Massage Tutorial: Rhomboids (myofascial release, pain between shoulder blades)
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- Опубліковано 8 лип 2024
- My new book is out! It's called Massage Is Weird: massagesloth.com/book/
Got clients with pain between their shoulder blades? Here's a strategy for dealing with it without causing excessive soreness the next day. We go over some of the anatomy and do some palpation as well.
0:00 Introduction
0:35 Anatomy and palpation
5:43 Working directly with the rhomboids
7:35 Working with the pain indirectly
The rhomboids are mostly covered by trapezius. It can be very difficult to distinguish between the two, leading some massage therapists to identify the border of trapezius as a "knot." While you can work on the rhomboids through trapezius, just realize that both will be affected.
Also realize that both are quite thin, and that they're likely chronically overstretched and hypertonic. This can lead to all sorts of pain symptoms and dysfunction. While I do work directly in that region with some myofascial steamrolling, I find it much more beneficial to work on all of the muscles creating that force outward: The rotator cuff, serratus anterior, and pectoralis minor.
Let me know what you think! Do you prefer more direct interaction in this area? Have you had success with the indirect method? Thanks for watching!
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A pleasure to watch your work and you’re an excellent teacher. Please never stop making your informative tutorials.
I love your videos. I'm a Connecticut licensed massage therapist :-)
This video helped me create a better plan of attack on tissue surrounding Rhomboids.Thank you!!
thank you for this demo. I have so many clients with these issues. I have been doing similar work but much too superficially. I have been a massage therapist for 8 months. I planned on talking a myofascial release class, actually, this weekend but just found out it was cancelled. So glad I saw your video. It feel like I will provide more relief to my clients.
Nancy Marquez Great, let me know how it goes! Finding the right depth and duration is a process of trial and error, especially at first. I highly recommend taking a myofascial class when you next get the chance, just know that we sometimes say weird things :)
I am so glad to learn this! My dear husband has been wailing on those rhomboid trigger points and it's never letting up; now I know why! Thanks to you, Ian, I may eventually get real relief! And no more forward head, uh-uh!
Glad this shed some light on it! As far as forward head posture, it's a fine thing to try to be more aware of your posture as you go through your day, but trying to force yourself to stand in a military posture (and then shaming yourself when it starts to hurt and you stop) is a good path to frustration. Be mindful of your posture, but mostly rely on stretching and strengthening for long-term changes. Best of luck!
I absolutely love your videos. They are so incredibly informative and I learn so much from you. You are an amazing teacher. I too wish I had you as a instructor at my massage school. Thanks so much!
Wow i wish I had seen this video sooner, before I spent all that time and agony digging deep with the massage ball trying to find all the rhomboid trigger points. Instead I should have been focusing on the muscles around the shoulder, particularly stretching out and loosening the chest muscles.
Thank you for the explanation/demonstration differentiating rhomboids and trapezius!
Thank you for providing these videos! Very clear explanation of what exact muscles are causing chronic pain.
Great stuff! I would recommend your videos to all massage therapist. Your explanations on each muscles are great! Thank you!
Your channel is my favorite on myofascial release and massage in general, as someone who practices neuromuscular therapy, these techniques really compliment a lot of that work. Thank you for your contribution and knowledge! Cheers!
Much appreciated, Andrea!
Finally some decent massage video... TQvm... keep up the good work.
Glad to have finally found an excellent tutorial/tutor after searching the net for ever. You have a very engaging, calm and articulate manner that is very easy to watch and understand so BIG THANKS from Australia!
Alisa Tierney Glad to be of service, thanks Alisa!
thankyou for your videos! extremley helpful, explained at a good pace, with patience and detail! A great support to my studies :)
oh my gosh! you've helped answer so many of my questions! I'm going to be in a happy mood at work today!
Thank you very much for the perspective massage sloth! I have watched many of your videos now and putting into to practice your very helpful tips. Your way of massaging has taught me to be kinder to my client's body i'm no longer digging in unnecessarily and getting a better relief pay off with slower broader techniques. Also your video about the "not knots" also really resonated with me and I have been putting that into practice, I had never looked at it in that way before and your videos opened up a whole new way of thinking for me. You make an excellent teacher!
I really appreciate the kind words, and I'm continually grateful that my philosophy resonates out there. Thanks for watching, and let me know if there are videos you'd like to see!
Thank you so much! I've been working on a client with pain in this area, and while I work all the areas stated I never realized that I could be overworking the rhomboids as well-it makes perfect sense to think of them as the victim that's already stressed! I will try steamrolling and focusing my more detailed work on the other areas, hopefully we'll see some improvement! I love your videos, thank you so much!
Glad to help, and thanks so much for the kind and thoughtful comment!
Your videos are my favorite!!!
Great instructional video.
Wonderful explanation to help anyone understand!! Thanks 🙏
When I hit lotto I’m gonna hire you because I’ve been in constant pain for almost 30 years. Gonna get my TENS unit soon. I got a Theracane too.
Subscribed in a flash, and looking forward to viewing more of your videos. I wish I had you as a lecturer on both massage courses I've done, the learning, on another level, starts here. Thanks.
Smile Fitness Exeter - Personal Training, Biomechanics Coach and Massage Therapy Much appreciated!
very good work and explanation!
just amazing work....thank you for all you videos!
Thank you so much for your videos. You've helped me so much
I love working around the complaint area. Great video. Awkward but efficient, that's so LMT.
That was a great video on the rhomboids! Thanks so much!!
Awesome video!
I like how you explain that the rhomboid trap pain is probably stemming from how slouching elongates and loosens the rhomboids making them less stable. Now I understand things
Hello Ian ... I just wanted to send you greetings from Barcelona - Spain !!! You are a good professional, have sense of humor and I understand your English perfectly when you comment the videos ... :) They are helping me a lot .. Gracias !!
Thanks so much, Sara!
Brilliant video! Thank you.
Very informative,indepth presentation.
Great video. Ian, is the best in my opinion.
Thank you so much for you videos!! Very educational and it add on to my practice.
thank you for sharing
So well explained....❤
Thank you for demo of the rhomboid muscles!
In so much pain!
AWESOME!!!!
Want to take your class, so refreshing info and easy to understand.
I bet that feels heavenly ❤️
Very Informative Thank you!
Amazing video. 👍🙏
Thank you! I love your videos 🙏🏼
amazing, thanx!
Very soothing voice
Thankyou!!💗
Thanks so much for my Daughter is having this pain and I have learnt how to have that soft and rotating move. She is in pain and discomfort and I am trying all the moves that u have taught .Thanks again.
That's really nice of you to work on your daughter! She may also benefit from a stretching and strengthening regimen from a physical therapist, and as always, if her pain persists or worsens, I do recommend seeing a doctor. Best of luck!
Great video. Has back spasms last week..
dude! you offer time codes your amazing!
Nice!!!
merci!!
Omggg the best area to be massaged... it is always tight .... when massaged it hurts so good 🙌🙌❤️❤️❤️❤️❤️❤️❤️❤️❤️❤️
That Has Gotta Feel Good !!!!
“But that’s not really the full story of the rhomboids...” this man is poetic
WHAT ABOUT YOU? YOU KNOW ZUMA🐍
@@anawahid2509 zumakabilang buhay 😂😂😂✌️
This is awesome! I learned so much!
Also- couldn’t help but notice the blue canary in the outlet by the light switch, who watches over you! Must be a They Might Be Giants fan! Bonus points!
Great video! I have had nagging pain here for years, won’t go away. I wish you were local to me. :( I need someone like you!
Just realize that there's a lot you can do yourself! Pain in the rhomboid region has to do with the tug-of-war between front and back (and maybe some shoulder and neck involvement as well). A full-body movement regimen of some sort (weight training, yoga, etc) led by a trained professional could help, and this might even be a job for a physical therapist. They'll be able to give you a customized regimen of stretching and strengthening that can get that nagging pain to gradually decrease in intensity. Best of luck!
Great stuff as always! Thanks again! :)
I learn so much with your videos . I wish I had you as my professor at the Massage School.
hi up to now from what ive seen you seem to be the most knowledgeable in every aspect . Im taking courses in Dominican republic on massage and am having to learn everything from othersources since what they teach here is incredibly limited. I know better anatomy an physiology than teacher. so I was wondering where you received your massage degree or school and where are you based in. please. great stuff
Thank you, all your vids are so informative...just wondering, how did you become so familiar with anatomy??
Cassandra Breedon Great instructors at the Florida School of Massage, A&P courses at college, and lots of reading! I also taught A&P at a massage school for a while, so that really makes you step up your game. Thanks for the question and for the kind words!
very good information!! I will take a different approach to working rhomboids now.
Really nice! Thnx :D
How would the massager use the elbows arm and other body parts
Hey Ian! I'd like to recommend a video on how to use back of palms or how not to strain wrists while massaging, I've been using too much open fist and palms and it's hurting my wrists :/
joseph lee Hey Joe! I'm definitely down to show more techniques for taking pressure off the wrists, but can you tell me a bit more about it? What do you mean by "back of palm"? Where are you feeling the pain, and during what parts of the move? For instance, you might feel it when your wrist gets to an extreme angle of extension, or it might get worse as you reach the low back, etc. Feel free to message me if you'd prefer, I'd like to hear some specifics.
For now, consider using a supported palm more often (ua-cam.com/video/P19ENoUaWKs/v-deo.html), and try bracing your wrist when you're using your open fist at an angle that causes pain. To do this, just wrap the other hand around the wrist gently but firmly. You're not trying to force it to stay in place, just offering a little support. I'll have a video on open fist use this coming Monday. Keep an eye out for opportunities to use your forearms/elbows as well! Good luck, and let me know how it goes.
Thank you! Great video, great instruction! Most videos on rhoboid pain
here on youtube tell you to strengthen your serratus anterior - you
emphasize releasing it. They want you to widen the space between the
shoulderblades, you want to allow the rhomboids to keep the
shoulderblades close to the spine without other muscles interfering. Do
both methods go together or do the contradict each other? And do you
think one has to be wrong, or does it depend on the case or person?
That's a good question, and the answer that I've come to after many years is: The body isn't picky, it can make use of a lot of stimuli, and it can usually adapt. So, while it might seem counterintuitive to strengthen the serratus anterior and pecs when they're already winning this particular tug-of-war, that stimulus could potentially be pain-relieving, and will almost certainly be better than doing nothing (i.e. continuing to be sedentary, or just giving your body the daily stimuli that resulted in pain in the first place). I could easily see the body finding a new state of balance with daily serratus exercises, even strengthening the rhomboids reciprocally. Anything is better than nothing in this case.
My preference, keeping in mind that I'm not a physical therapist or trainer, would be for any client with upper back pain to have a broad strength training regimen rather than something so specific. They'd do moves that strengthen their shoulder retractors, yes (rows, pull-ups, etc), but also everything on every other side of that equation. They'd press forward, they'd press up, they'd do core work, and even lower body work. With time the nervous system would use this information to find a more comfortable resting tone, rhomboids and the shoulder protractors would both gain mass, and the rhomboids would almost certainly be left happier and less stressed out.
This is just my working theory, btw, but it makes sense to me based on how many seemingly contradictory physical therapy and massage therapy regimens seem to get good results. The body figures it out.
@@MassageSloth Thank you very much for the detailed answer!
Now I do have a question that may or may not be relevant to the subject in the video, but I like to keep my routine fluid and rhythmic, would you say it's crucial to maintain that flow for specific work or for clients that want insane amounts of pressure? I just find it hard to reconnect strokes when I'm doing specific or very deep pressure lol, for instance some therapists maintain contact at all times but some take there hands off and re position elsewhere
Hydroxoid You can definitely do this type of work while maintaining a constant "flow," you just have to be willing to slow that flow way down for certain deep and meaningful moves. You can return to slightly faster smoothing and warming moves in between, and the change in rhythm can make it all seem new and lovely. If you'd like to incorporate some deeper and more specific techniques into a flowing massage, realize that you can set up each move and finish each move with just a single hand.
For instance, while I'm finishing with a stroke down the back, I'll gently move one hand to the next starting position (say, for a steamrolling move across the low back). As that fist is getting into place, the other palm will finish and move to its new starting position. Once I'm done with the two-fisted move, one will gently come out and set up the next move, and so on. I call it "mime hands." See if you can spot it in one of my more general videos. Thanks for the question!
Feels like my spine and the areas beside it hurt. I finally had that growth removed from the erector spinae muscle. It was deep! I’m doing physical therapy but I really need massage.
What were the symptoms of the growth?
@@rebeccakellogg3948 You could see the thing even when I was fully clothed.
Where is your office located? If it's anywhere near me, I think you're the massage therapist for me! You're very knowledgeable, obviously experienced, and are an excellent teacher.
+singwisevocals Thank you! I'm down in Pensacola, Florida... which is usually pretty far away from people :) If you can't see me, good luck on your quest!
Massage Sloth I live in Daphne, I would love to come see you. Im a LMT as well.
Kara McIlwain It'd be great to see you, Kara! You can find me at www.painfreepensacola.com
I wanted to get your input on my condition I have bad back acing in the mid back exactly where romboid muscle is but I only have pain there when I'm on standing and walking also with arm movement. I don't have it when I'm sitting or lying down the pain is like a burning, acing, very uncomfortable to live like this. what do you think?
same here 🙃 I feel same pain only when I walk or do physical activity for more than an hour
@massage sloth, does myofacial pain of the shoulder/upper back region completely heal with time (as in muscles finally release full time)?
Upper back and shoulder pain can absolutely reduce and even disappear over time, if the body receives the right inputs. That can be massage, but it can also be in the form of more frequent breaks at work, improved desk ergonomics, implementing a yoga or strength training regimen, etc. If you're waiting for something to heal, just realize that the body is likely structurally sound and stable (and so its job is done), but the sensitivity and pain can stick around because the body thinks you need tightness and sensitivity. You can prove that it can loosen up by moving in new ways or changing some habits. This can be self-directed, but you might benefit from a few visits with a physical therapist or occupational therapist for a customized regimen of stretching and strengthening. Best of luck!
Could you explain STEAM ROLLING?
Tracie Hoenig Ah, great question! I've been saying it for so long that I forgot that I made it up. By steamrolling an area, I just mean slowly smoothing it out. This can be with a lot of pressure or a little, but it should be broad. I do this to work with the broad sheets of fascia rather than any particular muscle. By angling the technique (about 45 degrees rather than directly down), it involves a bit of skin stretching as well. By patiently "ironing out" the myofascia like this, you can warm and soften large areas. It feels good, and it can be a good warm-up for more specific techniques.
Thanks for commenting!
My husband has sharp pain in shoulder just certain moves not all the time. I think it is from playing guitar with gusto. What can I do for him and what can he do to prevent or stop the pain. It could be rotator cuff or bone spur perhaps. Bone spurs ? How do you deal with those?
+Dina Metaweh Hi Dina! A medical evaluation may be necessary, especially if the symptoms persist or grow worse. In the mean time, some gentle "ironing out" or the pecs and rotator cuff may be helpful. Don't worry about working with the joint itself, just try to encourage the muscles that surround it to chill out. Here's my rotator cuff video: ua-cam.com/video/kn1vyKlf-KQ/v-deo.html Best of luck!
Hey Massage Sloth....do you use any waxes, creams etc when doing Myofascial work ?
marijka ter morsche Good question! I need to start including this in more videos. I use a bit of jojoba oil or shea butter. A little goes a long way, and they provide excellent "grip" when you use less. That said, I veer over to the Swedish side of things regularly, and jojoba works great for the faster work.
Massage Sloth thanx :) im currently doing a myofascial release course and exploring this....I am being taught to not use anything, but to get that glide that I see in your videos I thought you possibly do...I will give it a go :)
marijka ter morsche I see! My advice would be to start out with minimal or no lubrication while you're still learning from a teacher that does this. You'll get a different appreciation for the work, and you'll learn a way of approaching the tissue that most other massage therapists can't do. Start adding more oil and other techniques once you feel like bending the rules a bit :) Good luck!
thanx :)
Massage Sloth I’m allergic to oils & lotions. I have to moisturize my damp skin with Vaseline brand petroleum jelly. 🤷♀️
why does my rhomboid hurt everyonce in a while after a pull workout? i was doing some dumbell rows and my rhomboid on my left side started aching again. When i take a deep breath i can feel a slight tension or pain on it
I can't be exactly sure, but a muscle could be getting tweaked. This could be rhomboid, or one of the other nearby muscles (intercostals, erector spinae). So, I can't say exactly why, but I do recommend either modifying that exercise, or replacing it with another pulling movement (cable rows, pull downs, etc). This change is best made under the guidance of a well-qualified trainer. In the mean time, give your injury some time to heal, and consider seeing a doctor if your pain persists or worsens. Best of luck!
This can be a slipped disc
Would it be beneficial to work lateral to medial?
Quin Mayunga Great question. While some instructors emphasize the direction of the stroke, they seem to do so out of the belief that we can convince the tissue to go one way and stay there. This assumes that we're making structural changes, an idea that isn't borne out by research. It's more likely that, by way of prolonged stretch of the myofascia, we're convincing the nervous system to reduce tone and sensitivity. I'm not convinced that the direction of stretch has any effect on that, but I'm willing to be wrong. Thanks for commenting!
arnt you describing the traps?
10 years back I used to go to gym and I had racer cycle and I stretched my upper back muscles and they became so sore that I had to give up gym and cycling and even a bumpy ride in bus would give me sore upper back.......years past and now I work for bank and have to spend 8 hours in front of complete everyday and that pain is back with more severety.
I am seeing physio and she told me it was rhomboid muscle and I need to improve my posture.... After 8 sessions I have no improvement and I landed to this video.....
I was wondering if any one could help me or suggest me to cure this chronic pain please
Abhijat Bhanot how is it now?
This can be a pain due to slipped disc .
hey Massage Sloth, i was curious, are you using any kind of lubrcation while doing this work?
In most cases I have some jojoba oil applied. I kind of... forgot to mention this in a lot of older videos 😩
@@MassageSloth Haha no worries, i was just curious.
I also wanted to say thank you for your videos.
I've been a LMT since 2013, stopped practicing for a few years, and recently started a new job as a MT again. It's been so incredibly helpful to have someone like you who posts content like this for someone like me who has struggled to get back into massage again. It can be overwhelming: all of the muscles ( O, I and A of them all), anatomy, physiology, etc is a lot at times, but your demo's and knowledge is very straight forward and has been such a huge help for me. Thank you so much.
Edit: typo
@@Ooccoo31 Ah, that's so good to hear, Maddie! Congrats on getting back to it, and glad to have helped 🤗
I've read that rhomboids are one of the more "unstretchable" muscles. Any truth to that? I do a lot of protraction exercises and stretches and have been having some mild soreness in the upper back. But not it seems as though it may not be rhomboid. Can overdoing protraction (belly lifts, cat cows, punches) lead to rhomboid injury?
The rhomboids are made to extend, often in prolonged and even bombastic movements (think pitching or boxing, both of which involve rather violent protraction of the shoulder blade). Massage therapy itself basically involves doing a partial plank for an hour at a time (at least the way I do it), as do a lot of crafts and manual labor jobs. So, keep all that in mind when I say this: Lots of protraction is normal, but the solution isn't more protraction. Basically, if you're doing a lot of work/exercise with your arms thrust forward, you won't find relief for your aches and pains by doing *more* stretching of your rhomboids. Instead, keep doing your planks and cat cows and bag work, but make sure you're also doing some shoulder retraction. Make sure you're doing pull-ups/pull-downs and rows. Make sure you're stretching your pecs and rotators cuffs (I discuss some good ways to approach that here: ua-cam.com/video/Ascz2whmczs/v-deo.html). Forget about targeting the rhomboids, and just make sure your stretching and strengthening regimen is balanced and varied, and you'll avoid a lot of pain. That said, if you've got upper back pain that persists or worsens, do see your doctor for a referral to a physical therapist. Sometimes nothing beats a customized regimen.
@@MassageSloth Wow! Thank you for this thoughtful response. Makes a lot of sense. Very much appreciated 😀
Stuff im already doing
What, if any, are you using as lubricant?
+Joseph Tosti Good question! I'm trying to get better at mentioning this in my videos, but my brain is terrible at staying on script. I use a small amount of jojoba oil, usually a nickel sized pool in my palm. Not enough to create a visible oil slick, but enough to keep me moving. If I feel like moving quickly (more of a myofascial Swedish), I'll apply some more.
if i have pain there and i dont do anything will it go away?
Hi Angela, in my experience this upper back pain tends to be persistent unless some changes are made. That can mean simple things like standing up and moving more often at work, some brief daily stretches, or a new gym regimen. What exact changes need to be made vary from person to person. You can try implementing some changes yourself (following a brief yoga routine in the mornings, etc), but it can help to see a professional. That could mean a personal trainer, yoga instructor, massage therapist, or physical therapist. I recommend seeing your doctor if this pain persists or worsens, or if it's interfering with your life. Best of luck!
So....talk about what One can do....if they don't have a professional table...the table is 'everything' for massages; both for client/clinician. Any ideas anyone....Beds don't work....too low and soft. What do you use for massage oil.
all my back pain is about to be gone ❤️😍
Is it gone now?
My scapula is in agony today - grinding and referring pain all over. Watching your videos while in this much pain is a little like watching porn. I keep moaning and saying, "Yes please, can I have that move right there?" I think I'm going to take these videos and show them to the people where I go for PT - or better yet, can I be one of your demo models?
sp44113 If you're ever near the Florida panhandle, I'm always looking for models :) I mostly use my friends, and I fear that one day they'll hold an intervention and make me stop. Sorry to hear that you're in pain, best of luck!
sp44113 exactly!!! I’m doing the same thing. Looks like he nailed it. I need to find someone to do this for me. I’m in horrible pain.
Lord, would give ANYTHING to be Kristina right now...I've had awful upper back pain, & nothing has helped.
Bạn có thể phụ đề tiếng việt tốt biết mấy
The poor rhomboids!!
So being HUNCHED over all day Installing woodflooring Could be the Reason I have pain there??
"northward" 😁
How do you properly "guard a woman's breasts....not to get crushed under her weight whilst she's prone? We're all different sizes....but breast tissues are tender. Thx.
Why is the bed so low? It looks so awkward and not good for his back. I've never seen that in any other physio therapist or chiro videos 😏
I talk about my reasoning here: ua-cam.com/video/DGIkIU_1Bns/v-deo.html I like it because I get to use nice straight arms and let gravity do most of the work. For anyone trying a low table, I advice easing into it and listening to your body!
Is that katy perry? Lol
Half of the video is literally explaing rhomboids
How dare you call me a Rhomboid
Es masnlo que habla que lo que hace. Me hizó perder mi tiempo
Talk to much and work little bit. I lost my time
Cindy L the explanation is what makes the video. It’s why we come.