That Strange Knot Along Your Shoulder Blade: Where Did It Come From?

You know the spot.

It’s somewhere along the edge of your shoulder blade, often around the middle or slightly toward the outside and suddenly it feels like there’s a knot there that you can’t stop noticing.

You roll on a tennis ball. You stretch. You reach across your body trying to get to it. Maybe you ask someone to stick an elbow into it.

And somehow, it’s still there.

So what exactly is that “knot,” and why did it seemingly appear out of nowhere?

First, It May Not Actually Be a Knot

When we describe something as a muscle “knot,” we’re usually talking about a small area that feels unusually tight, tender or sensitive.

But the spot you feel isn't necessarily a little ball of muscle that simply needs to be smashed until it goes away.

Several muscles live in and around the shoulder blade, including the rhomboids, trapezius, infraspinatus and teres muscles. The muscles of your neck, chest and shoulder can also influence how your shoulder blade moves and how the area feels.

That's why I don't automatically assume the painful spot is the entire problem.

Why Did It Suddenly Show Up?

Sometimes the answer is pretty obvious.

Maybe you increased the weight you're lifting, tried a new exercise, spent several hours at your computer, carried something heavy, slept in an unusual position or did a repetitive movement your body wasn't accustomed to.

Other times, nothing obvious happened.

Muscle discomfort can build gradually until one day you suddenly notice it. Your body may have been compensating for something for days or weeks before that particular area started asking for your attention.

And sometimes the activity responsible for the discomfort isn't one we'd normally think of as strenuous. Hours spent reaching for a mouse, looking down at a phone, driving, working with your arms in front of you or repeatedly reaching overhead can all change the demands placed on the muscles surrounding the shoulder blade.

Why Digging Into the Spot Isn't Always the Answer

When something hurts, our natural instinct is often to attack the painful spot.

More pressure must be better, right?

Not necessarily.

If an area is already irritated, repeatedly digging into it can sometimes make it feel even more sensitive.

This is one reason I like to look beyond the exact place a client points to.

How is the shoulder moving? What does the neck feel like? Are the muscles across the chest tight? What has the person been doing differently lately? Is the rotator cuff working harder than usual? Does the shoulder blade move comfortably when the arm moves?

The answers can provide much more useful information than simply finding the sorest spot and pressing harder.

What Can You Do at Home?

If the discomfort is mild and seems muscular, gentle movement is often a good place to start.

Try moving your shoulder through a comfortable range of motion, taking breaks from prolonged sitting, and changing positions throughout the day. Gentle stretching or light self-massage may feel good as well.

A massage ball against the wall can be useful, but you don't need to punish the area. Think comfortable pressure, not how much pain can I tolerate?

And pay attention to what happened before the knot appeared.

Did you change your workout? Spend six hours on your laptop? Sleep differently? Do a lot of gardening? Increase your pulling exercises at the gym?

Sometimes identifying the pattern is more valuable than finding the perfect stretch.

When Massage May Help

This is one of my favorite types of problems to work with because it requires a little detective work.

Rather than spending an entire session pressing on the one uncomfortable spot, I may work around the shoulder blade as well as the shoulder, upper back, neck or chest depending on what I find.

The goal isn't simply to “get rid of a knot.”

It's to understand what may be contributing to the tension, calm down irritated tissue and help the area move and feel better.

And sometimes that stubborn spot you've been trying to reach for days isn't really asking for more pressure.

It's asking us to look at the bigger picture.

A note: New, severe or persistent pain, especially pain associated with an injury, weakness, numbness, tingling, chest pain, shortness of breath or other unusual symptoms, should be evaluated by an appropriate healthcare professional rather than assumed to be a muscle knot.