What’s Causing That Pain Under Your Shoulder Blade? 7 Possible Reasons And How Physiotherapy Can Help You Fix It

 Pain under the shoulder blade (also called the scapula) can be a nagging, uncomfortable issue that interferes with daily life. Whether it appears as a dull ache or a sharp stab, this kind of pain can stem from a variety of causes—some minor, others more serious. Fortunately, physiotherapy plays a vital role not only in treating such pain but also in preventing it from becoming a recurring problem.

       In this blog, we’ll explore seven common causes of pain under the shoulder blade and how physiotherapy helps manage and prevent this issue effectively.

 

1. Poor Posture

Cause:

One of the most common causes of shoulder blade pain is poor posture, especially from prolonged sitting, slouching, or looking down at screens. Over time, this can lead to muscle imbalances, tightness in the chest, and overstretching of the upper back muscles.

Role of Physiotherapy:

Physiotherapists assess your posture, identify imbalances, and teach corrective exercises to improve spinal alignment. Ergonomic training, postural correction, and strengthening of the upper back can prevent the recurrence of this pain.

 

2. Muscle Strain or Overuse

Cause:

Lifting heavy objects, sudden twisting movements, or repetitive overhead activities can strain muscles like the rhomboids or trapezius, which sit near the shoulder blade.

 

Role of Physiotherapy:

After identifying the affected muscles, your physio will use soft tissue release, ultrasound, or dry needling to reduce muscle tension. They will also guide you through proper warm-up routines and muscle conditioning to prevent future injuries.

 

3. Cervical Spine Issues (Neck Problems)

Cause:

A herniated disc or degenerative changes in the cervical spine can compress nerves that refer pain to the shoulder blade area. This is often accompanied by neck stiffness or radiating arm pain.

Role of Physiotherapy:

Physios perform a comprehensive neuro-musculoskeletal assessment to pinpoint cervical involvement. Treatment may include manual therapy, traction, nerve glides, and targeted neck and scapular strengthening to relieve referred pain and restore function.

 

4. Scapular Dyskinesis

Cause:

This condition refers to the abnormal movement of the shoulder blade due to weakness, tightness, or imbalances in the scapular stabilizing muscles. It often affects athletes and people with repetitive overhead movements.

Role of Physiotherapy:

Rehabilitation focuses on restoring proper scapulohumeral rhythm through retraining of the serratus anterior, lower trapezius, and rotator cuff muscles. This helps the shoulder blade move smoothly and efficiently, reducing stress and pain.

 

5. Myofascial Trigger Points

Cause:

Trigger points or "knots" in the upper back muscles can cause referred pain under the shoulder blade. These may develop due to prolonged static positions or emotional stress.

Role of Physiotherapy:

Physiotherapists use techniques like myofascial release, dry needling, and stretching to deactivate trigger points. Education on stress management and postural awareness is also a key preventive tool.

 

6. Gallbladder or Other Referred Pain

Cause:

Though rare, certain internal organs can cause referred pain under the shoulder blade. For example, gallbladder issues often refer pain to the right scapular region. Similarly, cardiac or lung problems may mimic musculoskeletal pain.

Role of Physiotherapy:

A skilled physiotherapist is trained to recognize red flags. If your pain doesn’t fit a musculoskeletal pattern, they will refer you to a medical doctor for further evaluation. Early detection can be life-saving.

 

7. Thoracic Spine Dysfunction

Cause:

Dysfunction in the mid-back or thoracic spine, such as joint stiffness, poor mobility, or vertebral misalignment, can lead to localized or referred pain under the shoulder blade.

Role of Physiotherapy:

Physios use mobilization, spinal manipulation, and targeted exercises to restore thoracic spine mobility. They may also recommend strengthening exercises to stabilize the spine and scapula for long-term relief.

 

How Physiotherapy Prevents Shoulder Blade Pain?

Physiotherapy doesn’t just relieve pain—it prevents recurrence. Here’s how:

1. Postural Training: Educating patients about optimal sitting, standing, and workstation ergonomics.
2. Strengthening Weak Muscles: Addressing muscular imbalances, especially in the scapular stabilizers and core.
3. Movement Correction: Teaching correct lifting techniques and movement patterns.
4. Flexibility Improvement: Restoring flexibility in tight structures like the pectorals, upper trapezius, or levator scapulae.
5. Education: Empowering patients with knowledge about their body, contributing factors, and injury prevention strategies.

 

When to See a Physiotherapist?

If your shoulder blade pain:

1. Persists for more than a few days,

2. Worsens with movement or activity,

3. Radiates to the arm or neck,

4. Or interferes with daily activities, 
Then it’s time to consult a physiotherapist.

 

Early intervention can significantly reduce pain duration, improve mobility, and prevent chronic issues from developing. Pain under the shoulder blade is more than just an inconvenience—it can signal underlying biomechanical or systemic issues. Physiotherapy plays a crucial role not just in treating the symptoms but in identifying root causes, correcting movement patterns, and empowering you to prevent recurrence. Don’t let pain linger. Consult a physiotherapist and take proactive steps toward a pain-free, active life.

 

Need help with shoulder blade pain?

CB Physiotherapy offers personalized assessments and expert care to get you back on track. Book a session today and experience the difference.