevent muscle weakness, and prevent a reoccurrence or chronic rhomboid pain.

These can be achieved by using:

  • Thermal therapy which can be ice or heat to relieve pain
  • Myofascial massage which releases muscle knots and can also relieve pain
  • Stretching exercises
  • Strengthening exercises if there is muscle weakness
  • Postural education and lifting techniques

A review will be carried out regularly to ensure that goals are being achieved and exercises will be prescribed depending on the level of tolerance and healing.

6. Exercises

Exercises are prescribed by the physiotherapist depending on the pain and immobility levels. Some of these exercises are:


Shoulder Blade Squeeze

This exercise can be done sitting or standing

  • Place your hands by your side
  • Pull your shoulder blades towards each other and hold for 5 seconds
  • Release and repeat for 30 seconds to 1 minute

Rhomboid Muscle Stretch

  • Straighten both arms out in front of you
  • Place your right palm on the back of your left hand and twist your body towards the right
  • Change hands to twist your body towards the left
  • Hold the stretches for 10 to 20 seconds
  • Do this 2 to 3 times on each side

Neck Rotation Stretches

You might be wondering why we are doing neck exercises. The rhomboid muscles actually start from the neck region and for these muscles to be stretched, the neck has to be stretched as well.

    • Take your chin to your left shoulder and hold this stretch for 5 seconds
    • Return your head to the neutral position and repeat on the right side.
    • Repeat 3 to 5 times and do it slowly

Side Arm Stretches

  • Take your left hand across your chest pointing towards the right
  • Place your right palm on your left elbow to increase the stretch
  • Hold for 5 seconds and do on the other arm
  • Repeat this 3 to 5 times on each side

Neck Flexion-Extension Exercises

  • Keep your head in a neutral position
  • Slowly bend your head forward and relax your neck
  • Gravity will pull your head forward to stretch the rhomboid muscles
  • Hold for 5 seconds
  • Slowly take your head back and hold for 5 seconds
  • Repeat 5 times

Recovery Time

The healing process of rhomboid muscle pain depends on the severity of the injury or strain and how soon treatment and rehabilitation starts. It usually takes a few days for mild strains and several weeks for more severe strains.


  1. Avoid slouching when sitting
  2. Stop exercising once you start feeling sore
  3. Warm-up properly before any sporting activity to avoid muscular injury
  4. Lift the right way 
  5. See a doctor to correct any deformities
  6. Go on stretch breaks
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