Anatomy, Function & Dysfunction Rhomboid Muscles - Everything You Need To Know - Dr. Nabil Ebraheim
Dr. Ebraheim’s educational animated video describes anatomy, function, and dysfunction of the rhomboids muscles in the posterior shoulder.
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The rhomboid muscles lie underneath the trapezius muscle. The rhomboid muscles connect the scapula to the vertebrae, so they are really helping to hold the scapula close to the thoracic wall. The rhomboid muscles get their name from their combined shape (having the shape of a rhombus). The word rhomboid means a “diamond” or “kite” shaped object. The rhomboid minor arises from the nuchal ligament and the spinous processes of C7 and T1 vertebrae. It inserts into the medial border of the scapula above the insertion of the rhomboid major muscle. The rhomboid major arises from the spinous processes from T2, T3, T4, and T5 vertebrae. It inserts into the medial border, which is the vertebral border of the scapula. From the level of the scapular spine to the inferior angle of the scapula. The rhomboids adduct or retract the scapula by pulling the scapula towards the vertebral column. The rhomboids work with the levator scapulae to elevate the medial border of the scapula. The rhomboids also rotate the scapula downwards with respect to the glenohumeral joint. The rhomboids participate in proper movement and stability of the scapula which is critical for shoulder function. Clinical entities related to the rhomboid major and rhomboid minor muscles is the brachial plexus injury. If the patient has a brachial plexus injury and the EMG shows evidence of an intact signal in the serratus anterior muscle (supplied by the long thoracic nerve) and also an intact signal in the rhomboid muscles (supplied by the dorsal scapular nerve), this situation indicates that the lesion of the brachial plexus is a postganglionic injury which will have a better prognosis than a preganglionic injury of the brachial plexus (poor prognosis). Preganglionic injury is associated with Horner’s Syndrome (ptosis, miosis, and anhidrosis) due to disruption of the sympathetic chain. There will also be medial winging of the scapula due to loss of the serratus anterior and the rhomboids muscle function. The inferior border of the scapula will move medially. In the pre-ganglionic injury the brachial plexus, there will be loss of the muscle function of the levator scapula and the rhomboids muscles. Basically, you will exam proximally the muscles that are innervated (root level motor branches, nerves that are coming out of the roots). Detecting if the brachial plexus injury is a preganglionic or postganglionic injury is important! A normal paraspinal muscle activity on EMG indicates a postganglionic injury which will have a good prognosis. Usually the patient will complain about superficial pain between the shoulder blades and the patient describes this pain as “ache” or that they feel “knots.” The pain is closer to the scapula than to the spine. The pain occurs especially at rest and movement does not influence the pain. The patient may also feel grinding, snapping, or a crunching noise during movement of the scapula. In this case, you need to rule out scapulothoracic impingement or a snapping scapula. Other muscle trigger points can be associated with rhomboid muscle trigger points. What may aggravate the condition of rhomboids trigger points? Painters who are holding their arm above the head for a long time. Bad posture may also cause aggravation. People who work habitually in a slumped forward, round shoulder position (protracted position) such as a computer related desk job, sewing, or reading. In this situation, the pectoralis muscle which is antagonistic to the retraction function of the rhomboid muscles, may have become shortened and over active. The rhomboids become stretched from trying to counter act the pull of the pectoralis muscle. To avoid aggravating the problem, some physicians believe it is better to work o stretching out the pectoralis first before working on the rhomboids, because if you stretch the rhomboids with a tight pectoralis muscle, this may increase the weakness and irritation of the rhomboids trigger points. Treatment of rhomboids trigger point pain include: anti-inflammatory medication, try to stretch the pectoralis muscle first, rhomboid trigger point release (tennis ball), and possible injection of the trigger points. It may be really hard to tell if it is the rhomboids that is causing the pain between the shoulder blades or other muscles that are inserted around the same area.
Пікірлер: 120
I've been to plenty doctors and chiropractor this video has informed me better than they have. Thanks doc
@floatingchimney
3 жыл бұрын
Doctors are not teachers - their job is to treat you, not give you personal lessons on anatomy.
@IamThatiAm420
2 жыл бұрын
The medical system is a joke. It's not a problem unless you see a surgeon was the takeaway for me.
@IamThatiAm420
2 жыл бұрын
@@floatingchimney Bullshit! Doctors have sold out to Big Pharma. They would prefer you take celebrex so they can refer you to their cardiac buddy. The cancer industry is hoping you'll take an immune depressant such as humira to treat your autoimmune disease which was caused by one of the vaccines we were compelled to take to enter the mind training camps aka educational system. We spent an entire semester in nursing school solely focused on pharmaceuticals.
@Saintlittleguy
2 жыл бұрын
But have you found any solution?
Origin: Spines of c7-t5 Insertion: scapula Action: elevation & adduction . Stabilize scapula.
Been in pain for a year!! Pain Specialist, Orthopedic and Neuro Surgeons. Finally today we are moving into physical therapy and trigger point injections. This Doctor nailed it in under ten minutes!!!
Better explanation than I've gotten from any doc I've seen. Thank you!
Finally, it makes sense and gives me a place to start addressing this issue.
This is really good material. I am recently having problems with exact pain as it is described here. I have been to 3 specialist: 1 had no idea what was going on, the other ones did not mention rhomboideus at all, they said that is it all fault of trapezius. Pain is really annoying, but it ia not blocking any movement, i feel pain the most when i press any weight with shoulder upwords. I caused it mosr probably by lifting too much on gym plus i have physical work. Have a good day Guys
@mrbigolnuts3041
4 жыл бұрын
Like described in the vid these are specific muscles which help to hold the bone structure in a consistent shape, they are difficult to target, but there are specific exercises which target them and avoid injury. Pain you just have to suffer, but don't massage when it's inflamed.
@aymeninoubli8272
4 жыл бұрын
Hello Pawel. Wish you are doing well. I'm in the same situation as you. Ex body builder. and I want to know if you've found a treatment for this trigger point pain. Thank you
@CB3INVEST
4 жыл бұрын
aymen inoubli any relief been having this pain for 8 months here
@paulaburzotta4717
2 жыл бұрын
I have had scapula winging for years. It became much worse after the C~7 ruptured. I finally went to our local orthopedic group here in Atlanta. The MRI clearly showed that the disc was on the large scale of a disc rupture. Dr. Valez suggested spinal surgery. I chose to give it a little time to heal including PT, just to try and avoid surgery. Well he was right! Upon return, I had another MRI and the surgeon came to tell us that the herniated disc did heal, however, we were shocked because it was actually worse. Dr. Valez noticed something odd with my shoulder. So he sent me downstairs to the shoulder surgeon. Again, yet another problem. My first rib was shattered and had calcification buildup around some nerves and arteries. Nothing could be done at that point according to the surgeon, until I went to a neurologist - which showed positive on the NCS test. I had to see a brachial plexus specialist. He said that it’s I possibly to shatter a 1st rib, without a direct hit to that exact area. Otherwise impossible to fix he said…. Long story, but short version is after meeting with many specialist, (rule out lung cancer, bone cancer, full body imaging, etc) they suggested to have a spinal cord stem unit surgically inserted to help with pain. HUGE waste of money! We had neurosurgeon, Dr. Betsy Grunch remove the stem unit and take a pic to show that the paddles of the leads were missing and I had a “jumble of wires” were leads were inserted. Awful experience. Mean while, after recovery from that madness, my shoulder and ribs were extremely painful. I tried injections, dry needling, cupping, chiropractic care, PT, creams, anything that might take the edge off. Even meditation. Nothing. So, second opinion from another shoulder specialist said there was not a surgery he could do to fix it. By then 1 1/2-2 years passed. Everything from working to chores became worse. I could feel the burning, stabbing sensation all-the-time! I quit my job. (Sadly was highly tense and physical labor at times as well) Finally a well known surgeon at Northside Hospital said the first thing to do is to remove the 1st rib to hopefully receive blood flow and nerves back if it was less than 18 months, (2 1/2 yrs passed of compressed nerves, which was a concern that nerve regrowth may never happen. They were correct about the nerves, but my arm is no longer purple! And my fingers were not as numb after that surgery. Several years later I was still in pain, more than I could tolerate without gabapentin, inflammation meds and muscle relaxers with adderal to keep me awake during the day with the other medications. With all of those meds, I could work again. However, another prob occurred…. Muscle atrophy. Oh, I forgot to mention the fractured 2&4th ribs from before surgeries) again, no incidences, no car crash, nothing I could remember and my family never recalled any trauma either. My body became noticeable “crooked”. A 2 inch slant on 1 side of my body. Finally, I went to see the Neurosurgeon Dr.Betsy Grunch. She ordered an MRI and CT of my neck. At first, it was just 2 C-discs that were in need of anterior discectomy and fusions, but the final test showed a third was needed to be done too. So I had a 3 disc/ or multiple fusions. I am in my 6th month of recovery and feeling better where the pain radiated from my neck and the burning arms that woke me throughout the night became no existence! Huge relief. But she did tell me that this surgery would not fix the scapula. She was right. No matter how much I exercise my right arm and shoulder, and scapula are still the same. And I am always very fatigued, but I do the strength training given to me by PT. Could the nerves be the culprit of his awful, burning, agonizing pain? Could it possibly get better with time and exercise? I’m still on the medications I listed above because they help me get through the day productively. But I am just 54 and feel like an old lady. Now I’ve been diagnosed with arthritis. Every joint in my body hurts. My fingers and toes are noticeable effected. But wow do my joints ache. Any correlation between this new diagnosis of arthritis, fatigue, continued burning pain and winging scapula? Thank you for reading. But this is the “nutshell” version! Thanks!
@nindajuka8427
2 жыл бұрын
@@paulaburzotta4717 what's the caused? did you weight lifting?
ماشاءالله عليك يادكتور الله يجعلك من اهل الجنه ويطول بعمرك يارب this man is really helpful and I like him so much
@maithamalkinani8829
5 жыл бұрын
God bless you
I'm studying for the massage therapy board exam your videos are amazingly helpful thanks!!
This Dr. is my go-to guy for kinesiology. I'm a veteran weight lifter and have seen my share of problem so when something is wrong, he's my main researcher.
Thank your a clear explanation of the anatomy and function of the rhomboid. However, for treatment of rhomboid pain, I would advocate strengthening the muscle with training, such as scapular pull-ups and rowing exercises, before resorting to medication and injections.
@missa1goins
10 ай бұрын
Yes, this is the truth, strength your muscles to relieve discomfort.
So informative and very easy to understand. Thank you!!!
YES! 10 years of pain, starting to understand
Thank you very much that was very well explained and demonstrated. Really helpful.
I love your lectures....now getting the anatomy easily
That was awesome. I feel I have an understanding of the pain in my back. Thanks.
Brilliant. Thank you.
@nabilebraheim
10 ай бұрын
Thanks
omg Ive been struggling with this pain for 2 years. Ive never understood what it was and Ive used stretches and a tennis ball forever. THESE ARE MY PEOPLE!!!!!!!
@westyw.4235
3 жыл бұрын
try smashwerx if you want some serious mobility exercises, travis will make you graduate to the peanut lol
@behappywithkuhu3229
3 жыл бұрын
Before 2year did you injured ur shoulder?
@redhood2171
3 жыл бұрын
@@behappywithkuhu3229 yes, mine started hurting after my shoulder injury.
@behappywithkuhu3229
3 жыл бұрын
@@redhood2171 did you broke ur scapula?
@redhood2171
3 жыл бұрын
@@behappywithkuhu3229 No, I had shoulder dislocation on my right hand and I got it fixed immediately. I didn't even realize that my rhomboid pain was caused due to the shoulder injury until I watched this video.
Many thanks for taking the time to create this video it has helped me tremendously.
Very useful and very clear presentation. Thank you 💐
Very clear and scientific explanation of rhomboid muscle stiffness.
Vry informative ....u explain so beautifully n easily.....looking frward for tutorials.....thanks so much !!
Awesome! 👍🏼Strained it playing golf. It’s been hurting for days now
Yes indeed that was very helpful. Thank you
This is a very good presentation, doctor, thank you for taking the time to prepare it for us. 👍
Thanks for the gift of knowledge and hopefully the gift of pain relief
Fantastic video Dr. Clear, concise, and substantially informative.
Perfect lesson. Thank you!
Amazing video! Keep educating us
Superb presentation -- thank you.
Sooo helpuful. Thank you
Great information and images about the rhomboids AND associated muscles. Importantly for me you mentioned the interaction of the antagonistic actions of the pectoralis and rhomboids, with their antagonistic actions. I have chronic frozen shoulder (almost 8 years), so various muscles in and around my shoulder have had changed force and load over an extended time. After doing a couple of days of moving ( it has to be done!), I had what felt like a strain in the clavicular head of my pectoralis major. Next day it was worse; sometimes the pain, strain and heat extends along the muscle into my armpit region. Then the next day it was also aching in the region of the rhomboids, at all three trigger points. I assume it is rhomboids rather then anything else. I was looking for the connection between rhomboids and pectoralis - you have described it. THe strong rhomboid ache is almost constant. The only way to relieve the ache is to take the weight off the arm by resting the elbow on something or using a sling. Lots of ice packs, rest, then some stretching and strength exercies.
Great video, very helpful 👌🏾
Tanqqq so much... Nce presentation with apt content
It was helpful, thank you!
Thank you so mich, excellent describe about this
You are a great Doc......It was so simple to understand my illness in few minutes . Now, I can cure myself in a better way. Thanks again.
@lalboihangsing1187
2 жыл бұрын
How?
Rhomboids & Scapula!
Thank you for all your help...
What a great video. Visuals were very good and good insight. I have back pain for 30 years, especially rhomboid and low back. Hard to find a solution, so I am self-educating.
@Ragnarockalypse
Жыл бұрын
Try strengthening the muscles of the back. Scapular pull-ups and rowing exercises for the rhomboids, hyperextensions and deadlifts with moderate to slightly heavy weight for the lower back. Consult a physiotherapist before beginning a workout routine, and gradually increase the weight of exercises for progressive, controlled overload. Doctors are very knowledgeable, but they might only prescribe pain medication that treats the symptoms but not the cause of your back pain.
@dyardsale5475
Жыл бұрын
I've been having good results with a light lat bar stretch as I lean downwards and do partial behind-the-back pulling motion with a lat bar and low weight. I think my tight shoulders are causing problems (I can't squat with normal hand spacing).
Is it not often the facetjoints in torso, neck, that are slippingo and so irritating the nerves or even torn tendons in the facetjoint, that causes the problem?
Thank you.
Thanks a lot doc, for this great video ..
that was amazing doctor, but why you didn’t mention the physiotherapy as a treatment for rhomboids trigger points?
Thank you
I like the anatomical breakdown but I would never suggest any of the solutions for pain that he does. You want to get blood flow to the rhomboid by active stretching/compressing of the muscle. This clears up my pain in a few minutes. For long term management you want to work on strengthening your back and pectoral muscles to improve your posture.
Thanks KZread you better than some doctors
Very helpful
IT'S VERY HELPFUL FOR ME
Thank You . I have been fighting pain and inflammation in these muscles for 6 months ..And still counting.. I am well past the stretching, the tennis ball, the Astym . The Estym makes me puke... Now, about those injections?
zayak ya 3aaaaamy! thank you very much, doctor
Very useful sir Thank you
I really wanna know if it's my rhomboid or trapezius who's aching. When I hold on to something on the train the pain shoots up but when I hold on the Handels above my head no pian at all
Thank you this video is very helpful.
Very informative sir👌
Great vid, thank you
I've lost function in my right side pectoralis major after a month of severe pain in right side rhomboid area also with a stiff neck. Could the pain in my right rhomboid be causing the loss of muscle function in my pectoralis?
Very good thank you!
🙏🏾💙 thank you
THANKS SIR
Hey Doc, what could it mean If the pain is close to the spine, rather than the scapula?
What is a pre/post ganglionic injury in case of brachial plexus..... I mean is it wrt dorsal root ganglion of sensory roots or sympathetic ganglion?
Very !!! Helpful thank you
Amazing
Extremely helpful
How to confirm what is causing the issue? Can I get a scanning done?
Planchers will relate 4:20
excellent tks
...respect🌹
i like your viedio so much,
Hi Dr. Nabil, what do think about a new method to use to relieve pain called HiDow international. it generates vibration on the muscles. Thank you for your opinion.
@DrNick-jz2yn
4 жыл бұрын
Mahnaz Mondi Safa Hi 👋 This is my method. That’s why I Say Hi everybody 👋
I like this video since i have weak rhomboids
Is it possible to get arrythmias from this impingement?
Sir i have same problem how can i diagnose please reply
عندي نفس الحاله شو العلاج ؟
I have pain in this area for more than 5 years, i think its a muscle torn rather than spasm ...can you please advise as its really affecting my life
@mohammedjaffar38
2 жыл бұрын
@@rdw7166 what is magnesium iv 10x
What State do you practice in? I would love to setup a consultation beforehand?
Is it suitable to join gym for rhomboid injuries? Waiting for your reply. Thank you sir.
@Emmanuelx13
2 жыл бұрын
They said to wait until your body is healed fully
Hi doctor. I have pain at the same point looks like inside the scapula feeling like knot especially with moving up my neck. The knot that causing the pain .feeling at the same time applied a pressure on nerve. The affected nerve are radial nerve. Because I feel a tingling sensation on my thumb .feeling pain sometimes at level of axillary nerve. What is your diagnosis. Which muscles are affected .??
@YoungLink51423
3 жыл бұрын
I feel very similar pain :/
@maccher1
3 жыл бұрын
@@YoungLink51423 it was bitter now i thing from my pillow or working position so light workout helpful everyday , i think it was deep inflammation on tendon that is way take long time for cure
This was not helpful! Why would you stretch the rhomboids if the overactive pectoralis muscles already stretches the rhomboids muscles making it weaker? Would you not stretch the pectoralis then strengthen the rhomboids? Possible use tennis balls method but not stretch!
Bonjour Dr SVP Jaime la traduction en français merci
I have an ache on the left rhomboid for 3 years because of an injury while doing chinups at the gym. Since then I can remove the trigger points from the left rhomboid using a tennis ball but 2 days after that I have again the back with the stiffness. I tried everything. The MRI displays a bulge in C5-C6 but some doctors say that is not related with my stiffness. This injury was as soon as I got to the gym and started doing chinups without warming up. Perhaps someone can help?
Oh yeah its all about rhomboids
Aslaaamwalaikum. Is it possible to consult with you or send you an email? Kind regards Mustafa Dar
C8 ????????
🌟⭐🌟
Hi everybody 👋 I get a tight rhomboid when I watch Cinemax at after dark.
@pinkrainbowkennelz1640
4 жыл бұрын
🤔😮
This guy is drunk
Thank you