Often during a massage when working around the neck and shoulder areas, clients notice a “clicking-thing” at the top of their shoulder blade and ask me what it is. They tell me no matter how much they have worked on it themselves it won’t go away. “Is it a knot?” is often another question. This is not a painful state I am referring to. If there is pain consult a physician or a physical therapist. I am referring to the medial and superior borders of the shoulder blade and the hardened tissue that can be palpated there.
The answer is that what they are generally paying attention to and noticing is the tendon of the Levator Scapula Muscle. The tendon is where the muscle attaches to the bone and we want it to stay there! This does not mean that tension and “knots” aka adhesion do not accumulate around this area. They tend to for various reasons (please see my article entitled, “Why Are My Neck and Shoulders in Pain?”
A knot is also known as an adhesion and is defined as two tissues “stuck” together which ordinarily would not be. I am mentioning this area of the scapula as often times a well-meaning massage therapist will continue to try to release this area at the request of a client. The more one works on it the sorer it will be the next day. The “clicking” won’t go away. The obsession to do so is pointless-simply let it be. One would be better off learning techniques to relax and strengthen the muscles around the shoulder. There are many reasons why we accumulate tension in the neck and shoulders. For details, read “Why are my neck and shoulders in pain?”
There are many techniques to help relax and strengthen muscles of the shoulder. Classes such as Pilates and Yoga when taught by a skilled professional are very useful. Again, for acute and serious chronic pain please consult a physician or a physical therapist. The use of a pillow that provides proper alignment of the neck is also very useful. Please see my article entitled Bolsters and Pillows for Joint Support.
The important thing is not to over stimulate the tendons so they can do their very important job of attaching the muscle to the bone. Consistently working on them can lead to a great deal of unnecessary discomfort. A massage therapist can help release the whole area. Just imagine opening a can of paint that is stuck. The best way is to gently pry around the edges of the entire circumference of the can instead of forcing it from one specific point. The latter can potentially create more tension in the body whereas the former is gentler and more effective.