That friggen knot under your shoulder blade
You know the one. It aches when you're at your laptop, it burns after a long drive, and it is heaven when someone digs their thumb into it, but comes back.
What is that knot, anyway?
Most of the time it's a group of muscles that are tired and a little overprotective. They're doing a lot of holding: holding your arms out over a keyboard, holding your head forward toward a screen, holding a kiddo on one hip, holding your shoulders up near your ears because you just read the news.
Those muscles aren't weak or damaged. They're just being asked to hold one position for longer than they're ready for, so they get sensitive!
Why rubbing it doesn't fix it
Digging in feels great for about 10 minutes, and then it's back. That's because the knot is usually the spot that's complaining, but there are other areas involved. Stiffness in your mid-back, how you sit, how much you move during the day, and how stressed you are all feed into it. If we only chase the sore spot, it keeps coming back.
3 things that help:
Change positions often. “Your best posture is your next posture” is a very popular saying in conservative healthcare right now. It means moving around often is better than textbook perfect ergonomics. Set a timer to switch in an hour, take a phone call standing up, switch from desk to couch to counter. Variety beats "sitting up straight" every time.
Move your mid-back. Lie on a foam roller placed across your upper back and gently let your chest open over it for a minute. Or sit tall and slowly rotate side to side. A stiff mid-back makes those shoulder-blade muscles work overtime. A 2023 review found that adjusting the mid-back reduced pain and disability in adults with chronic neck pain, a good reminder that the cranky spot isn't always the whole story.
Make those muscles stronger, not just looser. Rows, band pull-aparts, and squeezing your shoulder blades back and down a few times a day. Stronger muscles can hold you up longer before they start to complain. This is the step that actually keeps the knot from coming back. A 2024 review of office workers with chronic neck pain found that strengthening the neck, shoulder, and shoulder-blade muscles reduced pain and disability.
Moving more also seems to keep this stuff from starting in the first place. A 2023 review found regular exercise cut the risk of developing neck pain roughly in half, especially for office workers: about 30 out of 100 people down to about 17.
And YES, a lacrosse ball against the wall for 30 to 60 seconds is a totally fine treat, just don’t expect that to fix it long-term.
When to come see me
If it's been bugging you for more than a couple of weeks, keeps coming back, or you've tried all of the above and you're still annoyed, come in. Usually it's a combo of loosening up what's stiff, calming down what's cranky, and giving you a short, doable home plan so you don't need me forever.
And please see a medical doctor right away if shoulder blade pain comes with chest pain, shortness of breath, nausea, or sweating, or if you have numbness, tingling, or weakness down your arm. Those aren't knots.
Your body is on your side. It just needs a little help and a better plan.
<3 Dr. Laura
Teichert F, et al. Effectiveness of exercise interventions for preventing neck pain: a systematic review with meta-analysis of randomized controlled trials. Journal of Orthopaedic & Sports Physical Therapy, 2023. https://pubmed.ncbi.nlm.nih.gov/36875686/
Jones LB, Jadhakhan F, Falla D. The influence of exercise on pain, disability and quality of life in office workers with chronic neck pain: a systematic review and meta-analysis. Applied Ergonomics, 2024. https://research.birmingham.ac.uk/en/publications/the-influence-of-exercise-on-pain-disability-and-quality-of-life-/