What is a rhomboid strain or spasm?

The rhomboid muscles in your upper back connect the inner edges of your shoulder blades to your spine. A rhomboid strain is a stretch or tear of these muscles. A rhomboid spasm is a sudden tightening of the muscle that you cannot control.

What is the cause?

A rhomboid muscle strain or spasm is usually caused by overuse of your shoulder and arm. This can happen from:

• Overhead activities, like serving a tennis ball or reaching to put objects on a high shelf
• Rowing
• Carrying a heavy backpack, especially if you carry it over just one shoulder
• Poor posture, especially while you are using a computer for a long time

What are the symptoms?

A strain causes pain in the upper back between your shoulder blade and your spine. A spasm feels like a knot or tightness in the muscle. You may have pain when you move your shoulders or when you breathe.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, activities, and medical history and examine you.

How is it treated?

You will need to change or stop doing the activities that cause pain until your muscles have healed. For example, you may need to run or ride a bicycle instead of playing tennis or rowing.

Your healthcare provider may recommend stretching and strengthening exercises and other types of physical therapy to help you heal.

A mild rhomboid strain may heal within a few weeks, but a severe injury may take 6 weeks or longer.

How can I help take care of myself?

To help relieve swelling and pain:

• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time. You can lie down with your upper back against the ice.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Putting an NSAID gel on your skin can decrease pain, with fewer side effects than pills taken by mouth. Ask your healthcare provider if a prescription is right for you.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

Put moist heat on your back for up to 20 minutes at a time to help relax tight muscles or muscle spasms. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or a hot shower. Don’t use heat if you have swelling.

Do the exercises recommended by your healthcare provider. Massage is also very helpful. Here’s a way to do a form of self-massage:

• Put a tennis ball on the floor and lie down with your upper back against the ball.
• Shift your position to gently roll the ball against your muscles.

You can also buy a foam roller or a self-massage tool.

Follow your healthcare provider’s instructions. Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent rhomboid muscle strain or spasm?

Here are some of the things you can do to help prevent rhomboid muscle strain or spasm:

• Do warm-up exercises and stretching before activities to help prevent injuries.
• When you work at a computer, take frequent breaks to stretch your neck and back.
• Follow safety rules and use any protective equipment recommended for your work or sport.