Common Compensations: Trapezius Pain

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Neck PainA sword piercing through the eye. Massive headaches. Aching jaw. Tingling fingers. Shooting pain down the arm. Uneven shoulders. Weak grip. All of these issues and more are caused by probably the most common compensation of all, upper trapezius.

The upper trap extends from ligaments near the first 6 cervical vertebrae to the top of your shoulder. The muscle normally functions to upwardly rotate the shoulder blade to help you raise your arm above 90 degrees. When the upper trap functions as it should, all is good with the neck and shoulder complex. However, if you have weak rotator cuff muscles such as the supraspinatus muscle along with weak scapular stabilizing muscles (rhomboid, middle trap, and lower trap), every time you raise your arm, whether overhead or out to the side, above 90 degrees or below, the upper trap is happy to assist in your movement to allow you to do what you need to do. Whether it’s reaching for a dish in an overhead cupboard, painting a ceiling, driving with your arm leaning on the door, or playing baseball in your summer rec league, you may feel like you’re doing just fine; but silently, overuse of the upper trap muscle results in increasing muscle tightness, even at rest. Subtle symptoms will start to occur- neck stiffness with prolonged computer work, headaches when driving, or shooting pain down the arm when holding an infant are all signs of an overused upper trap.

Trapezius MusclesHow do you know if this is the source of your symptoms? First, find a physical therapist who can diagnose the problem. When the upper trap is excessively tight, it frequently sends trigger points to the same side eye, which feels like a piercing pain going directly through your eye. When the upper trap is excessively tight, the levator and scalene tend to be tight as well, pulling the posterior first rib into an elevated position. This can compress the brachial plexus, a bundle of nerves that exits the cervical spine levels and extend to the muscles of the arm. The result is pain, numbness, tingling, and burning sensations down the arm, and even arm weakness if the nerve compression continues. These symptoms are often called a brachial plexus injury, Erb’s palsy, or brachial radiculitis.

What is the solution to all of these painful symptoms? Relax the upper trap, reverse the compensation pattern, and strengthen the rotator cuff and improve the scapular stabilizing muscle group activation and strength, so the upper trap never has to compensate again. Also specific manual therapy treatments to resolve joint tension at the cervical-thoracic junction of the spine and at the posterior first rib and clavicle performed by a manual physical therapist are also very critical to release any brachial plexus nerve compression as well.

Your posture is very important to help prevent this injury from re-occuring. Keep your shoulders low throughout the day (maintain the space between the top of your shoulders and the bottom of your ear) and when performing prolonged tasks, such as painting, working at a computer, and driving. Use a heating pad for 15-20 minutes and then stretch the muscles of your neck gently to maintain and gain muscle flexibility. The Theracane is a self-soft tissue mobilization tool specifically designed to address upper trap muscle tension and tightness. Using it daily or simply as needed is another good way to keep your muscles relaxed and happy, without the extra helping.

Theracane

*All of the following stretches should start with excellent posture in sitting. Warm muscles stretch better, so stretch after a work-out, hot shower, or heating pad helps increase your flexibility more. Also, you can sit on your hands (palm side up) to increase your stretch, if the stretch is hard to feel.

 

Scalene Stretch

Scalene Stretch

1. Tilt your head to one side to feel a stretch, but no pain at the side of your neck.

2. Hold for 20-30 sec.

3. Repeat to the opposite side.

 

Levator Stretch

Levator Scapulae Stretch

1. Tilt your head to one side to feel a stretch, then rotate your head to look down at the floor.

2. Hold for 20-30 sec.

3. Repeat to the opposite side.

 

Upper Trap Stretch

Upper Trap Stretch

1. Tilt your head to one side to feel a stretch, then rotate your head up to look up toward the ceiling.

2. Hold for 20-30 sec.

3. Repeat to the opposite side.

 

Part of our Common Compensations series.