As a massage therapist, I have at least 80% of clients complaining about “between the shoulder blade” pain, some of them blame the nagging knots around shoulder blade. But when people come in treating room, they like saying: I have muscle strain, I have tight traps , rhomboid…At the beginning of my remedial massage experience, I treated my clients according to their believes. But we all know that traps and rhomboid are all very superficial muscles, and… I seldom got a satisfactory result. After three years of studying and practicing, I realized it is not just muscle problem, especially for chronic pain, the muscle itself is usually not the culprit. Highly innervated joint capsules, spinal ligaments and nerve dural tension often play the pain generator role.
Most of the time, massage therapist work in and around the paravertebral back muscles. When working through the bulky erector spine muscles, our fingers can encounter small, hard and sometimes very tender knots . Hypertonic knots in the lamina groove indicate joint dysfunction and extremely tender iliocostalis muscle at the lateral rib angle informs that the rib may be torsion. So what is beneath the lamina groove that can make joint fixed? It is 4th layer transversospinalis muscles: multifidus, rotatores, levator costalis and intertransversarii,
Now when I palpate the knots and go deeper to loose and melt the 4th layer muscles, I finally can feel the unwinding sensation under my hands.