How Posture Affects Shoulder Blade Pain

I'm Dr. Molly, with Your Goals Physical Therapy, let's talk about that burning pain between your shoulder blades or maybe it's right underneath your shoulder blade. You can feel a knot there and you just want to dig the sucker out, but it just keeps coming back every month like clock work. 

When you go to your massage therapist, it gets better for a little bit, but the knot and pain comes back after 3- 4 weeks just like clockwork. Then you're grabbing your shoulder blade like the pain never left. It feels like if somebody could just take their elbow and dig into just the right spot it would finally just disappear. But meanwhile, it hurts when you move your arm a certain way, or if you have a stand in the same position at your desk. It's just constantly talking to you every day without fail. And it's progressively getting worse. How frustrating! If you ever wonder, “Is this really just from how I'm holding my stress?”, or “Is this something that I'm gonna be dealing with forever.” 

That's what I wanna talk about. Your stress can definitely cause things in your body to hurt, but many times when talking about the burning pain in your upper back or shoulder blade, it's actually caused by your posture.

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I wanted to give you three tips to determine if it's your posture that is causing that pain to be progressively getting worse. Here are the three things to look at: 

1. Where is your Head? Is your head right over your shoulders?  The best position for your neck is to have your ear over your shoulder; because your neck muscles and the upper back muscles don't have to do any work. The moment your head is in front of your body, all your neck muscles and your upper back muscles have to do a lot of work to keep your head from just completely going forward.
2.  Where is your thumb pointing? If your shoulders are in the “normal” anatomical position, which is the ideal position for your body, then when your arms are relaxed by your side your thumb will be facing forward.  But for many of us, that thumb starts to turn in until it points at our leg. When your thumb points at your leg it means that your shoulders are pulled forward causing your back and shoulder muscles to be stretched. When those muscles get pulled to the end of their range then the muscles will protect themselves by causing a muscle spasm.   
3. Where are your shoulder blades? This one you might need a friend to help you with. How far from your spine are your shoulder blades? Take two fingers and put them between your spines and shoulder blade.  If you can only fit two fingers there, then your shoulder blade is in the right place. BUT If  you can fit more than two fingers between the spine and shoulder blade, then it indicates that your shoulders are rounded.  The increase in space between your spine and shoulder blade is caused by stretching the back muscles; once they stretch to the end of their natural range the muscle will spasm to protect itself.  

So if you find one or more of these changes to your posture, then that could be why your general exercise program and your monthly massages help you manage your pain but have not resolved your pain.  What you need are very specific exercises that get your muscles and ligaments to restore your good posture. The program needs to help your muscles relearn how to work correctly, and it needs to help you know what up right posture feels like. It may sound easy but really it's complicated because there are a lot of muscles in your upper back, so learning how to move muscles that have been overstretched is hard. 

I love helping people improve their posture! I help people stop that burning pain between their shoulder blades permanently by improving the strength and function of their upper back and neck muscles. When my clients are finished they may still get monthly massages BUT it is only because massages are amazing…not because they are managing pain. 


I just wanna get out the word that it's not necessarily just the stress of your job that's causing you to have burning pain between your shoulder blades, it could be a change to your posture.  If you need some specific exercises and a specific plan to help you, simply send me a direct message and we can talk about your specific situation so we can get started. I hope you're having a great day. 

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