Pain in the Neck - The Upper Trap

“I hold my stress in my neck”. This is one of those things you hear on a daily basis as a physio. Most often, the pain is in the upper trap. There are several reasons for this, but the most common one I see is simply an imbalance. It shows up like a shrug as someone raises their arm up, especially with resistance. 

The scapula floats on top of the ribcage and is embedded in a lot of muscle. Coordination of muscle groups dictate how it moves. It is designed to both be mobile and stable, and it’s the prime driver of your shoulder position. 

When you raise your arm overhead, the scapula sort of “kicks out” to the side. Otherwise known as upward rotation of the scapula. Three muscles make this happen; the upper trap, the lower trap, and the serratus anterior. See below:

Upper traps are rarely weak, especially since shoulder shrugs are a staple exercise in many gym programs. However, the lower traps and serratus anterior are rarely targeted in most programs and there are few, if any, machines in a gym that are designed to hit these muscles. So it becomes pretty easy to have a relative weakness in these muscles compared to the upper traps. Then the downward rotation looks more like a shoulder shrug because the upper trap has the ability to shrug the shoulder. It just dominates the movement, particularly when you add resistance. 

What to do about it? You can certainly massage the upper trap, but until you address the underlying weakness, it’ll just keep coming back.

Strengthening the lower traps can be tricky, and I usually start off very basic just to establish the mind to muscle connection with something like this:

Then I’ll progress to this:

And eventually to this:

The serratus anterior is known as the boxing muscle, so it does sort of a punching motion. So like the lower trap, are start basic like this:

And progress to this:

Then finally this: 

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