Upper Trap Dominance

Spring and summer are upon us and baseball season is here! Not only that, it's also home renovation and yard work season, all of which mean that your shoulders better be in good shape for all the work that they're in for.

If you're already hurting, then it's a good thing you're here to read on.

One of the most common things I see on clients who come in with shoulder injuries (especially the chronic, overuse ones) is the dominance of the upper trapezius muscle. Like many large, easy-to-engage muscles of the body, the upper traps like to act as the overbearing workaholic that does all the work for everyone else in the office. Pulling, lifting overhead, and more, these muscles have a tendency to initiate many large movements at the shoulder that smaller muscles are initially intended to take charge of.  It's too the point that I (mostly) joke about just severing the nerve to the traps to see if can correct things that way.

This habitual dysfunction is a learned one, most likely from our desk job lives and sedentary behavior. (Being seated with arms elevated to high will shrug the shoulders up and result in increased tonicity of the traps.) Past that, poor education about body mechanics and constant reinforcement of using the incorrect muscles at home, at work, etc. grinds these habits in deep as we get used to using the largest and least-fatigueable of the shoulder muscles to do all the work. They're also muscles that are quick to spasm and guard in response to injury (such as whiplash). What's more, the popularity of weighted shrugs at the gym doesn't help, and removal of them from workout routines is, so often, one of the first instructions I give individuals in my office.

Why this is a problem is that this increased activity of the upper traps usually correlates to a weakness of the smaller scapular stabilizers (such as your serratus), both of which result in an excessive upward rotation of the shoulder blade and destabilization of the shoulder girdle.

While remembering that textbook perfect posture is not a realistic thing to have to worry about, if you do experience pain, these mechanics may be involved. Structures can be impinged from the incorrect shoulder positioning, you could have spasm through the upper traps causing neck pain, and you may be finding that your shoulder isn't handling well against impact and trauma.

With this in mind, you can see the importance of keeping those muscles beneath and below the shoulder blade strong and engaged while keeping the upper traps relaxed and ready as a complementary muscle to movement rather than the prime driver. And for crying out loud, stop shrugging at the gym; the only thing it helps is your ego.

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How Your Eyes Relate To Your Head and Neck Pain

Try this at home: Sitting comfortably, find the muscular soft spot at the top of your neck, just below the base of your skull. Use the pads of your finger tips to slowly strum through the tissue and gently sink into the tissue. Now, move your eyes around. You should feel the muscles twitching underneath your touch. Fascinated now? Keep reading.

I've treated clients with concussion symptoms and whiplash quite a few times now. To some degree, there's always some involvement of the eyes in their symptoms, whether it's pain, disorientation, or inability to focus. Most of us would never have thought about the importance of the eyes with these movements before, but when you think of it, it makes sense.

Wuuuuhhh?

Eye movement, like every other movement of the body, is initiated by muscles. The muscles of your eyes are small and sensitive, due to the fine control needed for sight. Of these many muscles, the suboccipitals in your neck (sub=below; occiput=the base of the skull) are of high clinical significance.

I've talked before about how pain and spasm work. You experience an injury, your brain senses pain and instability, it causes spasm of the muscles to protect the area, more pain results, and we cycle through over and over again.

When it comes to the topic at hand, when the neck or head experience trauma (such as a concussion or whiplash from a car crash), the suboccipital muscles are among the structures that are sent into this protective spasm. As well-meaning as your body is by doing this, this contributes greatly to the symptoms that follow. As tension increases and the strength and motor control of those muscles is lost, many people will become plagued with symptoms such as migraines, vision problems, eye pain, neck pain, and more.

So to alleviate your symptoms, what can be done. Massage? Yes, but also no. How many of you with these conditions have tried that with only semi-successful results? The pain may go away for the rest of the day, yet it returns soon enough.

Like with any other injury, massaging those suboccipital muscles is only half the work. Remember, the problem is that these muscles are spasming, weak, and lacking motor control. Manual therapy will take care of some of the spasm, but strengthening and reteaching control of the eye movements is mandatory to fully rehabilitate the condition.

Since cluing into these relationships, I've since incorporated eye-tracking assessments and exercises into my rehab programs for clients with neck and head injuries, and these methods have had the most drastic effect on patient recovery over anything else. Once we're able to restrengthen the eye muscles, the spasm and tension in the neck settles down, and symptoms start to subside.

Like I said, the relationship between the eyes and these conditions is not an obvious one, but it's very understandable once brought to light. I'm happy to have found these conclusions, as being able to relieve these life-altering symptoms in shorter time has been very rewarding.