Rhomboid Major and Minor Muscles: Location, Actions, and Trigger Points
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By Ground Up Strength

The proper names for the muscles we call the rhomboids are Rhomboideus Major and Minor or the Rhomboidei. Although two different muscles, they are very difficult to distinguish from one another and perform the same actions together. They run obliquely downward from the spine to the inner edge of the scapula, on each side of the middle back and connect the vertebra in that area to the medial border of the scapula. They are largely covered by the more superficial trapezius muscle.

The rhomboids get their name from their shape, the word rhomboideus referring to a diamond or kite shaped object1. The rhomboid minor begins at the last vertebra of the neck (cervical) and ends at the first thoracic vertebra. The rhomboid major begins where the minor leaves off, at the second thoracic vertebra and continues to the fifth thoracic vertebra. The rhomboid major is bounded by the lattisimus dorsi inferiorly and the minor is bounded by the levator scapula, superiorly. They share their attachment to the medial scapular border with the trapezius and levator scapulae muscles.


rhomboid major and minor muscle diagram

Rhomboid Major and Minor



The rhomboids are used anytime you forcefully lower your arms or pull down or back with them, as when performing pullups or drawing back a bow string. They are also important as brakers of scapular protraction during throwing movements, and are also active when walking, stabilizing the scapula during the arm swing.

One of the most popular strength training and bodybuilding exercises, the Shrug, is meant to strengthen and add mass to the upper trapezius. However, this exercise may just as likely overemphasize the rhomboids because the shoulders are held in downward rotation, making the rhomboids active over the upper trapezius and lower trapezius, which cause upward rotation. This can also contribute to levator scapulae dominance in the same way. This leads to short and overactive rhomboids. It may be better to perform overhead shrugs so that the scapula are upwardly rotated, thus emphasizing the upper trapezius. The activity of the serratus anterior muscle must also not be overlooked, as it is a force couple with the upper and lower traps, upwardly and laterally rotating the scapula. It is also the major scapular abductor, in direct opposition to the rhomboids, thus may become weak or even paralyzed. the serratus anterior holds the shoulder blade flat against the ribs and if not functioning properly as a scapular stabilizer, cause many problems with shoulder movement.

Habitually working in in a slumped-forward, round-shouldered (protracted) position, as with computer or other desk work and many other occupations cause the pectoralis major and minor to become shortened and hypertonic, thus stretching out the rhomboids and causing them to become very tired, leading to overwork, weakness, and trigger points. Too much bench pressing with shoulders protracted as well as too much internal rotator work in general help lead to this same problem.


Rhomboid Video Presentation


Rhombodei Origin, Insertion, and Actions

Origin: The rhomboid minor originates on the spinous processes and nucal ligaments2 of vertebrae C7 through T1. The rhomboid major originates on the spinous processes of vertebrae T2 to T5 (last neck vertebra and first five thoracic vertebra.

Insertion: The rhomboid minor inserts onto the medial border of the scapula, at the level of the spine. The rhomboid major inserts onto the medial border of the scapula, inferior to the spine.

Actions: Similar to the middle fibers of the trapezius, the rhomboids major and minor retract (adduct) the scapula and cause slight elevation of the scapulothoracic. They also rotate the scapula downward to depress the glenoid cavity and help hold the scapula close to the thoracic wall. In this way, although they are agonists with the middle trapezius, they are antogonists for the upward scapular rotation of the upper and lower traps, similar to the levator scapula. These actions make the major role of the rhomboids is as a scapular stabilzer and they fix the scapula into adduction when the shoulder joint is adducted or the arm is extended forcefully. They keep the lower angle of the scapula close to the ribs, keeping it from protruding outward and causing scapular winging when pushing against something in front of you, as when performing the pushup or leaning against a wall, etc.


Rhomboid Synergists and Antagonists

Adduction Abduction
Rhomboids Major and Minor Serratus Anterior
Trapezius Middle Fibers Pectoralis Minor
Downward Rotation Upward Rotation
Rhomboids Major and Minor Trapezius Upper Fibers
Levator Scapula Trapezius Lower Fibers


Rhomboid Trigger Points Causes and Symptoms

Several common causes of rhomboid problems, trigger points, and pain, are discussed above. Tension in the upper body, that keeps the shoulders raised causes rhomboid strain just as it does many other muscles in this area, such as the trapezius, levator scapulae, etc. Other problematic habits and activities are:

  • Military posture - continually pulling the shoulders back
  • Throwing a ball, as in baseball pitching
  • Rowing a boat
  • Anything that requires you to repeatedly raise and lower the shoulders
  • Upper thoracic scoliosis
  • Tight pec muscles (as mentioned above)

Those with a round-shouldered kyphotic posture should first work on their tight and over-active pectoralis major and minor. Stretching these muscles out and deactivating the trigger points in them must be done first, before you can begin to relieve the pain caused by the rhomboids. When the pecs are tight, the rhomboids will be stretched and in a continual eccentric contraction, being stretched while trying to pull back and counter-act the pull of the pecs. If you stretch the rhomboids when they are in this shape, you'll only add to their problems. You may not feel any pain as a result of the pectoralis problems, but the strain caused in the weaker interscapular muscles will cause pain in this area.


rhomboid major and minor muscle trigger points and referred pain

Rhomboid Major and Minor Trigger Points



Trigger points in the rhomboids refer pain nearby to the inner edge of the scapula, which manifests as a superficial, aching pain between the shoulder blades, closer to the scapula than to the spine. Snapping, grinding or crunching sounds when the scapula is moving may mean that the rhomboid is involved3 but it can be difficult to distinguish exactly when the rhomboids are causing between the shoulder blades pain because there are actually ten other muscles which also refer pain to this region, among them are the scalenes, infraspinatus, serratus anterior, and levator scapulae3,7

Trigger points in these muscles may need to be treated before rhomboid trigger points become apparent. Paraspinal muscles can also cause pain in the same area of the back but this will be closer to the spine.

Rhomboid Trigger Point Treatment

Rhomboid trigger points can be treated with a tennis ball or a Thera Cane.

To use a tennis ball, place the ball against a wall and place your back against it so that it makes contact with the area just inside your shoulder blade. You may want to first place the ball in a long sock so that that end of the sock can act as a handle. Roll up and down letting the ball massage the muscles in this area. You can also lie down on the ball and roll on it but this will not work as well for heavier people, since the ball will deform. A lacrosse ball can be used for more pressure, as treatment is extended and you can withstand a harder tool and more pressure. A knobby massage ball also feels fantastic on the rhomboids. When you find a particular trigger point, which will be hypersensitive and may even be palpable as a knot, concentrate on that area and apply more pressure. Treat several times a day for several minutes.

For treating this area and getting to the trapezius and underlying serratus posterior, the Grid Foam Roller works well and provides great general trigger point massage. But don't rely on this completely as you'll want a precision tool to find and treat individual points.

For more information on finding and treating associated trigger points see the Trigger Point Therapy Workbook and other resources.

Resources
1. Rockwood, Charles A. The Shoulder. Philadelphia, PA: Saunders/Elsevier, 2009. 55.
2. Davies, Clair. The Trigger Point Therapy Workbook: Your Self-treatment Guide for Pain Relief. Oakland, CA: New Harbinger Publications, 2004.
3. Simons, David G., Janet G. Travell, Lois S. Simons, and Janet G. Travell. Travell & Simons' Myofascial Pain and Dysfunction: the Trigger Point Manual. Baltimore: Williams & Wilkins, 1999. 425-430.
4. Hertling, Darlene, and Randolph M. Kessler. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. Philadelphia: J.B. Lippincott, 1996.
5. Sahrmann, Shirley. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby, 2002.
6. Kendall, Florence Peterson, and Florence Peterson Kendall. Muscles: Testing and Function with Posture and Pain. Baltimore, MD: Lippincott Williams & Wilkins, 2005.
7. Ferguson, Lucy Whyte., and Robert Gerwin. Clinical Mastery in the Treatment of Myofascial Pain. Philadelphia: Lippincott Williams & Wilkins, 2005. 213-217.

Unless otherwise noted, all images on this page used under license. Images by LifeART (and/or) MediClip image copyright 2010. Wolters Kluwer Health, Inc.- Lippincott Williams & Wilkins. All rights reserved. Images not for reuse.


This page is provided by Ground Up Strength for information purposes only and should not take the place of professional medical advice. Although we have done our utmost to provide accurate and safe information, we are not medical professionals and the information on this page should not be taken as professional medical advice, or any other kind of medical advice.

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This page created 28 Feb 2012 17:35
Last updated 24 Apr 2014 01:07

This page contains affiliate links to Amazon.com. We have not been compelled in any way to place links to particular products and have received no compensation for doing so. We receive a very small commission only if you buy a product after clicking on one of these affiliate links.

© 2014 by Eric Troy and Ground Up Strength. All Rights Reserved. Please contact for permissions.