That nagging ache under your shoulder blade can turn simple tasks like reaching for a coffee mug into painful reminders that something isn’t right. You’re not alone in this struggle, and the good news is that this type of pain rarely signals anything serious.
Most shoulder blade pain comes from muscle tension, poor posture, or joint stiffness – all issues that respond well to targeted treatment. Your daily habits, from hunching over a computer to sleeping in awkward positions, often create the perfect storm for this discomfort.
Understanding what’s causing your pain is the first step toward getting relief. Physiotherapy offers proven techniques to address the root causes, not just mask the symptoms, helping you get back to pain-free movement.
Why You Have Pain Under Your Shoulder Blade
Pain under your shoulder blade usually comes from four main causes: bad posture from sitting too much, weak muscles that can’t support your shoulder properly, injuries from lifting heavy things or doing the same movements over and over, and medical conditions that affect your muscles or joints.
Poor Posture and Ergonomics
Your shoulder blade pain often starts with how you sit and stand every day. When you slouch at your desk or crane your neck forward to look at screens, you put extra stress on the muscles around your shoulder blades.
Poor posture causes your rhomboids and middle trapezius muscles to stretch and weaken. These muscles normally pull your shoulder blades together and keep them in the right position.
Here are the most common posture problems that cause pain:
- Forward head posture – your head sits too far forward
- Rounded shoulders – your shoulders roll inward
- Slouched sitting – your upper back curves too much
- Uneven shoulder height – one shoulder sits higher than the other
Your workspace setup makes a big difference! If your computer screen is too low, you’ll look down and round your shoulders. If your chair doesn’t support your back, you’ll slouch forward.
A physiotherapist can check your posture and show you better ways to sit and stand. They’ll also give you exercises to strengthen the muscles that keep your shoulders in good position.
Muscle Weakness and Imbalances
Weak muscles around your shoulder blade create pain because stronger muscles have to work harder to make up for the weak ones. This creates an imbalance that puts stress on your joints and tissues.
The muscles that commonly get weak are your rhomboids, middle trapezius, and serratus anterior. These muscles control how your shoulder blade moves when you lift your arms or reach for things.
When these muscles are weak, other muscles like your upper trapezius and levator scapulae get tight and overworked. This creates trigger points and muscle knots that cause pain under your shoulder blade.
Common signs of muscle imbalance:
- One shoulder blade sticks out more than the other
- You can’t squeeze your shoulder blades together
- Your shoulders feel tight after sitting for a while
- Pain gets worse when you reach overhead
Physiotherapy treatment focuses on strengthening weak muscles and stretching tight ones. Your therapist will design specific exercises based on which muscles need work in your case.
Injury From Lifting or Overuse
Lifting heavy objects the wrong way can strain or tear the muscles around your shoulder blade. This happens most often when you lift something while twisting your body or when you lift more weight than your muscles can handle.
Overuse injuries develop slowly from doing the same movements over and over. Athletes who throw, swim, or do overhead activities are at higher risk. Office workers who reach for their mouse in the same way hundreds of times per day can also develop overuse pain.
Common lifting injuries include:
- Muscle strains in the rhomboids or trapezius
- Ligament sprains where muscles attach to bone
- Trigger points from sudden muscle contractions
Signs you’ve injured yourself include sharp pain that started after a specific activity, pain that gets worse when you move in certain ways, and muscle spasms or cramping.
A physiotherapist will assess your injury and create a treatment plan. This might include manual therapy to reduce pain, exercises to restore movement, and education about proper lifting techniques to prevent future injuries.
Underlying Medical Conditions
Some medical conditions cause pain under your shoulder blade even when your posture and muscles are fine. These conditions need different treatment approaches than simple muscle problems.
Thoracic outlet syndrome happens when nerves or blood vessels get compressed between your collarbone and first rib. This causes pain, numbness, and tingling that spreads from your shoulder blade down your arm.
Cervical radiculopathy occurs when nerve roots in your neck get pinched or irritated. The pain travels from your neck to your shoulder blade and sometimes down your arm.
Other conditions that can cause shoulder blade pain include:
- Fibromyalgia – widespread muscle pain and tender points
- Myofascial pain syndrome – chronic trigger points in muscles
- Arthritis in the joints of your spine or shoulder
If you have numbness, tingling, or weakness along with your pain, you should see a healthcare provider for proper diagnosis. A physiotherapist can work with your doctor to provide treatment that addresses both your symptoms and the underlying condition.
Some conditions need medical treatment before physiotherapy will be most effective. Your physiotherapist will know when to refer you to other healthcare providers for additional testing or treatment.
How Physiotherapy Can Help With Shoulder Blade Pain
A physiotherapist can identify the root cause of your pain through detailed assessment and create a treatment plan that includes hands-on therapy, exercise programs, and posture education. Professional treatment focuses on both immediate pain relief and long-term prevention strategies.
Assessment and Personalized Treatment
Your physiotherapist will start with a thorough examination of your shoulder, neck, and upper back. They’ll test your range of motion and muscle strength.
The assessment includes checking your posture and how you move during daily activities. Your therapist will ask about your work habits, sleep position, and exercise routine.
Based on these findings, they’ll create a treatment plan just for you. This might include manual therapy techniques like massage or joint mobilization.
Manual therapy techniques often used:
- Soft tissue massage
- Trigger point release
- Joint mobilization
- Myofascial release
Your therapist may also use treatments like heat, ice, or electrical stimulation. These help reduce pain and muscle tension quickly.
The goal is to address your specific problem areas. No two treatment plans are exactly the same!
Posture Correction and Education
Poor posture is often the main cause of shoulder blade pain. Your physiotherapist will teach you how to sit, stand, and move properly.
They’ll show you the correct way to set up your workspace. This includes monitor height, chair position, and keyboard placement.
Key posture tips you’ll learn:
- Keep your shoulders back and down
- Align your ears over your shoulders
- Support your lower back when sitting
- Take breaks every 30 minutes
You’ll also learn exercises to strengthen the muscles that support good posture. These include your deep neck muscles and upper back muscles.
Your therapist will give you reminders and cues to use throughout the day. Building new habits takes time and practice.
Strengthening and Flexibility Exercises
Weak muscles around your shoulder blade often contribute to pain. Your physiotherapist will prescribe specific exercises to target these areas.
Strengthening exercises focus on your middle trapezius, rhomboids, and serratus anterior muscles. These muscles help stabilize your shoulder blade.
Common strengthening exercises include:
- Rows with resistance bands
- Wall slides
- Scapular squeezes
- External rotations
Flexibility work is equally important. Tight chest muscles and neck muscles can pull your shoulders forward.
Your therapist will teach you stretches for your chest, neck, and upper back. You’ll need to do these exercises regularly at home.
The exercise program will progress as you get stronger. Your therapist will adjust the difficulty level based on your improvement.
When To Seek Professional Help
You should see a physiotherapist if your shoulder blade pain lasts more than a few days. Don’t wait if the pain is getting worse or spreading.
Seek help right away if you have numbness, tingling, or weakness in your arm. These symptoms could indicate nerve involvement.
Red flags that need immediate attention:
- Severe pain that doesn’t improve with rest
- Pain that radiates down your arm
- Numbness or tingling in your fingers
- Weakness in your arm or hand
If over-the-counter pain medication isn’t helping, it’s time to get professional treatment. Early intervention often leads to faster recovery.
Your family doctor can refer you to a physiotherapist. Many clinics also accept direct referrals without seeing a doctor first.
Don’t let shoulder blade pain become a chronic problem. Getting help early can prevent long-term issues and get you back to your normal activities faster.
Conclusion
Pain under your shoulder blade doesn’t have to control your life. The good news? Most causes are treatable with the right approach.
Key takeaways to remember:
- Poor posture is often the main culprit
- Muscle tension builds up over time
- Early treatment prevents bigger problems
- Simple changes make a huge difference
Your body gives you warning signs for a reason. Listen to them!
When to seek help:
- Pain lasts more than a few days
- Symptoms get worse instead of better
- You feel numbness or tingling
- Daily activities become difficult
Physiotherapy offers proven solutions that work. We use hands-on treatment, targeted exercises, and posture correction to get you back to feeling your best.
Don’t wait until the pain becomes unbearable. The sooner you address the problem, the faster you’ll recover.
What you can do right now:
- Check your workspace setup
- Take regular movement breaks
- Practice gentle stretches
- Apply heat or ice as needed
Remember, every person’s situation is different. What works for your friend might not work for you. That’s why personalized treatment matters so much.Ready to say goodbye to that nagging shoulder blade pain? Our team at Cloverdale Physiotherapy & Sports Injury Clinic in Surrey, BC is here to help you get back to living pain-free. Book your appointment today and take the first step toward feeling better!