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Upper trapezius - Does this muscle really get short?

November 14, 2014

We have a multitude of patients who come through our doors with the belief that they have "tight upper traps". Having been told by various professionals, training partners and coaches that this muscle is short, or 'needs stretched', yet despite doing this; still get neck and shoulder girdle pain despite all their efforts. This muscle remains controversial in the literature, yet there is little research evidence which supports the notion that this muscle becomes tight, although it's activity can alter in the presence of pain due to serratus anterior dynsfunction (Helgadottir et al 2011)

Thinking logically about the attachment points of this muscle at the distal clavicle, the spine of scapula and the ligamentum nuchae (a fascia as opposed to a true anatomical ligament) it has 2 primary roles of action:

1. An Upward rotator of the scapula aiding rotation of the clavicle in conjunction with serratus anterior (Pizzari et al 2014).

2. A stabilising muscle of the neck. It has a role to add tension to the posteior cervical fascia to aid other muscles which stabilise the cervical spine .

It cannot elevate the scapula when looking at the fibre orientation and attatchment points. Clinically, it is unusual to find that upper trapezius is truly short in the presence of normal neural tissue. A short session teaching a patient to position the scapula in neutral (Not backwards and downwards), to facilitate upward rotation, can eliminate trigger points and usually suggests the trapezius is more long and weak than short and upregulated. Stretching this muscle normally leads to pain provocation in patients where neural tissue is involved, or continues to lengthen an already long and weak muscle, without addressing it's true ineffiencies; which normally lie in it's inability to stabilise the scapula or cervical spine.

This is classically seen in patients with whiplash injuries where they are given exercises to lengthen the trapezius, failing to address the underlying cause of dysfunction and further compounding the problem.

It is also useful to remember that rehabilitation of this muscle is important at the threshold at which it is failing. Therefore, it is normally not advised to give activation work to a patient which develops inefficient upward rotation of the scapula in 90 degrees flexion of the scapula. It is also very improtant to consider the shoulder girdle in patients with recurrent neck pain.

This is an intersting video by Mark commerford who dicusses the trapezius myth.....

Helgadottir et al. 2011. Altered activity of the serratus anterior during unilateral arm elevation in patients with cervical disorders. Journal of Electromyography. 21 (6) pp.947-953.

Pizzari T, et al. 2014. Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula. Clinical Biomechanics. 29 (2), pp. 201-205.


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Physio's in Sport Blog

March 26, 2014

Check out the latest Blog from Physio in Sport.gif .  This is an interesting read which examines how we can improve physical literacy in children, with childhood obesity on the increase.  It looks to offer solutions as to how we can get the next generation more active to help improve their health! 


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Sport Relief Mile 23 March 2014

March 26, 2014

Well the sun shone, then it hammered down with rain, then the sun shone and it hammered down with rain again.  As runners were warming up with Suzie Hopkins and gtfm providing the soundtrack, our team was sheltered in a marquee, but could not help feel inspired by the fundraisers who were out there pushing their bodies in spite of the elements, throught the various distances at the Sport Relief event at Ynysangharad Park, Pontypridd.

Feeling energised by the day, both Ben and Andrew set the stall out (excuse the pun) by competing in the 1 minute cycle challenge run by the RCT Sports Development Team.... after a gruelling minute of burning lungs and limbs the victor was eventually Andrew, with a modest distance of 0.89 km and with director Ben Searle checking to see if the bike had been rigged!!

Kate Favell our Practice Manager was on hand to help fundraisers with any queries and help cheer on competitors, with our sports therapy students working hard offering sports massage to all who were willing to give a small donation.  

A big thank you to our sports therapists Ross Oakley and Rachael Morrison for their hard work and the advice offered to all fundraisers.  Also a big thank you to Sport Relief for putting on such a fabulous event... 


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The Performance Matrix

March 26, 2014

Want to see how we can help you perform better and help prevent injury?  Here's an example of how we retrain uncontrolled movement at our clinics...

 

 


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ON THE DOWNLOAD

March 26, 2014

We have now introduced a new Downloads feature to our website, where you will be able to download new advice documents for specific conditions, pain diaries, exercise diaries and much more.  We will let you know via facebook and twitter when new documents are uploaded in the coming weeks.

Right then...back to treating people.....see you later :)


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