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Rhomboid Muscle Strain

A rhomboid muscle strain is the tearing or overstretching of muscle fibers of the rhomboid muscles, which are in the upper back. The diamond-shaped muscles, the rhomboideus major and rhomboideus minor, connect your spine to the medial (inner) edges of the shoulder blades and assist with movement of the arms and shoulders, the stability of the shoulder blades, and the maintenance of correct posture. In particular, these muscles are used when forcibly lowering a raised arm, for example, when serving a ball during tennis.

Rhomboid strains can also be felt as muscle spasms, an involuntary contraction of one muscle within a group of muscles, which may result in the formation of knots in the muscle.

The most usual cause of a rhomboid muscle strain is overuse of the muscle, particularly actions that involve raising the arm above the head.

Other causes can include carrying an uneven load such as a heavy pack over one shoulder, sitting with poor posture at a computer for long periods, or participating in a sport such as rowing.

  • Pain between the shoulder blades and spine, which may be worse with movement
  • Feeling of tightness or tenderness in the upper back
  • Pain may be worse when taking a deep breath
  • Palpable knots in the muscle
Your doctor will take your medical history and will ask for the details of any previous injuries to your back or shoulders. You will be asked about the circumstances of the present injury, your current symptoms and whether you normally participate in sports or other activities. You will then have a physical examination. Your back and shoulders will be palpated (touched) to find areas of tenderness or tightness, and you may be asked to move your arms in particular directions to determine the range of movement and if such movement causes pain.

Rhomboid muscle strains are treated conservatively (non-surgically). You will have to avoid any activity that makes the condition worse, which may involve temporarily changing your sport to one that does not involve using the strained muscles.

The application of ice to the affected area will help to reduce inflammation and pain. Ice can be crushed in a bag, covered with a towel, and placed under the back when you lie down. You can apply ice every few hours for the first two or three days after the injury, and keep the ice in position for as long as is comfortable.

After a couple of days of treating the area with ice, hot showers can often be an effective treatment for pain associated with rhomboid muscle strain.

You can take over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) according to instructions, or your doctor may prescribe stronger medication if necessary. Examples of NSAIDs are ibuprofen (Advil), naproxen (Aleve) and aspirin.

Massage can provide relief, and can be done at home quite easily by placing a tennis ball on the floor, lying down and rolling the ball under the rhomboid muscles.

Physical therapy in the form of exercises will be recommended. You will be advised when it is safe to start performing the exercises. Go carefully and do not continue to exercise if you are finding it painful.

When you are able to move your arms and shoulders without pain, you can resume your normal activities. Recovery times depend on the individual, but the sooner you start treatment after the injury, the shorter the recovery time will be.

Rhomboid Stretch:
With your arms stretched out in front of you, one hand on top of the other, carefully and slowly reach forwards. You should feel a gentle stretch between your shoulder blades. Carefully bend your head forward and hold the stretch for 15-30 seconds. Repeat exercise 3 times. You have already overstretched your rhomboid muscles, so be very cautious doing this exercise. The aim is to encourage flexibility, not force your head down.
Resistance Row:
Place an exercise band around a solid object, such as a bedpost, that is about waist high. Facing the post, and standing an armís length away from it, hold one end of the band in each hand. Pull on the ends of the band (so that your shoulder blades move towards each other) until your elbows are at your sides. Repeat the exercise 10 times.
Neck Stretch:
Sitting or standing and looking straight ahead, let your head tip to one side so that one ear is moving towards your shoulder. Keep both shoulders down as you tip your head. Hold the stretch for 15-30 seconds, then raise your head and tip it to the opposite side. Hold for 15-30 seconds. Repeat entire exercise 3 times.
Neck Rotation:
Keep your chin level and gently rotate your head to one side as far as it will go without straining. Hold for 15-30 seconds then rotate your head to the other side. Hold for 15-30 seconds. Repeat exercise 3 times.

Warming up properly before exercising will help to avoid re-injury of the rhomboid muscles. Making efforts to maintain good posture when sitting for long periods will also help.

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