- All right, Bob, today, we're gonna talk about
- and Sam
- Sam, yeah. He's gonna help for a short time here.
Rhomboid pain, scapula pain.
It's pain like in this area,
in the thoracic part of the back.
The rhomboid muscle is actually connects the scapula
to the spine
and they're shaped like a rhomboid.
- Right.
- Kind of a, a rectangle that's skewed a little bit.
But this can be very misleading.
People think it's the muscle.
They think it's the scapula and the origin
of the pain oftentimes can be coming from the spine.
So it gets mistreated and does not improve.
So we're gonna show you how you can do that properly.
- ♪ Bob and Brad ♪
the two most famous physical therapists on the internet.
- Okay. Let's get to the biggest mistake first, Bob.
The people, you'll feel that pain back in here,
you know in this area and you think, ah,
we're gonna stretch it out.
- Right.
- So the biggest mistake is if you think,
well maybe if I stretch my neck downward
and maybe pull on it a little bit,
you can feel that stretch.
- Right.
- Or take your arm across this way
to try and stretch the muscles out.
And then you may stretch the muscles.
You may get some relief, but you may make it worse
because the pain is not from,
there's a tight muscle there
but the muscle is just not tight for no reason.
Often it's a time or cause from
- It's reacting.
- It's what?
- Reacting.
- Reacting to poor posture.
- Right.
- That slumped over posture associated
with working at the workstation, driving.
- So this stretching is making it worse.
- Yeah particularly with the neck, you want to...
- Right.
- Get rid of that.
So let's do the number one thing.
I think you probably do this, too.
As a therapist,
- Right.
- Let's rule out the neck
because the neck often time refers pain
to that specific area.
- Right.
- The muscles tighten up.
- The problem is up with neck
but since pain down to that area.
- Yep. It's called a referral pain,
and it's not uncommon at all.
So first thing I'd like you to do is
check your range of motion in your neck.
Sit with good, tall posture.
First thing I want you to do is bring your chin out.
I call this the goose neck. See how it feels.
Come back, look to your right, look to your left.
Keep your shoulders still and notice any pain.
You know. Maybe it's painful to the right
but not to the left.
Or you can go farther one way or the other.
And then we're going to do a general chin tuck
and then go backwards like this.
- And quite often you'll be lacking going back.
- Right.
You may have some pain this way and this way
but oftentimes this is the worst pain.
- That's the problem.
- Yeah. And if that's the case,
the chances of it being in your low neck are very high.
- Right.
- So we want to treat that first
before we even start doing things with our mid back.
So the most common thing we do is,
well we've got a couple of things.
We're gonna do a chin tuck,
and Bob how many times have we mentioned this exercise
over the last...
- Several thousand.
- Several thousand times to say the least, but do that.
And sometimes that alone can alleviate the symptoms.
- And help.
- And then you'll find that
stretching backwards becomes easier.
You may put your hands here...
- Get a little support.
- Yep. You may take a rolled up towel,
put it around your neck and do that.
We have a number of videos on neck pain level
that go into detail on this.
Okay. The next thing is you can use a round ball like this
put it back here.
And that just acts for some support up in your upper
mid back between the...
- [Bob] Right.
- shoulder blades. And you can...
- [Bob] You can adjust the up and down.
- Yep, exactly.
You know, we can do that
and do the same exercises with that.
There gives a little more support
and it does work that upper back.
- [Bob] Again these should all feel good.
- Exactly.
- It should feel like they're working.
- Right. Right.
If the pain feels like it's going more down
into that area.
- When you do these.
- Yeah.
- No good.
- If you do this and it feels like,
oh it's hurting more in the neck.
- Right.
- That's a good sign.
- But less in the scapula.
- Yep. So it's showing up this way.
We call it centralization.
Now, if you do these exercises
with your neck and it's like,
oh, that's not doing anything.
- [Bob] Right.
- Oh, your neck is clear when you go to
go to step number, the second step.
Okay, Bob. So we cleared the neck.
The next thing we're going to check on
is that thoracic spine between the shoulder blades
and how do we get that to mobilize
and free up to allow those muscles to relax.
On the floor, you don't want to do this on the bed.
You can take a tennis ball.
Carpeted floor works the best. Lie that down there.
You can use something harder.
You could use a baseball, but it's pretty aggressive.
- [Bob] Or a lacrosse ball or softball.
- And I'm gonna go right,
not on the spine, but it's going be just to the side.
- [Bob] Between the spine and the shoulder blade.
- Right. And that happens to be right on the rhomboid.
- [Bob] Right.
- And the nice thing about a tennis ball
it's not real hard, and you can roll on it
back and forth like this. And you'll find the spot.
And again, this is one of those things that may hurt
while you're doing it when you first start,
but it should be one of those feelings
like it hurts so good.
- [Bob] So good. Right.
- That hurts, but boy I think it's doing the trick.
And then you get done and it's like, it did do the trick.
- [Bob] Right.
- [Bob] You could start with a towel over the ball too.
- Yep.
- If it is uncomfortable.
- Yep. Just fold the towel up and that'll help.
- Right.
- If you do have one of these balls like we used before,
that can be helpful.
- Sure.
- And this, I will put right over my spine.
If you want you do it
- [Bob] Right. It's soft enough.
- Where it feels good.
- [Bob] Right.
- And you can roll, you can bring your arms up like this
and arch over the back.
Again, should feel good.
If it does, you're right on.
Work it for a minute or so.
Arms up this way.
Sometimes just one arm works.
You have to kind of vary with this a little bit.
- [Bob] Sure.
- And work it out.
- [Bob] Experiment.
- Yep.
And all the way down here.
And you will probably feel it cavitate or crack.
You'll have pop pop a little bit,
and that's a good thing.
If you happen to have a roller like this,
I use one of these on a regular basis for maintenance.
- Me too.
- And I don't know about you, Bob,
but I regularly get my back to crack with this.
- [Bob] Right.
- I did this last morning already, so.
- [Bob] Yeah, me too.
- I'm clear, but it just feels good.
Ooh, there we go.
I got a little bit down on the lower.
Okay. And you'll work this only a minute or two.
You don't have to hang out on it for a real long time.
- [Bob] It's fast.
- Good.
Now this one Bob is oftentimes forgotten about.
- Right.
- It's rotation.
Maybe it's a problem with rotation
of the thoracic spine between your shoulder blades.
- Mid back.
- Yep. I think this is one of the best ways to address it.
In a seated position,
and actually I would probably get a chair that was
a little lower than this, but this is okay.
We want to stabilize the pelvis...
- Lock it in place.
- Exactly.
- Lock and load.
- (laughing) And then take a cane, a stick,
I'm using the booya stick.
You need something about three to four feet
long at least, or longer.
This is five feet and that's not too flexible.
Put it across your shoulders like this,
behind your neck, and then put your hands like this.
And what that does is it puts you in good posture.
Okay. And then you're going to arch your back slightly.
- Right.
- Not extended, but in a neutral position.
Definitely not rounded.
So get that straight,
and then simply rotate one direction like that.
- And it shouldn't hurt.
- Right. And then rotate the opposite direction.
Now, if it is part of a rotational problem
you'll probably find one way is, well that's okay.
And then you go the other way.
It's like oh my goodness that kind of hurts.
So what we're going to do is not force it,
but go the pain-free way and work it.
- Take what the body gives you.
- Yep. Go the other way.
And what you can do is you can actually bump
into it and see how that feels.
- Yep.
- You know, the pain-free way.
- Just give it a little over pressure.
- Yep. A little bounce.
There should be no pain.
You're not creating pain.
You're making it feel better.
Then go back the painful way and see if you can gain on it.
You know, sometimes you can actually combine the ball
or the roller...
- Right.
- And work that and then come up and do this
and have a combination to get that spine loosened up.
And then those muscles, those rhomboids start to relax.
Life is good again.
And you can carry on with a normal life.
- You're happy.
- That's right.
Good luck with your rhomboid, scapula,
as well as anything else that you do. Be careful.
(ending music)