Middle and Lower Trapezius

Shown above is the pain pattern for the Middle and Lower Trapezius muscle. The pain radiates from between the shoulder blades upwards toward the shoulder and into the back of the neck.

Activities Which Aggravate the Pain
The Middle Trapezius is affected by holding the arms up and forward, such as placing them on top of the steering wheel while driving, or placing or taking objects from a shelf. The Lower Trapezius is affected by sitting and reaching down below the seat of the chair, resting the chin on one hand for long periods, and resting the elbows on a table or armrests that are too low.

Positions that Aggravate the Pain
Sitting for prolonged periods with the shoulders rounded and hunched. This figure below where the muscle is located in the body and how it is attached to the bones of the body.

Anatomy Facts - Middle and Lower Trapezius

Muscle Action
The entire trapezius helps with upper spine extension, scapular elevation and retraction. It also helps with head and neck extension while rotating the chin to the opposite side. Acting unilaterally, the muscle elevates the shoulder, helps to perform shoulder flexion, arm abduction and bends the head toward the same side.

Muscle Origin
These fibers originate from the occipital bone, ligamentum nuchae and the spinal processes of C7 and T1-T12.

Muscle Insertion
The upper trapezius inserts onto the outer third of the posterior portion of the clavicle. The middle trapezius inserts onto the inner portion of the acromion process and along the spine of the scapulae.

The lower trapezius converges and inserts onto the lower portion of the scapular spine.

Muscle Innervation
The entire trapezius is innervated by the spinal accessory nerve and by branches from the 3rd and 4th cervical nerves.

Trigger Point Locations - Middle and Lower Trapezius

You can find your own trigger points by using your thumb or finger to press on the spots shown in the picture. They are not difficult to find. Or you can ask a friend or family member to help you. Press firmly in a step-by-step manner until you find the exact spot that is tender. That is the trigger point.

By pressing firmly on the trigger point, and holding that pressure for several seconds, you will discover the pain lessens dramatically. In fact there are devices that can help you do this. We recommend a device called a "TheraCane" that can be purchased at many stores such as Sammons Preston Medical Equipment that has a mail order catalogue that can be contacted at 1 800 323-5547. The TheraCane is their item # 5244. The TheraCane can use be purchased at many local pharmacies.

Unfortunately this technique, known as acupressure, or shiatsu, provides only temporary relief. Some physicians inject drugs like Novocaine into trigger points, but these offer only temporary relief as well, and can cause scar tissue in the muscle.

Isometric Contraction Testing - Middle and Lower Trapezius

A painful muscle will become more painful if it is forcefully contracted (flexed). Use this picture to test this for yourself with the help of a friend or family member.

Follow these Directions
Sit with your hands in your lap and your head upright while your assistant stands behind you to one side and places the heel of his/her hand along the inside of the painful-side shoulder blade and the other hand on the front side of the same shoulder. To test the Middle Trapezius, attempt to bring your shoulder blades together while your assistant resists this movement. To test the Lower Trapezius, bend forward at the waist with your hands hanging down and attempt to bring your shoulder blades together and downward while your assistant resists this movement.