Helping Upper-Trapezius Pain

Does your upper back ever feel tight, as though you have “knots” in it? You may have an upper-trapezius strain, a common repetitive stress injury (RSI). An RSI is a condition usually caused by placing too much stress or strain on a joint or musculoskeletal tissue. RSIs are often associated with performing recurring motions, whether on a computer, on the telephone or in a sports activity.

What can you do about an upper-trapezius strain? Catherine Logan, MSPT, a physical therapist, certified personal trainer and Pilates instructor at Sports and PT Associates in Boston, explains the causes of this strain and offers suggestions on what you can do to ease your pain.

The trapezius is either of a pair of large triangular muscles extending over the back of the neck and shoulders and moving the head and shoulder blade. Upper-trapezius pain can be triggered by consistently overusing the muscle group, even at a low intensity. Because repetitive motions do not allow the affected tissue to rest between movements, they can cause stress and irritation. Performing simple, everyday movements—such as habitually holding a telephone between the ear and shoulder—can trigger upper trapezius pains.

Why don’t the upper trapezius muscles always function properly? If you aren’t holding them in the proper position, the muscles can lengthen or shorten and cause problems. The upper trapezius muscle can shorten beyond its optimal length in certain situations; for example, when the shoulder is elevated and the neck is extended, side-bent and rotated, as when you are cradling a phone between your ear and shoulder. Throughout the day, this might happen to the upper trapezius muscle, while, alternatively, the rhomboids (muscles connecting the shoulder blade to the vertebrae) might be overly lengthened when the shoulders are rounded. Moving out of these positions from time to time throughout the workday will increase blood flow and oxygen delivery to the muscles. Developing better posture will help maintain the optimal length of the muscles. For helpful moves, see “Exercises at the Office,” below.

Specific exercises can also help prevent upper trapezius pain. For help strengthening your upper trapezius and related muscles at the gym, seek the guidance of a qualified, certified personal trainer. To promote endurance in these postural muscles, you might benefit from using an upper-body ergometer (UBE) for cardiovascular exercise. Rowing machines, if used with correct form, might also improve the aerobic capacity of these muscle groups.

For exercises you can do at the workplace for upper trapezius pain, read Stretching at Your Computer or Desk by Bob Anderson (Shelter Publications Inc. 1997) or see “Exercises at the Office.”

Sitting with upright posture, perform 15–20 reps of the following exercises every hour when
you are at your desk for upper trapezius pain.

1. Scapular Pinches. Roll the shoulders back, and pinch the shoulder blades together.

2. Shoulder Shrugs. Raise the shoulders up toward the ears, then lower them back down.

3. Neck Side-Bending. Tilt one ear toward the shoulder, and hold briefly. Repeat on the opposite side.

4. Neck Rotation. Look over one shoulder, and pause briefly. Repeat on the opposite side.

If you feel tight or sore in the upper trapezius after the above movement-oriented exercises,
perform 1–3 reps of the following static stretch, holding each rep for 30 seconds.

5. Neck Side-Bending/Rotation Stretch.

• In a standing or seated position, place the right hand on top of the head and let the
  left arm rest at the side.
• Gently pull the head toward the right shoulder with the right hand.
• Rotate the head down and look at the right hip. (The stretch should be felt on the left
  side of the neck/shoulder area.)
• Repeat on the opposite side.

If your shoulders tend to round forward, you can improve this condition by the scapular
pinch and by a pectorals stretch.

Have a question about upper trapezius pain? Ask it here.