There are various causes for achiness or soreness under the shoulder blades. The shoulder blade is the triangular bone that forms the back of the shoulder. This pain can range from dull, sharp, burning, or a combination between the spine and shoulder blade to tender or achy across the shoulder or upper back. Pain can spread from another body part or structure, like the neck or spine. Inflammation from injury or overuse is noticeable at onset or gradually after engaging in physical activity and can limit arm movements and interfere with regular activities.

Improper Posture

Improper poster combined with prolonged sitting can cause the spine to develop structural changes that cause pain under the shoulder blade. Habits that lead to poor posture include:

• Hunching the back.
• Tilting the head down – looking at the phone.
• Leaning to one side while sitting, working.

Poor posture habits cause the muscles to weaken, placing added pressure on the spinal discs, muscles, and ligaments. This body imbalance can contribute to upper back and shoulder pain.

Lifting Improperly

Lifting weight above the head and not using the proper technique can leave the upper back and shoulders vulnerable to injury. Lifting an object that is too heavy or is held in an awkward way causing the spine to be misaligned creates added pressure in the upper back. This can strain the muscles, sprain ligaments, injure the shoulder joint, or spine, which can cause spreading pain under and/or near the shoulder blade.

Repetitive Overuse Injury

Painting, moving furniture, or participating in sports are activities that can overwork the upper back muscles and shoulders. Overuse can lead to muscle strains and ligament sprains. This can cause pain in the upper back between the shoulder blade and the spine. Scapulothoracic bursitis, also known as snapping scapula syndrome, is when the bursa between the shoulder blade/scapula and the thoracic spine becomes inflamed, causing pain.

Cervical Herniated Disc

A herniated disc in the cervical spine/neck happens when a disc’s outer layer/annulus fibrosus tears and the inner layer/nucleus pulposus starts to leak outward. This can cause pain and cause the nearby nerve roots to become inflamed, causing pain to run down into the shoulder, arm, and/or hand. A disc herniation in the lower part of the neck usually radiates pain into or near the shoulder blade area. Although less common, a herniation in the upper back can cause pain around or near the shoulder blade.

Dislocated Rib

An accident or fall could cause a rib to become dislocated or misaligned after repetitive/overuse strain or reaching too far overhead. Sharp pain near the shoulder blade can result from this activity and can sometimes make it challenging to take a deep breath.

Compression Fracture

A compression fracture occurs when a vertebral bone in the upper back weakens and compresses. This can lead to back pain with a heightened sensitivity across the shoulder area. The pain usually decreases with rest. Compression fractures are commonly caused by osteoporosis in older individuals. Any back or shoulder pain that persists for weeks or interferes with regular activities should be evaluated by a doctor or chiropractor. If the pain is severe or accompanied by symptoms like headache, tingling, weakness, or nausea, individuals are recommended to seek medical attention.

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Body Composition

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Carbohydrate/Carb Loading

Carbohydrates are macronutrients that serve a critical function in the body, as they are the body’s primary energy source. The body breaks down carbohydrates into sugar that enters the bloodstream and is stored for energy use in the muscles and liver as glycogen. The muscles only store small quantities of glycogen. And when engaging in physical activity or exercise, the energy stores get used up.

Carbohydrate loading can raise glycogen stores in the muscles from 25 to 100 percent of their average amount in men. Women have shown mixed results in studies on carbohydrate loading. Women need to take in more calories than men when carb-loading to experience the same gains in glycogen. Reasons to carb load are either to:

• Build-up stores of glycogen so an individual can use the extra energy storage to help improve endurance.
• Fill the muscles with glycogen to bring water into the muscles to help gain mass and tone.

References

Hanchard, Nigel C A et al. “Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement.” The Cochrane database of systematic reviews vol. 2013,4 CD007427. 30 Apr. 2013, doi:10.1002/14651858.CD007427.pub2

Mizutamari M. et al. Corresponding scapular pain with the nerve root involved in cervical radiculopathy. J Orthop Surg. 2010; 18(3): 356–60.

Sergienko, Stanislav, and Leonid Kalichman. “Myofascial origin of shoulder pain: a literature review.” Journal of bodywork and movement therapies vol. 19,1 (2015): 91-101. doi:10.1016/j.jbmt.2014.05.004