Fix Your Scapula Pain

The Most Common Causes

The most common causes of scapula pain are minor muscle strains that occur because of muscle tightness or slight muscle imbalances. Fortunately, these are easily treated with simple exercises to mobilize the scapula and strengthen the major muscles that hold it in place.






"common causes can be divided into two categories"

When you are having scapula pain the most common causes can be divided into two categories.

  • Bone pain from the scapula itself
  • Pain from the many muscles and muscle attachments that connect to the scapula

The most common cause of bone pain from the scapula itself is fractures. Also known as the shoulder blade, the scapulae are located on the right and left side of the upper back.

Scapula fractures are not common, but they do occur. If you have been in any kind of an accident, suffered a fall, or sustained a heavy blow to the upper back, you may have a fracture.

You need to be seen by a doctor and evaluated with x-rays. Many times these fractures can be treated without surgery, and they heal without incident or permanent impairment.


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"muscular pain from the many muscles and their attachments"

The more common cause of shoulder blade or scapula pain is muscular pain from the many muscles and their attachments to the scapula.

Muscular scapula pain may be a sharp and stabbing pain that occurs with certain motions or a dull nagging ache that never goes away. The pain may begin suddenly or develop slowly over time.

"18 different muscles that attach to the scapula"

The most common causes of muscular scapula pain are poor posture, deconditioning, and muscle imbalances of the many muscles that interact with the scapula. To help understand the causes of scapula pain it helps to consider the anatomy.

There are 18 different muscles that attach to the scapula. When any of these muscles become weak from lack of proper exercise, they can cause extra strain on other muscles. When muscle becomes short and tight from improper stretching, they prevent normal motion of the scapula and shoulder.

"the major scapula stabilizers"

The scapula "floats" on the posterior chest wall, held in position by it many muscle attachments. It has some limited, but very important motion, which contributes to our shoulder range of motion. Of the 18 muscles that connect to the scapula there are four large muscle groups that are the major scapula stabilizers:

  • THE SERRATUS ANTERIOR muscles attach to the inner surface of the scapula along the medial border. It functions to hold the scapula flat against the chest wall.
  • THE MIDDLE TRAPEZIUS muscle attaches along outer third of the clavicle and the upper edge of the scapular spine. It pulls the scapula in and up, elevating the shoulders.
  • THE LOWER TRAPEZIUS muscle attaches along the scapular spine. It pulls the scapula in and down, rolling the shoulders back.
  • THE RHOMBOID muscles attach along the medial border of the scapula. They pull scapula back, pulling the shoulder back.

"When there is weakness or imbalance..."

These muscles work to stabilize the scapula and hold it flat against the chest wall. When there is weakness or imbalance the scapula is pulled out of position causing strain on the other muscles that are attached to it.

The secret to resolving muscular scapula pain is stretches to mobilize the scapula and released tight muscles, and strengthening exercises to strengthen and balance all muscle groups. Stretches and exercises to condition these four major groups will also stretch and condition the minor muscle groups.

Stretch Tight Muscles and Ligaments to Relieve Scapula Pain

These exercises will target the muscle groups that commonly become short and tight with some easy stretches that will help to mobilize the scapula.

Easy to do:

  Rhomboids and Trapezius

  Rhomboids and Trapezius 

More complicated to perform:

   Levator Scapulae Stretch

   Scapula mobilization

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Strengthening Exercises to Correct Muscle Imbalances

The muscles of the scapula all work together in a coordinated effort to move scapula while holding it in place. These exercises are labeled for the major scapular stabilizers, but they will really work to strengthen all of the different muscles attached to the scapula.

Easy to do:

   Serratus Anterior



More complicated to perform:

   Serratus Anterior



"if the imbalances are severe"

The basic exercises for strengthening the muscles are straightforward and easy to do, but if the imbalances are severe you may need to be evaluated by a physical therapist who can prescribe specific exercises to strengthen specific muscles or muscle groups.

Other syndromes that may affect the scapula and cause pain include:

  • The winged scapula syndrome caused by severe weakness in specific muscle groups
  • The snapping scapula syndrome which causes the scapula to not slide smoothly through its range of motion
  • Nerve injuries that cause muscle weakness in specific muscle groups.

These and other syndromes affecting the scapula are not likely to be improved with exercise. If you think you may have had an injury, you need to see your doctor, and be evaluated. Or, if you do the exercises consistently for 6 weeks, and do not seem to be improving, you need to see your doctor. You may have something more than just simple muscle strain or minor muscle imbalance.

"None of these exercises should cause pain"

You may experience some mild discomfort with some of the exercises, this is normal. None of these exercises should cause pain. If you are having pain, stop the exercise, you may be doing too much or doing it incorrectly. Check your technique and then slowly progress.

When you are having scapula pain, it is reasonable to begin with a home treatment program of simple exercises and stretches. You should do these exercises daily. Start off gently and then progress with longer harder stretches and strengthening efforts after you see how it feels. With patience and consistent effort you should begin to see results in 4-6 weeks.



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