This is the second part of a two-part post about strengthening the musculature in the posterior neck and shoulder region. Please read part 1 for the reasoning behind why this may help ease discomfort in this area (and for ideas on how to strengthen your rhomboids). This post will focus on a muscle we all know well … the upper trapezius! Many, many of us experience some type of discomfort in the upper part of the shoulder. We often attribute this sensation to tightness in the upper trapezius. However, I have found that stretching and massaging those fibers rarely provides any lasting benefit. Both of these interventions feel great and increase body awareness, which is one of the most important aspects of healing. In terms of prolonged benefit, however, I haven’t had much success. (Stretching and massaging the muscle directly beneath the upper trapezius, levator scapulae, is a different story altogether – this works wonders, and will be the subject of another post in the future.)
Yet, there is something going on with this muscle in many of my clients, as they exhibit the typical pain referral patterns and “question mark shaped” headaches associated with it.
Like the rhomboids, clients often feel a tautness in the upper trapezius accompanied by a constant throbbing sensation, suggesting that it is probably weak and overstretched rather than “tight”. Again, in these cases, clients will benefit more from strengthening than stretching.
ANATOMY & PHYSIOLOGY:
The trapezius is a large, superficial muscle that connects the collarbone and shoulder to the entire cervical and thoracic spine. The part I am concerned about in this post is the upper trapezius, which originates on the occiput, ligamentum nuchae in the neck and the spinous process of the C7 vertebra (some sources say all 7 vertebrae, some say just the connective tissue and C7). It inserts into the lateral third of the clavicle. In other words, it runs from the base of the skull and the fascial fibers in the back of the neck to the outer portion of the collarbone. There is some controversy as to the function of this muscle, and it is hard to separate the upper fibers’ function from the rest of the muscle. All of the fibers work together, although during different actions some areas of the muscle work harder than others. The standard anatomy answer is that the upper trapezius is a prime mover of scapular elevation, which means it raises the shoulder blade. However, there is some excellent research (see resources below) to suggest that, due to the transverse direction of the upper trapezius fibers, its main function is to move the clavicle medially, thereby transferring compression loads from the cervical spine to the sternoclavicular joint (where the collarbone meets the sternum). This essentially means that the weight of the arm and anything it carries is transferred to the chest and mid-body rather than the neck. Pretty important! It would make sense then that if this muscle is weak, we might have some neck pain. This also makes the case for strengthening.
It is worth mentioning again that movement is complicated and muscles perform various functions to varying degrees, depending on the orientation of the body. In this case, the upper trapezius DOES perform scapular elevation and upward rotation in conjunction with serratus anterior, once the movement is already started. It appears to be strongest when the arm is already slightly raised away from the body in abduction. We can use this to our advantage, as it gives us an easy movement to perform in order to strengthen the upper trapezius! The added benefit is that any overhead exercises eliminate the action of the levator scapulae, which is already overworked in most people.
Just as in my rhomboid post, these exercises are general suggestions. Unless you have specifically done these before, or are familiar with exercise physiology, please consult a personal trainer prior to incorporating these into your exercise regimen. It is important to start with the lightest weight (or no weight) first to make sure you have the proper form and to move slowly and gently (NO jerky movements). Always pay attention to your breathing during any movement – the general rule being exhale upon exertion. Finally, if you google these you will find some conflicting information. Many trainers and physiotherapists think that, “in general”, upper traps need to be stretched rather than strengthened. In addition to anything you may find on your own, I urge you to read the resources I have included at the bottom of the post and then make your own decision as to what you think might be happening with your shoulders.
Here are two exercises for strengthening:
The overhead shrug is a great exercise for the upper trapezius, provided you do not have a problem with shoulder mobility (in either flexion or abduction). Start without weight just so you understand the motion. Lift your arms directly above your head (from a standing or seated position, but I prefer standing), with slightly bent elbows. From that position, reach your arms more toward the ceiling and perform a shrugging motion. In the video below, her arms are straight, but I think it’s better to do them with slightly bent elbows like the picture above (forearms are still perpendicular to the floor, this is NOT a Y-shape). Ask a personal trainer which might be better for you. Some things to notice:
- Make sure your ribcage is not flared out when your arms come up. If it is, use lighter weight, OR you may need to work on your shoulder mobility for a few weeks prior to attempting this exercise. For the yoga people, let yourself hang out in a child’s pose for a few minutes daily until your shoulders can more easily go overhead without the rib flare.
- Make sure you are solid in your core as your arms go up.
- Make sure you are breathing properly.
If you do not like overhead movements and choose to do standard shrugs instead, I like Adam Meakins’ “Monkey Shrugs”. In order to properly engage the upper trapezius, your arm can not be in a neutral position; it must be in at least 30 degrees of abduction (away from the body). So he suggests taking weights in your hands with your arms at your side, sliding your hands up to about waist level and shrugging from THAT as your starting position. This will ensure that you are working the upper trapezius.
This exercise is excellent for upward rotation, which is a problem for many of us. It works both upper trapezius and lower trapezius. The photo and description are from flexibilityrx.com
Begin with your forearms in contact with the wall, shoulder width apart. The elbows are bent at ninety degrees and wrists in line with the elbows. Keeping your forearms in contact with the wall – slide your arms up and out – without shrugging the shoulders. Controlling the lower part of the shoulder blade with the lower trapezius helps prevent the shoulders from elevating during the movement.
I use the term ‘pack scapula down’ – not to describe a rigid position – but a controlled retraction of the scapula during its upward rotation (see illustration). Focusing on lower trapezius engagement as the scapula rotates out to the side creates this position of dynamic stability.
Integrating Lower and Upper Trapezius
At the top of the movement – with the arms extended, pull the arms back 2-inches retracting the shoulder blades (part B). A slight shrug while pulling the arms off the wall engages the upper trapezius for full upward rotation. Note – the shoulders remain relaxed down as the arms slide up and out (part A), before a shrug is added at the top position to pull the arms back (part B).
This motion is similar to an overhead barbell shrug where a shrug at the top of the lift is used to enhance upward rotation – as the scapula is controlled by the lower trapezius. This timing of lower and upper trapezius activation takes some practice – the initial focus should be upward rotation without elevating the shoulders (part A of the exercise).
After pulling the arms back off the wall (part B) return the arms to the wall and slide them back down to the starting position – maintaining contact with the wall (part C).
Some things to notice:
- As your arms slide up the wall, make sure you are not making a circle and bringing them together – the point HERE is to go out into a Y shape.
- Make sure your hands are not turning inward into medial rotation as you slide up. The outside of your hand should remain in contact with the wall.
- Make sure you are breathing properly.
“The Upper Trapezius Does Not Elevate the Shoulder”, Hammer, Warren, MS, DC, DABCO
“Anatomy and Actions of the Trapezius Muscle”, Johnson, G., Bagduk, N.
“The Upper Traps: Overassessed, Overblamed and Very Misunderstood”, Meakins, Adam (DISCLAIMER: This man is a sports physiotherapist and makes some brilliant points. However, his personality is caustic and he is completely against manual therapy. In my opinion, he takes a very simplistic view of the benefits of manual therapy and does not respect the gains to the nervous system and the importance of fostering body awareness. While I fundamentally disagree with his views on manual therapy, I still very much respect his knowledge of sports physiotherapy!)
“Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula.”, Pizzari, T, Wickham, J, Balster S, Ganderton, C, Watson, L