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Neck Pain, Depressed Scapulae, and the Rib Cage
I’ve recently begun to understand how rib cage positioning is affected by the muscles attaching to it. What I didn’t expect to find is just how much rib cage positioning affects scapular positioning, thereby affecting neck pain. If you’ve read my books about neck pain and headaches or shoulder and elbow pain, you understand how important it is for the shoulder blades (scapulae) to rest and move correctly.
Until now I’ve only been able to understand this from a scapular point of view. Then I realized that scapula positioning is often affected by the orientation of the rib cage. And now I’m beginning to see how the trunk muscles (specifically the latissimus dorsi, internal obliques, and external obliques) are affecting the rib cage and thereby the shoulder blades and neck. I also now understand how to release these muscles to free up the shoulder blades.
I learned this technique through practicing the Trauma Reflex Protocol created by Thomas Hanna (developer of Hanna Somatics). A few days ago I measured a client’s (with right side neck pain) scapulae and found the right side to be depressed. I then measured the rib cage and found the right side also to be depressed. I taped the right scapula into a corrected position and then re-measured the rib cage. It had also risen!
Yesterday I saw a woman with chronic right-sided neck pain after an accident whereby she fell on her right shoulder several years ago. It’s never been the same since. We measured her range of motion which was painful to the right side. The scapulae were sitting too low (depressed). I also found she had a right-sided Trauma Reflex pattern. After releasing the muscles of her right rib cage we re-tested. The right shoulder sat slightly higher and she instantly had more range of motion in her neck with significantly less pain.
This is an exciting connection because, although I understand the mechanical causes of most neck pain and know the exercises to correct those mechanics, sometimes it is not enough. This has always stumped me. But now I have a deeper understanding of the underlying causes of the depressed scapulae.
I’d love to hear your experiences with your neck pain or headaches. What have you tried? What’s worked? What hasn’t?
6 Responses to Neck Pain, Depressed Scapulae, and the Rib Cage
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Rick Olderman | (303) 477-4212 | 2555 West 36th Avenue | Denver, Colorado 80211 |
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6:28 pm
Rebecca
Hi,
i have had sever headaches caused from right side neck pain for many years (my GP believes it to be caused by a torn tendon in my shoulder, i have never had scans though). i did injure my wrist about 6 years ago and ended up with Chronic Regional Pain Syndrome for two years. the muscles in my arm diteriorated due to lack of use and this is when i began to suffer from the headaches. i am now suffering pain to the right side of my upper spine, under the shoulder blade and through my ribs. i also get tingling down the little finger side of my lower arm and wrist up to my elbow.
could this all be connected and would having the shoulderblade repositioned help?
thanks
7:39 pm
rick-olderman
Hi Rebecca,
I’m sorry to hear of your pain. Without seeing you I would guess that this is all connected. Because your pain is traveling down your ribs, I’m guessing that your right side of your rib cage is also depressed. This then pulls the scapula down as well, setting off a domino effect of problems at the neck and down the arm. The scapula may be repositioned but without correcting the rib cage, it is likely it will return to its dysfunctional position again. You never know though. Many people have repositioned their scapulae and resolved their problems.
I hope this helps and good luck!
10:44 pm
Peter
Read your article: Neck Pain, Depressed Scapulae, and the Rib Cage
Found your article very interesting, because my left scapula seems to be affecting my left lower rib which has the pain. Not sure if I understand the dynamics here, but in my 20s and 30s the reverse was true. I believe in those day I injured my left scapula by over stretching with yoga in my early 20s. This pain in my left shoulder blade stayed chronic for a good many years in my 20s, only to reverse in my chest(no longer chronic in my shoulder area) in my mid 30s. At present(I’m 54 now) the pain in my left rib area becomes chronic off and on for days at a time. Also curious, it seems that when I was 16 years old, I had periodic stabby pains for a short time in the exact chest area(left side). Some how I believe I have been predisposed for decades with these off and on syndromes in my left sided torso area. Most of my neck problems seemed more often in my 20s and 30s, not much now. Just wondering, but for the last couple of weeks there’s been a constant twitching in my left(almost center) lower rib area. This night the pain in my rib area for about 10 minutes became very intense, but was quickly relieved after my left scapula started twitching for a minutes or two. Really getting frustrated with this long term mystery. Hope I can resolve these pains soon so won’t be haunted the rest of my life. Not sure but your article seems very relevant to my condition. Interested to know your observations/input on this.
9:15 am
rick-olderman
Hi Peter,
I believe what you are describing may be a left sided trauma reflex pattern. Typically with this pattern, the left rib cage sit a little lower than the right and often the left iliac crest of the pelvis will sit higher than the right. You can check this in the mirror by palpating the outermost and lowest rib on each side and compare sides. You can also palpate the iliac crests on each side and compare. I’ve found it most helpful to have someone else do it for you as the angle is better to see the differences if someone is kneeling in front of you and their eyes are at the level of the ribs and pelvis. The muscles that pull the rib cage down and pelvis up are the latissimus dorsi, internal oblique, and external oblique. The latissimus dorsi also connects to the inferior angle of the scapula pulling it down as well. This pattern is described by Thomas Hanna who developed a treatment approach called Hanna Somatics. These muscles can be released (usually in one session). You should Google that term to see if there are any practitioners in your area.
4:32 pm
Sara
Hi this is interesting reading as I am currently having physio for my neck pain, which is always on the left. I’ve recently been having physio and he has spotted I have done too many abdominal crunches at the gym over the years and pulled my ribcage in towards my spine which he doesnt think is helping the situation so I have exercises to stretch my abs out. My scapulas are both depressed abducted and slightly rotated (left wings much more than right) and my shoulders are rounded over. Years of horseriding and slouching! My physio is trying to strengthen my lower traps (which don’t appear to work at all!) and stretch out my pec minors etc at the front which are tight. I basically use all the muscles around the top of my shoulders and neck instead of my lower traps which is why I have the neck pain as those muscles never switch off. Also tight in my serratus anterior. Do you think I will ever be able to be fixed?!
8:38 pm
rick-olderman
Hi Sara,
Yes, I believe you can be fixed. If things don’t go well with your physic, and you’d like me to take a look, we could have a Skype session. Hopefully your physio will be able to help though. Stay positive!