Rhomboid Pain: Causes, Treatment And Prevention

Have you ever felt a sharp pain around your shoulder blade, especially after being at a table for a long time or when you wake up? It can be very uncomfortable. Well, this pain is caused by an injury to the muscle called the rhomboid muscle.

In this article, we will be discussing what the rhomboid muscle is, things that can cause it to ache, how this pain can be treated and prevented.

What Is Rhomboid Pain?

The rhomboid muscles are found in the upper back under the scapula and they link the shoulder blade to the spine. They are found on both sides of the spine and play an active role in our upper body posture. It Is called rhomboid because it is shaped like a rhomboid.

There are two rhomboid muscles:

  • Rhomboid Major
  • Rhomboid Minor

The rhomboid major starts from the upper back while the rhomboid minor starts from the neck region and they both stop below the shoulder blade

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 pain that is felt in the upper back close to the shoulder blades.

What Causes Pain In The Rhomboid Muscle?

treating pain in rhomboids

Due to the position and functions of the rhomboid muscles, there is a tendency for it to be overstretched which can cause weakness. When we bend over our laptop, the muscles have to work against gravity to maintain the position. This causes a stretch in the rhomboid muscles which can eventually lead to pain if done repeatedly.

  1. Awkward positioning of the upper back such as slouching over a laptop for a long period of time without going on breaks.
  2. Carrying a heavy bag pack especially on one shoulder
  3. Not warming up properly before a sporting activity
  4. Upper back deformities such as scoliosis or hyperkyphosis. Scoliosis is the abnormal sideways curvature of the spine which can cause some muscles in the upper back to be tight. Hyperkyphosis, which is also known as a “hunchback”, can overstretch the rhomboid muscles which, in turn, can cause pain.
  5. Overuse of the rhomboid muscle can happen if you are into sports and you do a lot of over the head activities
  6. Strain to the rhomboid muscles which can occur from poor heavy lifting.
  7. Spasm is an involuntary contraction of the rhomboid muscles. These causes knots and pain in the rhomboid muscles.
  8. Muscle Weakness
  9. Lifting with your back and not your legs.

How Can You Tell It Is The Rhomboid Muscle?

  1. Pain at the upper back area
  2. Swelling
  3. Tenderness
  4. Muscle tightness or knots
  5. Occasional pain while moving the neck
  6. Pain in the arms which might be due to a nerve being pinched at the upper back
  7. Pain while moving the shoulder
  8. Discomfort while slouching or trying to stand erect

How Can It Be Treated?

treatment of rhomboid pain

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 Treatment

Place ice in a damp towel and place 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 commences, especially if ice has not been helping with the pain. Heat increases blood flow which will help speed up the healing process.

4. Medications

One of the causes of muscle pain is spasm as mentioned earlier. 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

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

How Long Does It Take Rhomboid Pain To Get Better?

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 to several months for the pain to completely subside.

Another factor that affects healing is not resting the muscle which can prolong the healing process.

In What Ways Can It Be Prevented?

prevention of rhomboid pain

  1. Correct your slouching posture
  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
  7. Reduce carrying bag packs or reduce the load in the bag pack or carry your bag pack on both shoulders instead of one

In Summary

The rhomboid muscles help in correcting our posture. Due to our daily activities, there is a tendency for the muscle to be stressed and cause pain. Rhomboid muscles heal well if treatment and rehabilitation commence as soon as possible.

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Adekanmi Lipede, M.Sc, MPH

Adekanmi Lipede is a licensed physiotherapist with a Master's degree in physical activity and public health from Loughborough University. She joined 25 Doctors in 2018 and is passionate about educating people about the best steps to take when trying to be physically fit or when recovering from a mobility-related condition. For fun, she loves to exercise and read.
Adekanmi Lipede, M.Sc, MPH