For many patients who are experiencing chronic shoulder pain at the top of the shoulders, leading into the neck, there are three main sets of muscles that are likely to be tense. These muscles tend to be tight as a result of stress or poor posture (frequently due to poor ergonomics when working at a computer). Learning to stretch these muscles and to periodically check they are in a healthy position, especially when working under stressful conditions, can be very helpful in minimizing this type of shoulder and neck pain. An acupuncture treatment can help relax these muscles to alleviate much of the pain, but learning good posture is critical for preventing the problem from recurring.
The first and most obvious muscle is the upper portion of the trapezius, which extends from the base of the skull to the outer edge of the shoulder. Flexing this muscle causes the outer portion of the shoulder to rise. Second is the levator scapula, which extends from the upper vertebrae of the neck down to the inside top corner of the shoulder blade. Flexing this muscle causes the inside part of the shoulder blade to rise. The third set of muscles are the scalene muscles, which connect the neck bones to the upper ribs, and assist in respiration by lifting the ribs a little bit. Most people don’t have a lot of conscious control of the scalene muscles.
If all three of these muscle groups are tight, then your entire shoulder is elevated (which makes your neck look shorter than it really is, and makes your shoulders look square), and it may be a little bit hard to take a deep breath. If all of these muscles are chronically tight and knotted, severe neck and shoulder pain are not far behind. Unfortunately, stretching these muscles to alleviate the tension and pain is difficult. If you attempt to stretch the muscles on one shoulder by tilting your head, it’s difficult to avoid aggravating tension in the same muscles on the opposite side.
Now consider the Venus de Milo. Like many ancient Greek statues, her neck appears very long and elegant. This posture comes from elevating the head while lowering the shoulders. To get into this position, the woman who modeled for the sculptor must have had relaxed muscles throughout her upper shoulders and neck, and we can presume that at least at that point in her life, she didn’t have any pain in that part of her body.
The stretch I recommend is to imitate the appearance of the Venus de Milo’s neck in several steps.
- Hold a light weight such as a one pint water bottle or small barbell in each hand, and let your arms hang at your sides
- Elevate your head up as high as you can
- Allow the weight of the water bottle to pull your shoulders down.
Hold this position for perhaps 30 seconds, until the neck appears longer (indicating that the levator scapula and scalene muscles are elongating) and until the shoulders angle downward on the outside (indicating that the trapezius muscle is elongating).
I would suggest doing this stretch preventatively if you have a profession that requires a lot of sitting at a computer desk, or if you have any sort of job which requires holding your arms up for prolonged periods, e.g. driving.
One other hint is to be careful of the types of bags you hang on your shoulders. If you carry a satchel or purse on one side, using a single strap on that same-side shoulder, you may be unconsciously elevating your shoulder to prevent the bag from sliding off. People who have shoulder and neck pain should avoid using this kind of bag. Instead, use a double strap backpack (which can also help you do the Venus de Milo stretch), or use a courier type strap which extends over the neck to the opposite shoulder, switching sides periodically to avoid lopsidedness.