Shoulder Blade Pain – Secrets Of How To Recovery
Shoulder Blade Pain
Shoulder blade pain can feel like aches/ spasms of muscles under the shoulder blade are often confused as being muscle knots or trigger points. Shoulder blade pain is treatable with exercise therapy, in combination with manual therapy. Often times resolving in weeks to months, depending upon severity.
As I wrote this article I decided to interview a few people just like you who’ve had shoulder blade pain. They were nice enough to share their stories so we can learn from them.
If you’re here to just find out what to do, I’d suggest to just go to my Achy Shoulder Blade Video Mini Guide. Super cheap, very effective and fully refundable if it’s not what you were looking for after all.
The most enlightening of the interviews was Becky.
She was able to successful return to full activity (work, yoga and sleep) after suffering from shoulder blade pain like you.
Becky has been a nurse for the past 10 years. She works 5 days a week in hospital, moving patients, charting notes and educating her patients about how to live a healthy life.
She’s currently fully capable of rolling patients over in bed, pushing wheelchairs, and going throughout her day without neck, shoulder blade or arm pain. Sleeps like the dead at night without the assistance of medication of any kind.
But she didn’t always feel this goods…
10 years ago, Becky was in grad school when she started to develop light headaches. Most days were mild just a light throbbing ache around the base of her head. Other days her headache would wrap around her head, towards her eyes and travel downward towards her shoulders. She got through most of the day with help of a frequent self massage and bi-weekly chiropractic work.
A few years later, her symptoms began to evolve.
Even though she feels great today, she can still recall the details like it was yesterday.
Most days she was in intense pain from the moment she opened her eyes in the morning. Sleeping was terrible due to the fact that it felt like a someone was taking a hand drill and boring a hole into her right arm bone all night, directly through her bicep.
Throughout the day, her pain began to increase and creep down into her midback and upper trap area. The pain was so intense at times that she said she would have been “willing to cut her arm off” if it would take the pain away.
She had to stop doing yoga, was unable to sleep at night and considered quitting her job.
Tucking her chin and looking upward at the sky were painful. Looking down to her chest was much better, but still not pain-free. While driving, she could not turn her head to check for cars as she changed lanes. She even bought those little blindspot mirrors so she could safely change lanes.
Sounds intense right? Yet, she was able to overcome it.
What did she do to feel better?
She didn’t it get better overnight. She spent months having her neck adjusted and getting massages with very temporary relief.
Eventually she found a chiropractor specializing in focal soft tissue work help her release a nerve in her neck and shoulder. After that she began to progressively get better. She looked forward to being able to work without pain and more importantly sleep and do yoga without any issues.
Want to be like Becky?
You can, you just need the correct plan of attack. The human body is truly resilient. You are just as resilient.
What is the correct plan of attack for shoulder blade pain?
I’ll take you through my 3-step process in this article. Recovery is simple if we first address the red herring that tends to distraction people away from REAL recovery.
REAL recovery returns you to ALL of the sports and hobbies that you love… not avoiding them because you feel “you’re getting too old” or afraid the pain will return.
Ask yourself what REAL recovery is for you.
What activity would you return to if you had ZERO fear of your shoulder blade pain returning?
What would life be like without shoulder blade pain?
Set a goal and focus on it. Set your goals high.
- Do you want to rock climb?
- Carry your daughter around on your shoulder?
- Play baseball and even pitch?!
This article will help you get there!
But first let’s get back to that red herring…
Companies that sell foam rollers, massagers, and trigger point products want you to believe your mid back/ shoulder blade pain is from a knotted up muscle, but they are wrong.
This belief is a red herring. It will make you believe you need to roll out your tight muscles on a daily basis. This red herring will hold you back from finding and addressing the source of your shoulder blade pain and ultimately getting better. Becky fell into this trap for years and progressively got worse.
The truth is your mid back pain (interchangable with shoulder blade pain) is not from a rouge muscle that has developed too much scar tissue from overuse.
That constant deep ache in the middle of your shoulder blades, that nasty shoulder blade pain, is actually a symptoms of nerve pressure, rooted in the neck or shoulder region.
Could your issue be knots and trigger points?
Sure, and those knots can be reduced with massage, myofascial release, foam rolling and trigger point devices.
These are what are called “compression therapies,” which is great for muscles knots, but not for nerves. The problem is that many times these “knots” are actually pain referred from nerve pressure, making these compressive therapies unproductive like in Becky’s case.
Nerves hate pressure and compression, but they love to breath (decompression therapies).
No, I’m not talking about that huge decompression machine that comes to mind. It’s simpler than that and it can be done in your own home. Becky needed a little assistance, but this is not the case for many people.
Stay tuned and I’ll get into more detail later in this article.
Nerves can tolerate some pressure, but if subjected to too much for more than 30 seconds they will let you know about it in the form of some of the sensations you’re feeling at this moment.
If foam rolling and massage hasn’t worked yet, consider the possibility that your source of pain is not from knotted muscles. You may just need to give the nerve a chance.
Personally, I give each treatment method a few weeks to produce a 50% reduction of symptoms. If these results aren’t found, then we simply move on to another method. The logical choice with “midback knots” is to address cervical nerves.
You’ve probably already experienced nerve pressure in your life.
Have you ever hit your funny bone that sends a zinger into your hand?
This is an example of how nerves are sensitive to pressure AND how they can feel so much better after the pressure is taken away.
NOTE: If they are under pressure too long they will actually develop long term damage.
Yes, the burning/ aching sensation under your shoulder blade is not the same sensation as a funny bone experience, but nerves can reveal a variety of sensations that can result from pressure.
- Creepy crawly flickers of the muscles
You name it and nerve pressure can make you feel it.
In the cases of chronic shoulder blade pain / tightness/ burning/ stabbing/ etc, the nerve that’s being subjected to too much pressure is the C5 nerve root (located in the mid neck).
As you can see in this image, the C5 nerve root is not the only cervical nerve root that can create shoulder blade pain. C6, C7 and even C8 can do the same, yet they often have other symptoms that present into the arm or hand (but not always).
Keep in mind, a pinched nerve can present differently on everyone. This is just a general presentation.
So forget what the gurus on social media have been telling you about foam rolling, massage and removing scar tissue from the muscles around the shoulder blade. They’re trying to sell you foam rollers and tools right?
They’re telling you that you’ll have to use their tools daily for the rest of your life to keep your symptoms at bay. They directly benefit financially when you believe your deep ache is a trigger point that needs to be rubbed away.
They benefit from the red herring.
If a treatment actually worked, then you wouldn’t have to do it everyday of your life, right?
So why does foam rolling, massage and trigger point work make you feel better?
Have you noticed the results only lasts for hours at most?
This is because compressive therapy tricks your nervous system and brain into ignoring the symptoms for a little while. Remember that old trick of stepping on your toe to make your headache go away… relief only lasts as long as your toe still hurts.
Compressive therapy bombards the brain with sensory information that dulls the pain.
If you’ve spent a good chunk of change on weekly massages and trigger point devices, not be embarrassed. Many people do the same thing before they find the true “fix.”
And to be honest, these treatments aren’t completely useless. They still yield a few hours of pain relief right? These treatments are amazing at pain “modification.”
They decrease pain momentarily so we can spend time addressing the real problem through MOVEMENT based correction (I’ll get into this more in a moment.)
Your body is amazing.
Your body has the ability to recover inherently built-in through movement.
Movement is the body’s natural way to un-pinch nerves and loosen up muscles.
Movement therapy doesn’t have to be complicated either. Simply taking a walk (relaxed with some nice arm swing) helps some people’s midback and shoulder blade pain. Crazy right?
Other people have improvement as they start to do yard work. I know it sounds silly, but people have been surviving for centuries without foam rollers.
I’ve even told some people to push their car (in neutral) to rehab their midback pain… they think I’m joking, but I’m actually very serious.
Pushing a heavy object (most people just happen to have a car) can be very therapeutic and decrease shoulder blade pain when used in the strength period of their care (discussed below).
Recovery from nerve-based shoulder blade pain comes in these phases:
- The First-Aid Period
- The Movement Period
- The Strength Period
Again if you’re tried of reading, you’re thinking you have nerve derived shoulder blade pain and just want to see what can be done…get my Achy Shoulder Blade Video Mini Guide. Affordable, very effective and full refundable if you hate it and simply tell me how to improve it.
The First-Aid Period (5-10 days)
The first aid period is just as you’d expect. First aid for cuts and scrapes is the simplest way to describe your nerve’s first aid period.
Rinse, clean the wound frequently, and don’t pick the scab as it heals.
With mid back tightness and shoulder blade pain, it’s the same thing. Your tools and methods are just a little different.
- Use position of comfort (these can vary) VIDEO TO COME
- Off load the nerve every hour for a few minutes while you’re awake
- Go for a walk (3 times a day for about 10 minutes per time)
Some movements may create symptoms during this period, so simply stay away from them of them.
Here’s a video of one of the first aid moves that has worked well for my clients, especially the people who have “psuedo rotator cuff syndrome”/ strains.
It’s called McKenzie Cervical Extension. It’s important to note that it’s a GRADUAL reduction and centralization of symptoms that I look for to validate this as a good first-aid for this person.
The first few may be tender, but as the reps increase it will do one of two things… make it more painful (in the blade) or reduced.
If reduced great! If not, then we would find another form of first-aid.
Not all first aids are created equal. The whole idea that there’s a “single exercise or treatment” that will work for everyone is complete bullshit.
Make notes of observation and patterns that develop. What seems to trigger your symptoms?
In the movement period, we start to re-integrate the triggering movements to become pain-free again.
Pain is a positive feedback loop and will feed itself if you let it.
This phase assists in breaking that loop, so we can exit the symptom cycle.
The Movement Period
In the movement period, we start to explore pain-free ranges of motion, without adding too much of a load challenge.
- Arm circles
- Legs circles
- Movement flow
These are great starts. I wouldn’t overthink this, just start moving.
If the symptoms return, then change that movement’s RANGE. Perhaps you weren’t ready for that much of THAT MOTION yet.
Don’t worry. You will more than likely be able to regain most of your motion back, if not all of it. Your body is very resilient.
Movement is medicine, yet sometime the medication is too much too soon.
The Strength Period
The strength period is where we have no acute pain, no fear that it will immediately return and we have already gained back most, if not all movements of the neck, shoulder and midback.
Often times the missing link (to gain more symptom-free motion) is the incorporation of some strength and support to the areas moving… the neck, shoulder and midback.
Funny though, in this period most people feel much better, so they tend to shy away from “making it worse.” To be honest, the lack of building strength around the pinched nerve is the reason WHY many people will have the same issues come back year after year, till they sadly start to tell themselves they are “broken” or “getting old.”
Depressing way of thinking huh?
How does strength support more pain-free motion?
The concept is simple.
What would happen if you were to push this sumo wrestler, yet you were significantly smaller?
No matter how hard you push, YOU would be the one moving. Not him.
Even if he just stood there (not pushing you back), you’d still be moving backwards. This is because his weight + gravity has made him MORE STABLE. More fixed to the earth. He’s like a rock that has been firmed planted into the Earth since the age of the dinosaurs.
What if we put you up against this lady?
Assume you’re both the same height and weight?
Some of you may think you could move her, but some of you are thinking, “well if her legs match her triceps then I’d be toast.”
Obviously she’s smaller than the sumo wrestler, yet still very strong in a smaller frame. She is still very STABLE.
Really we are talking about WHO is more STABLE AND FIXED TO THE GROUND in both analogies. The less fixed person is the one who will be moving.
Relating it back to your shoulder blade pain, we already know there’s more than likely some nerve pressure coming from the neck, so the question is HOW can we get the neck to move again without pinching the C5 or C6 nerve root?
Most people want to get back to full activity, but they are afraid of it coming back.
How can we be sure the neck can move and tolerate activities we love without becoming pinched again?
Simple, the neck moves better/ more freely when it’s surrounded by stable areas. Just like the analogies above, let’s simply build the strength (not size of muscles) of the areas in the shoulder blade, anterior neck (deep neck flexors) and deep core.
The mid back (thoracic spine) is important as well. It function less as a point of strength and more of a section of “attention.” Restoring midback extension and rotation are key in keeping your nerves from becoming pinched again.
Don’t worry about how to do this. This often times occurs as you strengthen the shoulder blade and core. What a bonus!
Adding load (resistance) to movements is actually therapeutic. Who would have thought?
Sadly, much of the general public thinks of resistance training as ways to lose weight or “get big like Arnold”… yet those are just extreme side effects. They occur when people “double down,” work really hard and spend more than a few hours a week partaking in weight training. It takes YEARS of hard work to boot.
I encourage you to get with a strength coach and start lifting weights. The weights don’t have to be extreme either. To get therapeutic benefits just make it “a little challenging.”
Contrary to what you think, lifting weights for therapeutic value doesn’t have to look like this guy. He is an extreme. Playing football once a week for 30 minutes won’t make you into a Pro Bowl star player. Weight training once a week won’t make you big either.
Special Note For Women:
Resistance won’t make you big unless you want it too.
I’m aware one of the biggest fear of picking up a weight (even to feel better in the neck and midback) is that you’ll get big.
Just chill and look around. Just a few observations you may notice.
Your friend who has been lifting weight 2 days a week for the last year, has gotten thinner, but you barely can see a muscle ripple. They’ve worked hard for that slight muscle ripple, very hard. A therapeutic dose of weights isn’t even close to what they’re doing so you can expect less muscles to show.
Second, if you did get big, don’t worry. Muscles are in style for women now. Maybe huge muscles aren’t, but take a survey of men you meet.
“Do you like a fit women?”
The answers may surprise you. Ask women the same question and see what happens.
I only bring this up because this ongoing fear that has been calmed by scientific evidence years ago continues to be a barrier for women to recover from simples aches and pain in their neck, shoulder and mid back.
This fear and false belief de-conditions the areas of your body that support healthy movements and feeling good.
If you’ve been struggling with midback burning, deep aches in your shoulder blade or upper trap tightness really take to heart the steps in this article. Remember Becky’s story?
The symptoms you’re experiencing are epidemic.
They’re extremely common and often times poorly addressed. Many treatment plans are cookie-cutter and non-specific to your unique end goal. Every person’s case is a little different.
Remember you’re not experiencing these symptoms because “it runs in their family” or because they’re “getting old.” Most people get problems like this because they’ve been mislead or unmotivated to make a change in their life.
You can do this.
Your body is not broken.
You’re not too old. You can feel as good as you did in your 20’s.
If you need help, reach out to me and I will do my best to help.
However, please be considerate that because I’m in the medical field that I cannot (by law) give advice to you directly… because I haven’t examined you. This is a medical code of ethics that’s present in every country in the world.
The only thing I can safely do is guide you through some video examples of exercises and methods we use in our clinic that will serve as guide for what to do within the 3 phases I revealed earlier.
My guide is not cookie cutter and not intended for you to simply follow the step.
The video guide is intended to enlighten, inspire and guide you to figuring out what works for you so you won’t be tricky into the “next best solution” that you see on Instagram.
My hope is this article and my video guide will shed some light on what should come next for you.
Dr. Sebastian Gonzales DC, Huntington Beach CA