Updated: Feb 1
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In my practice I see many people with neck pain and more often than not, there is one muscle that plays a huge role in the presence of that pain-the TRAPS!
The traps or trapezius is a large diamond shaped muscle that starts at the back of the skull, goes across the shoulders, and then down the back to a point at the mid back.
Most of us are only familiar with this muscle when we have to reach back and rub the top of our shoulders only to find tightness and pain.
The trapezius muscle becomes particularly stressed when we sit at a computer, desk, or hunched over a phone for an extended period of time. This causes strain over the muscle and tightening of the fibers into trigger points, or "knots".
The first thing you want to do is make sure that your desk or workstation is set up to reduce this stress over the muscle fibers. Check out how to do that here.
Overall, the trapezius muscle does a lot of work and plays a critical role in neck health. The muscle is actually made of up of three sets of fibers: the upper fibers, middle fibers, and lower fibers. Each group is responsible for different movement and function. All of the fibers play some role in bringing the shoulder blades together, as if you pull your shoulders back and stand at “attention” and rotating them upwardly. However how they do that is what is important to distinguish.
1. The Upper Trapezius (shown in red)
It starts at the back of your skull and runs along the top of each shoulder. This is the portion of the muscle that feels tight and sore when you have a “stiff” neck. It is also the area that you are looking for someone to massage when your neck begins to ache.
The role of the upper traps are to retract or pull your shoulder blades together in the back, rotate them upwards, as well as draw your shoulders up towards your ears, like when doing a shoulder shrug.
In most people (and all with neck pain) these fibers are extremely overactive and work in overdrive. When they become extremely overused, they actually will lose the ability to pull your shoulder blades back and the blades will then be able to pull apart. This contributes to a rounded shoulder and forward head posture and this is a HUGE source of muscle tightness and neck pain.
2. The Middle Trapezius (shown in yellow)
These fibers nearly horizontal from the tip of the back of the shoulders towards the center of the upper spine. Their job is to fully pull the shoulder blades together in back and upwards.
When we sit-particularly on technology-for long periods of time, it causes the rounding of the shoulders I mentioned above. This pulls the shoulder blades apart and puts the middle traps on a stretch, which weakens them. The weaker they get, the harder time they have in maintaining good posture. This causes your head to fall out in front of your shoulders.
3. The Lower Trapezius (show in blue)
These fibers start on the shoulder blade and travel down on an inward angle to the center of the spine. They also pull the shoulder blades together and rotate them upward, however they pull the shoulder blades down.
Although all the fibers work together to help you to maintain good posture, the upper and lower fibers counteract each other so that the shoulder blades can keep good balance in the up and down plane, while the middle traps help keep them centered in a side to side plane.
If all three sets of the traps are in good balance, then life is good. However, more often than not, the upper traps are hyperactive causing the shoulders to pull up and the middle and lower traps to become weakened and unable to counteract the pull of the upper fibers.
This causes a hiked up, rounded shoulder and forward head position and as I said, this causes tightness and PAIN.
So, what can you do?
A short term option for pain control is releasing the areas of tension in the muscle. This can be done through massage (if that is something you enjoy-go for it!) and/or direct pressure. Direct pressure promotes a release of fibers that have become clumped up into a "knot" which has become painful.
One of my favorite tools to apply direct pressure to these tight areas yourself is a massage hook. This is a tool that allows you to get to those areas that are hard to reach and allow you to apply sustained pressure over a painful area until it releases. Click here to check out a massage hook, see a video on how it works, and get one for yourself.
You will place one of the balls or knobs of the cane over a painful spot and push down through the cane to sustain pressure. Hold the pressure for 30-60 seconds or until you feel a lessening of pain. Relax and move your neck up and down and rotate side to side. You can repeat this 3 times in one session and do 2 sessions a day.
Now, for a long term solution, you have to strengthen the middle and lower fibers in order to regain balance in the entire muscle. There are several ways to do this, but I am going to give you two of my favorites.
Before you start the strengthening work, I recommend stretching the area, after you have used the massage hook and before you start your two exercises. A great stretch for this is the OPEN BOOK STRETCH.
Start by lying on your right side with your knees bent up towards your chest, arm stretched out in front of you.
Bring your left arm up and over to the other side of you while looking to the left.
Ideally, you want your shoulders to be flat, however if you have tightness and can’t go all the way over, put a pillow under your left arm to rest on.
Hold each stretch for 30 seconds while breathing (do not hold your breath!) and then return to the start position.
Repeat 3 times and then flip over and do on the same on the other side.
Great! Now that you are loosened up, you can get started on the strength exercises.
The first exercise is for the MIDDLE TRAPS and you will lie on your bed with your right arm dangling off.
Keeping your elbow straight, turn your thumb away from the bed.
Maintain this position and raise your arm up and out to the side until parallel to the floor (your thumb will be pointing to the ceiling) and then slowly lower down.
Repeat slowly and with control for 12 repetitions. Do this on each arm.
The second exercise is for the LOW TRAPS and you will sit at the dining room table or desk.
Roll up a towel and place your forehead on the towel
Extend your arms out straight over your head with your thumbs pointing upward
Keeping your arms straight and your head very heavy, raise your R hand off the table about 2-3 inches and hold for 3 seconds, then slowly lower down. Repeat with the left hand
Do 12 repetitions with each arm
IMPORTANT NOTE: Do NOT let your shoulders hike up towards your ears, you want to be sure that you are pulling them down and holding them down while raising your arms in either exercise.
If you find this to be difficult, reset your position between each rep to pull your shoulders down.
Start with 1 set of 12 repetitions and progress to 2 sets of 12 as you are able.
This stretch and these 2 exercises are a great way to build flexibility in your upper back, as well as strengthen the middle and lower trapezius. This will in turn, significantly improve the support around your neck. This increased support will not only go a long way to reduce your neck pain and stiffness, but also help to improve your overall posture as well!
Give these a shot and share them with any one you may know that asks you to rub their neck!
If you would like a printable copy of these exercises, sign up for the free RESOURCES page and grab them there.
Stay Well & Feel Good,
Always consult your physician before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider.
Hi! I am Dr. Kim MacDonald. I am a physical therapist who specializes in empowering my patients to optimize how they move their bodies and improve their ability to do the things they love regardless of age, experience, or capabilities.
My experience in the health care field allows me to teach the tools you need to ensure that you are working safely to improve your pain and maximize your physical potential.
If you would like to know more about how you can help yourself be healthier and live a more active lifestyle, join me here.