There’s a specific kind of ache that settles deep under your shoulder blade—the kind that won’t go away no matter how much you stretch or rub it. That nagging discomfort might be more than just muscle fatigue; it’s likely a shoulder blade pressure point. Identifying and addressing the root cause of shoulder blade pain is crucial, as it often involves trigger points in specific muscles that can radiate pain to the neck and shoulders. At Cohen Trigger Point Therapy, we specialize in finding and releasing these hidden sources of pain to restore comfort and function.

Introduction to Shoulder Pain

Shoulder pain is one of the most common musculoskeletal complaints, affecting people from all walks of life. Whether it’s a dull ache or sharp discomfort, pain in the shoulder joint can make everyday activities—like reaching, lifting or even sleeping—challenging. The shoulder is a highly mobile joint, relying on the coordinated action of many muscles, tendons and ligaments to function smoothly. When trigger points develop in these muscles, they can produce pain not only at the site but also radiate discomfort to the neck and upper back, leading to chronic neck and shoulder pain. Understanding how these trigger points contribute to muscle pain is key to finding lasting relief and restoring healthy movement.

Anatomy of the Shoulder Blades

The shoulder blades, or scapulae, are flat, triangular bones that form the base for shoulder movement and stability. Each scapula connects with the upper arm bone (humerus) and the collarbone (clavicle), creating a dynamic support system for the entire shoulder joint. The upper trapezius muscle, stretching from the base of the skull to the shoulder blade, is a major player in lifting and rotating the shoulders—and is a common site for trigger points that can cause neck and shoulder pain. Along with the trapezius, the rhomboid muscles sit between the spine and the scapula, working to retract and stabilize the shoulder blades. When these muscle groups develop trigger points, they can disrupt normal shoulder movement and cause ongoing pain.

What Are Pressure Points in the Shoulder Blade Area?

Pressure points—also known as trigger points—are hypersensitive knots within your muscle fibers. In the shoulder blade region, these points often form in the rhomboids, trapezius, levator scapulae, infraspinatus or scalene muscles. The scalene muscles are involved in neck and ribcage movement and trigger points here can cause radiating neck and shoulder pain.

These tight spots can refer pain to nearby areas, creating a sensation that radiates or feels “deep” and hard to reach.

While general tension causes soreness, pressure points act like neurological amplifiers—sending pain signals even when you’re at rest. They’re often confused with nerve pain or joint issues, which is why proper diagnosis and treatment is crucial.

Common Causes of Shoulder Blade Pressure Points

The Role of the Rhomboid Muscles

The rhomboid major and minor muscles are responsible for keeping your shoulder blades in the right position during arm movements. By pulling the scapula towards the spine, the rhomboids elevate the shoulder blade and help lower the shoulder joint. Trigger points in these muscles can create a persistent, nagging pain between the spine and the shoulder blade—a classic example of referred pain. This type of trigger point pain can last longer than pain from other muscles, making it especially frustrating. You need to address trapezius trigger points first, as tension in the trapezius muscle can mask or complicate the detection of rhomboid trigger points. By releasing both the trapezius and rhomboid muscles you can restore proper shoulder function and reduce pain during arm movements.

Infraspinatus Trigger Points and the Rotator Cuff

The infraspinatus muscle is part of the rotator cuff, a group of muscles and tendons that keep the shoulder joint stable and secure during movement. Trigger points in the infraspinatus can cause pain that radiates from the shoulder region down the front and side of the arm, sometimes even to the wrist. This muscle is involved in rotating the arm outward and maintaining shoulder joint stability. When infraspinatus trigger points are active, they can severely restrict arm movement and cause chronic shoulder pain. Addressing these trigger points is key to relieving pain, improving shoulder mobility and restoring normal function to the rotator cuff and surrounding muscles.

Teres Minor and Acupuncture Points

The teres minor muscle, another part of the rotator cuff, helps stabilize the shoulder joint and rotate the arm. Trigger points in the teres minor can cause localized shoulder pain and discomfort that can radiate into the upper arm. In addition to manual trigger point therapy, applying pressure to specific acupuncture points—such as those on the shoulder and upper back—can be very effective for pain relief. These acupressure points increase blood flow, relax surrounding muscles and promote healing in the affected area. By targeting the teres minor and related acupuncture points you can relieve pain, reduce muscle tension and support the recovery of the entire shoulder region.

Poor Posture and Sedentary Lifestyles

Hours of sitting at a desk or phone can lead to rounded shoulders and forward head posture. This constant strain loads the muscles between your shoulder blades and eventually leads to trigger point formation. Poor posture can also restrict neck movement and increase tension in the shoulder blade area.

Stress and Emotional Tension

Shoulder tension is a classic response to stress. When your nervous system is in a state of fight-or-flight, the muscles in your upper back are contracted and ready for action. Over time this guarding leads to chronic pressure points. Chronic muscle guarding from stress can also manifest as persistent shoulder pain, often affecting mobility and daily activities.

Overuse and Repetitive Motions

Whether you’re lifting weights, carrying heavy bags or performing overhead movements, repetitive use without balanced recovery can fatigue the scapular stabilizers. This fatigue turns into tightness which often develops in the shoulder area and leads to pain-triggering nodules.

Underlying Trigger Points

Some trigger points in the shoulder blade region are referred from other muscles, such as the infraspinatus or even the serratus anterior. Trigger points in these muscles can create a referred pain pattern with discomfort spreading to predictable areas between the spine and shoulder blade and sometimes above the shoulder blade. At Cohen Trigger Point Therapy we specialize in finding not just the local pain point but the origin of that dysfunction—often in unexpected places.

Symptoms of a Shoulder Blade Pressure Point

• Deep, aching pain under or around the shoulder blade
• Discomfort during deep breathing or twisting the torso
• Radiating pain into the neck, arm or chest as trigger points can radiate pain to these connected areas* Feeling of tightness or a “knot” that won’t go away
• Reduced shoulder mobility and stiffness

These symptoms can mimic nerve impingement or joint inflammation so accurate diagnosis is key for long term relief.

How to Release Shoulder Blade Pressure Points

Self-Release Techniques

Use a lacrosse ball, tennis ball or massage tool against a wall and target sore spots just inside the scapula. Apply slow, sustained pressure for 30-60 seconds per point. Breathe deeply and let the muscle relax under the pressure. Massage guns can also be used for deep tissue stimulation, a different approach to traditional massage tools.

Caution: Don’t press on the spine or joints—stick to muscle tissue only.

Stretching & Mobility Exercises

Incorporate stretches that target the upper traps, rhomboids and thoracic spine:

• Doorway chest opener
• Cat-cow mobility flow
• Thread-the-needle stretch
• Gentle head and neck movements

These help realign posture and reduce compensatory tension around the shoulder blade.

Hands-On Trigger Point Therapy

While self-care is helpful, professional trigger point therapy goes deeper. Working with a qualified therapist ensures proper assessment and targeted treatment of shoulder blade pressure points. At Cohen Trigger Point Therapy, we use precise, hands-on techniques to deactivate painful nodules and restore muscular balance. Physical therapy may also be recommended as part of a comprehensive approach to managing shoulder blade pressure points. Patients often report relief from shoulder blade pain within a few sessions.

Preventative Ergonomic Adjustments

Don’t underestimate the power of a proper desk setup. Use a chair with lumbar support, keep screens at eye level and avoid leaning to one side while sitting. These small changes support muscular health and prevent future trigger point formation. Consistently leaning to one side can create imbalances and may lead to discomfort or restricted movement on the opposite side.

How Cohen Trigger Point Therapy Can Help

Josh Cohen’s method combines anatomical insight with hands-on skill to treat shoulder blade pain at its root. Our approach includes:

• Targeted soft tissue release
• Postural re-education
• At-home care strategies
• Early intervention to prevent chronic pain cyclesIn addition to the upper trapezius, other shoulder muscles like the subscapularis, teres major, pectoralis major, deltoids, lower trapezius and rhomboid minor can develop myofascial trigger points and active trigger points causing pain and dysfunction. Upper trapezius trigger points and other trigger points in the shoulder, chest area and beyond can be addressed with targeted acupressure point therapy, chiropractic adjustment and techniques to improve blood flow. A comprehensive approach considers all relevant shoulder muscles and trigger points for pain relief and function.

Our patients don’t just want relief from symptoms—but to move, not recur and be at their best.

Shoulder blade pressure points are real, common and treatable. If you’re feeling deep, stubborn pain between your shoulder blades don’t ignore it or hope it goes away. The sooner you act the faster and more complete your recovery will be.

Ready to release that shoulder blade tension for good? Book your trigger point therapy session with Cohen Trigger Point Therapy today.