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.

Deep Tissue Release | A Vital Therapy For Muscle Balance And Muscle Congruity

 Muscle pain, stiffness, or restricted movement aren’t just inconveniences—they’re signs of dysfunction within the muscular system. While stretches and exercise can offer temporary relief, long-term muscle congruity—the harmonious alignment and function of muscle groups—often requires more targeted intervention. One of the most effective techniques used by physiotherapists to restore this balance is deep tissue release.

      Deep tissue release goes beyond surface-level tension. It targets the deep layers of muscle and connective tissue to break down adhesions (commonly known as "knots") and restore proper function. When performed by a skilled physiotherapist, this technique can significantly improve muscular health, mobility, and overall well-being.

 

What is Deep Tissue Release?

Deep tissue release is a manual therapy technique designed to relieve severe tension in the deeper layers of muscles, fascia (the connective tissue surrounding muscles), and tendons. Unlike a general massage, which targets relaxation and superficial tension, deep tissue release uses slow, firm pressure and specialized techniques to address specific musculoskeletal issues.

    Physiotherapists use their hands, elbows, or specialized tools to work through layers of tight tissue. The goal is to break up scar tissue, reduce inflammation, and promote better blood flow to facilitate healing and restore proper muscular function.

 

Muscle Congruity: What It Means and Why It Matters?

Muscle congruity refers to the optimal alignment, coordination, and tension of muscle groups. When muscles are congruent, they work together efficiently to stabilize joints, generate movement, and absorb force. This balance is essential not just for athletes, but for anyone who moves—whether it's walking, sitting at a desk, or lifting groceries.

      However, when one muscle becomes overactive or tight (often due to repetitive use, injury, or poor posture), it can pull joints out of alignment and force surrounding muscles to compensate. This can lead to:

1. Muscle imbalances
2. Restricted range of motion
3. Chronic pain
4. Joint instability
5. Increased risk of injury

 

How Deep Tissue Release Supports Muscle Congruity?

1. Breaks Down Adhesions and Scar Tissue

After injury or due to repetitive strain, muscles and fascia can develop adhesions—tough bands of scar-like tissue that limit flexibility and movement. These adhesions disrupt the natural glide of muscle fibers, reducing coordination and causing friction. Deep tissue release physically breaks down these adhesions, restoring the smooth movement necessary for muscle congruity.

2. Restores Muscle Length and Elasticity

Tight muscles not only feel uncomfortable, but they also restrict joint range and alter posture. Deep tissue techniques can lengthen shortened muscles and improve the elasticity of connective tissue. This helps maintain the ideal resting length of muscles, which is essential for balanced force production and joint stability.

3. Improves Neuromuscular Efficiency

When muscles are tight or inflamed, the brain may receive distorted signals, leading to poor motor control. Deep tissue release can recalibrate this neuromuscular communication by reducing overactivity in tight muscles and reactivating underused ones. This enhances coordination and overall muscle synergy.

4. Reduces Compensatory Patterns

One tight muscle can cause others to overcompensate, leading to a chain reaction of dysfunction. For instance, tight hip flexors can inhibit glute activation, which affects gait and spinal alignment. Deep tissue release helps identify and treat these trigger points, restoring normal function across the entire kinetic chain.

5. Supports Recovery and Injury Prevention

By addressing muscular tension early, deep tissue release can prevent minor issues from becoming chronic conditions. For athletes and active individuals, it’s a powerful way to reduce downtime, promote faster recovery, and optimize performance. For sedentary individuals, it can prevent postural strain and repetitive stress injuries.

 

Role of the Physiotherapist

While there are self-myofascial release tools available, such as foam rollers or massage guns, the expertise of a physiotherapist is irreplaceable. Trained professionals can:

1. Accurately assess musculoskeletal imbalances
2. Identify hidden or referred pain sources
3. Use precise pressure and techniques to target deep layers
4. Integrate deep tissue release into a broader rehab or performance plan

Physiotherapists also monitor your response during treatment, adjusting techniques to ensure safety and effectiveness.

 

Who Can Benefit?

Deep tissue release isn’t just for elite athletes or those recovering from injury. It’s beneficial for:

1. Office workers suffering from neck or back tension

2. Manual laborers dealing with overuse injuries
3. Older adults looking to maintain mobility
4. Fitness enthusiasts recovering from intense workouts
5. Post-surgical patients rehabilitating soft tissues

Muscle congruity is fundamental to how we move, feel, and perform daily tasks. When muscles are aligned, coordinated, and free from restriction, the body functions as it should. Deep tissue release, guided by a skilled physiotherapist, is one of the most effective ways to maintain this harmony.
Whether you’re experiencing chronic pain, limited mobility, or simply want to move better, consider deep tissue release as part of your wellness or rehab routine. It’s more than just a massage—it’s a therapeutic reset for your muscles.

Recurrent Musculoskeletal Pain | How Holistic Physiotherapy Unlocks Lasting Relief And Resilience

 Recurrent musculoskeletal pain is more than just an occasional nuisance—it can interfere with daily life, reduce productivity, and affect mental well-being. From nagging lower back pain and stiff necks to repetitive strain injuries and chronic joint discomfort, millions worldwide suffer from persistent pain that comes and goes without warning. While over-the-counter medications may offer temporary relief, physiotherapy provides a more sustainable, long-term solution.

In this blog, we'll explore how physiotherapy helps address the root causes of recurrent musculoskeletal pain and the evidence-based treatments that lead to lasting recovery and prevention.

 

Understanding Musculoskeletal Pain

Musculoskeletal pain can arise from a variety of causes: poor posture, overuse injuries, previous trauma, sedentary lifestyles, or degenerative conditions like arthritis. The pain may affect muscles, tendons, ligaments, joints, or nerves. Often, the underlying issue is mechanical, meaning it stems from imbalances, weaknesses, or improper movement patterns rather than disease.
Common conditions include:
1. Chronic lower back pain
2. Neck and shoulder tension
3. Sciatica
4. Tendinitis or bursitis
5. Carpal tunnel syndrome
6. Plantar fasciitis
7. Repetitive strain injuries (RSIs)

What makes musculoskeletal pain “recurrent” is its tendency to return, even after the initial flare-up subsides. Without proper treatment and rehabilitation, the pain cycle continues.

 

Role of Physiotherapy

Physiotherapy offers a multi-dimensional approach to treating recurrent musculoskeletal pain. Rather than masking symptoms, physiotherapists aim to understand the root causes of discomfort, restore function, and build long-term resilience in the body.

Here’s how physiotherapy can help:

1. Comprehensive Assessment and Diagnosis

Physiotherapists begin with a thorough physical assessment. They evaluate posture, range of motion, muscle imbalances, joint mechanics, and movement patterns. Sometimes, advanced techniques such as gait analysis or ergonomic assessments are used to understand how daily activities may be contributing to pain. This precise diagnosis allows them to tailor a treatment plan specific to the individual’s needs, goals, and lifestyle.

2. Manual Therapy

Hands-on techniques are often used to alleviate pain and restore mobility. These may include:

1. Soft tissue massage
2. Joint mobilization and manipulation
3. Myofascial release
4. Trigger point therapy

Manual therapy not only reduces muscle tension and improves circulation but also primes the body for active rehabilitation exercises.

3. Therapeutic Exercise

Exercise is the cornerstone of any physiotherapy program. Based on the patient’s condition, physiotherapists design customized exercise regimens to:

1. Strengthen weak muscle groups
2. Improve flexibility and joint range of motion
3. Correct posture and body mechanics
4. Enhance stability and coordination

For example, someone with recurring back pain might work on core stabilization, hip mobility, and lumbar strengthening. Consistency with these exercises is critical to prevent the recurrence of symptoms.

4. Postural and Ergonomic Training

Poor posture and improper ergonomics are common culprits behind chronic pain, especially in the neck, shoulders, and lower back. Physiotherapists educate patients on:

1. Proper desk and workstation setup
2. Safe lifting techniques
3. Correct walking and sitting postures

Making small ergonomic changes in work or home environments can dramatically reduce repetitive stress on muscles and joints.

5. Education and Self-Management

One of the most empowering aspects of physiotherapy is patient education. Individuals are taught to recognize early warning signs of pain, understand body mechanics, and apply preventive strategies. This knowledge reduces dependency on passive treatments and fosters a proactive approach to health. Physiotherapists may also advise on lifestyle factors such as weight management, sleep hygiene, stress reduction, and activity modification—all of which influence musculoskeletal health.

6. Modalities and Technology

In some cases, adjunct modalities may be used to manage pain and inflammation, such as:

1. Shortwave therapy
2. Laser therapy
3. CRET therapy
4. Ultrasound therapy
5. TENS (Transcutaneous Electrical Nerve Stimulation)
6. Dry needling or acupuncture
7. Chiropractor
8. Cryotherapy or heat therapy

These tools help reduce acute symptoms, making it easier for patients to participate in active rehabilitation.

Why Choose Physiotherapy Over Quick Fixes?

While painkillers, steroid injections, or rest may provide temporary relief, they don’t resolve the underlying dysfunction. Physiotherapy focuses on correcting the source of the problem, not just the symptoms. By addressing muscle imbalances, movement limitations, and lifestyle triggers, physiotherapy reduces the chances of future recurrences. Moreover, physiotherapy is non-invasive, drug-free, and evidence-based, making it a safe and effective long-term solution for people of all ages.

Movement Is Medicine

Living with recurrent musculoskeletal pain doesn’t have to be your norm. With the right physiotherapy approach, many people find lasting relief, improved mobility, and better quality of life. Whether you’re an athlete, office worker, or retiree, physiotherapy can help you move better, feel better, and live pain-free.

If pain keeps coming back despite rest or medication, it may be time to consult a qualified physiotherapist. By taking an active role in your recovery, you’ll be investing in a healthier, more resilient body—one that can carry you through life with strength and ease.

Why Exercise Is The Best Way To Lose Weight At Any Age | A Physiotherapist’s Guide

 In today’s fast-paced world, weight gain has become a common concern across all age groups. With sedentary lifestyles, increasing screen time, and easy access to processed foods, it's no surprise that more people are struggling with excess weight. While fad diets and quick-fix supplements often promise fast results, they rarely provide long-term success. Exercise remains the most effective, natural, and sustainable method for weight loss, regardless of age.

 

Here’s why? Science Behind Weight Loss and Exercise

Weight loss fundamentally comes down to one principle: burning more calories than you consume, also known as creating a caloric deficit. Exercise plays a crucial role in this equation by increasing the number of calories your body uses during and after activity. However, the benefits extend beyond simply burning fat. Regular physical activity:

1. Increases your metabolic rate
2. Builds lean muscle mass
3. Regulates hunger hormones
4. Improves insulin sensitivity
5. Enhances mental well-being

These effects make exercise a cornerstone not just for weight loss but for overall health improvement.

 

Exercise for Children and Teenagers

Children and teens today face growing risks of obesity due to reduced physical activity, increased screen time, and poor eating habits. Weight gain at this age can lead to early-onset diabetes, poor self-esteem, and long-term health complications.

 

Benefits of exercise in youth:

1. Builds strong bones and muscles
2. Supports healthy growth and development 
3. Improves coordination and motor skills
4. Reduces the risk of childhood obesity

Physiotherapist’s Advice:

Children should get at least 60 minutes of physical activity daily. Encourage activities like cycling, dancing, swimming, or team sports. Exercise at this age should be fun, not a chore.

 

Exercise for Adults (20s to 50s)

This is often the age when weight gain begins due to a combination of sedentary work, high stress, poor sleep, and lack of time for physical activity. Many adults also face lifestyle diseases such as diabetes, high blood pressure, and joint pain—all of which are worsened by excess weight.

 

Why exercise is critical for adults:

1. Boosts metabolism and aids fat loss

2. Improves posture, mobility, and joint health

3. Enhances mental clarity and energy levels

4. Helps manage lifestyle-related health conditions

 

Recommended Routine:

Aim for at least 150 minutes of moderate aerobic activity per week (e.g., brisk walking, swimming, cycling), plus two days of strength training. Resistance training helps retain muscle mass, a key factor in achieving long-term fat loss.

 

Physiotherapist’s Tip:

If you’re new to exercise or have physical limitations, start slow. Even 20–30 minutes a day of low-impact movement can help. Gradual progression is more sustainable and reduces the risk of injury.

 

Exercise for Seniors (60+)

Many seniors believe it’s too late to start exercising, but that couldn’t be further from the truth. Physical activity is essential in this stage of life for maintaining independence, mobility, and quality of life. Age-related weight gain often leads to joint pain, fatigue, and decreased function, all of which can be mitigated by staying active.

 

Benefits for older adults:

1. Maintains muscle strength and bone density

2. Enhances balance and coordination (reducing fall risk)

3. Supports heart health and circulation

4. Helps manage arthritis and chronic pain

Safe Activities Include:

1. Walking or light hiking

2. Chair exercises or resistance bands

3. Aqua aerobics or swimming

Physiotherapist’s Tip:

Before starting a new exercise regimen, seniors should have a functional assessment to tailor the program to their individual needs. This ensures safety and maximizes benefits without overstraining the body.

 

Why Exercise Trumps Fad Diets and Weight Loss Gimmicks

You may have tried low-carb diets, intermittent fasting, or fat-burning supplements in search of quick weight loss. While some of these can yield temporary results, they rarely lead to long-term success. Here’s why exercise is a better option:

1. Exercise helps build lean muscle, which burns more calories even at rest.

2. It regulates appetite, reducing cravings that often derail diets.

3. It improves mood and motivation, making it easier to stay committed.

4. It strengthens the body holistically, reducing the risk of injury, fatigue, and disease.

 

Fad diets often result in water loss and muscle wasting. Exercise, on the other hand, promotes real fat loss and a healthier, stronger body. If you’re unsure where to begin, consult a physiotherapist or a certified fitness professional. Your therapist will help you design a safe, personalized exercise plan that meets your current abilities and weight loss goals.

 

Remember: The journey to a healthier weight doesn’t start with perfection—it starts with movement. Let exercise be your medicine, your stress reliever, and your path to lasting wellness.