Pulled Muscle Near the Shoulder Blade: Causes and Recovery

01Anatomy

Muscles around the shoulder blade

The scapula (shoulder blade) is held to the trunk by muscles rather than a joint. The rhomboids pull it towards the spine, the trapezius moves and stabilises it, the levator scapulae lifts it, the serratus anterior holds it against the rib cage and the rotator cuff muscles attach to its surface. Overload or sudden strain of any of these produces pain in the upper back.

02Symptoms

Symptoms

• Aching, burning or sharp pain between the shoulder blade and spine, or along its edge.
• Muscle tightness or spasm; tender knots.
• Pain with arm movement, reaching, pushing or pulling, and sometimes with deep breaths or twisting.
• Pain after sitting or sleeping in one position.
• Stiffness of the neck and shoulder.
• Pain that is relieved by changing position.

03Causes

Causes

• Prolonged slouching or forward-head posture, desk work and phone use.
• Lifting heavy weights or sudden twisting, gym exercises (rows, pull-ups, bench press).
• Carrying a heavy bag on one shoulder or a poorly fitted backpack.
• Sleeping in awkward positions.
• Repetitive overhead activity: painting, swimming, racquet sports.
• Weak scapular stabilisers; stress and tension.
• Coughing or sneezing violently (rib and muscle strain).

04Red flags

Other causes of pain near the shoulder blade

• Neck problems: cervical disc or joint irritation referring pain to the shoulder blade, with arm tingling or weakness.
• Rib or thoracic joint dysfunction.
• Lung conditions: pneumonia, pleurisy, pulmonary embolism or pneumothorax, with breathing-related pain.
• Heart conditions: angina and heart attack, particularly in women, can present as upper-back or shoulder-blade pain.
• Gallbladder and upper abdominal problems causing right shoulder-blade pain.
• Shingles before the rash appears.
• See upper back pain (Spanish).

05Self-care

Self-care

• Stay moving: short walks and gentle range-of-motion exercises; avoid prolonged bed rest.
• Heat or cold for 15–20 minutes at a time, whichever eases the pain.
• Pain relief: paracetamol or, if suitable, a short course of ibuprofen; topical gels.
• Self-massage with a ball against a wall or a foam roller, gently.
• Take breaks from sitting every 30 minutes; set up your workstation.
• Sleep on your back or side with a supportive pillow.
• Avoid heavy lifting and painful overhead work for a few days.

06Exercises

Gentle exercises

• Shoulder rolls backward, 10 repetitions.
• Scapular squeezes: pinch the shoulder blades together, hold 5 seconds, 10 repetitions.
• Thoracic extension over a chair back, or cat–camel on all fours.
• Doorway chest stretch: 20–30 seconds, to mild tension.
• Rows with a band, light, 3 × 12, once pain allows.
• Wall angels and prone Y-T-W raises to strengthen the scapular stabilisers.
• See upper-back exercises (Spanish) and muscle strain treatment.

07Time

Recovery time

Mild strains improve within a week or two, and moderate strains in 4–6 weeks. Recurrence is common without addressing posture, workstation and strength. If pain persists beyond 4–6 weeks, becomes constant or is associated with arm symptoms, a clinician should examine your neck, shoulder and thoracic spine.

08Prevent

Prevention

• Change positions regularly and keep the screen at eye level.
• Strengthen the upper back and shoulder-blade muscles twice a week.
• Use bags with two straps and keep loads light and close to the body.
• Warm up before exercise and build load gradually.
• Manage stress with breathing and relaxation.
• Keep active; sedentary habits increase pain.

10Cases

Three common situations

Pain between the shoulder blades after long hours at a desk: posture changes, movement breaks and strengthening.

A sharp pain near the shoulder blade after heavy rowing at the gym: relative rest and gradual loading.

Right shoulder-blade pain after fatty meals with nausea: consider gallbladder problems; see a doctor.

11Gym

Training around shoulder blade pain

Keep exercising other muscle groups and the lower body. Reduce rowing, pulling and overhead pressing to a pain-free range, use lighter weights with slow tempo and practise good shoulder-blade control (pulling the blades down and back rather than shrugging). Return to heavy sets gradually over two to four weeks, and avoid training through sharp pain.

12Summary

Key points to remember

Most shoulder-blade pain is a muscle strain that improves with movement and posture changes. Exclude red flags, and see a doctor for persistent, severe or unusual symptoms. Our physical therapy team can examine your neck, shoulder and upper back.

This guide is for general information and does not replace an assessment by your own doctor, physical therapist or speech-language pathologist.