Trapezius muscle pain is perhaps one of the best examples of how taking a one-dimensional approach to resolving shoulder problems rarely works.
The research is very clear on this.
Shoulder pain is multifaceted. This subject is a rabbit hole, so I’m going to sidestep it for now in order to stay on task.
First some context on trapezius muscle pain.
FUNCTIONAL ANATOMY OF THE TRAPEZIUS
The trapezius muscle, often simply referred to as the traps, is a large triangular muscle that extends from the base of the skull down the spine and across to the scapula. Its function is varied but, in a nutshell, it plays a crucial role in stabilising and moving the scapula, neck, and head.
You might hear people talk about upper, mid, and lower traps. When we do this, we’re referring to one muscle which has multiple lines of pull or action on a joint, in this case, the scapulothoracic joint.
The upper fibres elevate and upwardly rotate the scapula and extend the neck.
The middle fibre retracts the scapula.
The lower fibres depress and upwardly rotate the scapula.
CAUSES OF TRAPEZIUS PAIN
This is where it gets interesting. Due to the anatomical location and function of the trapezius, pain is often not just due to the muscle itself.
Yes it can get pretty gnarly and ‘knotty’ in there and in addition to muscle tension, the spine and ribcage are often partners in crime when it comes to the cause of trapezius pain.
This is one reason why going for a sports massage for your upper trap pain provides some temporary relief, only for the same problem to repeatedly reoccur sometime in the future. Massaging the muscle may help relax the tissue, but it often won’t rectify the cause of why if got jacked up in the first place.
UPPER TRAPEZIUS PAIN
Let’s deal with the one that most people suffer with. Pain in the top of the shoulders and neck which can often lead to stiffness and headaches are likely to be related in some way to the upper trapezius.
Here are two things that might point to the solution:
1. You need to get stronger, in the right places.
Upper trap pain or soreness can often come from poor strength balance across the scapula. There are many muscles pulling the scapula in many directions and there needs to be a certain amount of balance across that force generation.
For example, when we move the hand overhead, the scapula needs to upwardly rotate which requires co-ordinated effort from the lower trapezius, serratus anterior and upper trapezius.
What often see is a lack of balance across this force couple. Simply put, the lower trapezius and serratus anterior aren’t strong enough and therefore the brain relies more on the upper traps to ‘pull’ the shoulder up.
If we can’t utilise the most efficient ‘option A’, appropriate contribution from the lower traps, serratus, and upper traps, the brain has to revert to option B. That means you might be placing an excessive demand on the upper traps.
2. You’re not breathing effectively.
Even though it is something you do unconsciously and as such, you may never give it much conscious thought, there is a right and wrong way to breathe. Well, a more effective way is perhaps a better description.
When you breathe your ribcage should expand anteriorly, posteriorly, and laterally. This usually indicates your primary breathing musculature (diaphragm and external intercostals) is functioning well.
If you have some level of dysfunctional breathing, you may well be relying on your secondary respiratory breathing muscles.
These being your upper traps, scalenes, sterocleidomastoid, levator scapulae and pec minor. So instead of the ribcage expanding, these muscles located around the neck and shoulder pull the ribcage up when you breathe.
As before, the brain is only doing this because the preferred option A isn’t being deployed. So once again, we overload tissues that are doing a job they aren’t designed to do.
Addressing your breathing issues, particularly during times of stress and duress is an important part of resolving upper trapezius and neck pain.
If you’re looking for proof, think about where you carry tension when you’re stressed. And when you’re stressed you might often breath shallow. So is it any wonder that stress brings on upper trap pain.
Ribcage function can also be part of the solution for pain around the scapula and we can use breathing exercises in certain positions to encourage ribcage expansion into the areas where we might have got a little stuck down and restricted,
Restoring movement of the ribcage is always going to be on the check list for trapezius pain.
IDENTIFYING THE CAUSE
As I explained in the introduction, shoulder pain is multifaceted. In the points above we have identified strength, breathing and ribcage function, stress, and physical fatigue.
These could all be contributors to the trapezius pain you’re experiencing. Therefore, the solution will need to address those which are relevant. To give you something of a checklist, this is the order we would explore the potential causes with a personal coaching client.
Lifestyle/Life Factors (work, family, relationships, stress etc).
Breathing mechanics (is your breathing dysfunctional? If it is, there is little point going after the ‘mechanical’ solution without addressing this component first. Working on this will also help you manage point 1 better too.
Shoulder movement, function, and strength. Use techniques to relax ‘tight’ muscles, strengthen what is weak and then integrate it into better movement patterns.
There are layers within each but it’s a simple starting point.
Whilst I could have written a blog post that says, here are the 3 best exercises for upper trap pain, that wouldn’t help you to understand the solution and progress the process of identifying the root cause.
And that is what we are about at Dynamic Shoulders. Addressing root causes and giving you the tools so you can get and stay free from shoulder pain for the long-term.
If you need help getting to the bottom of your shoulder pain, book a call.
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