trapezius_Grays

Overactive Upper Trapezius
Written by Melissa Hurley

Have you ever felt like a sword is piercing through your eye? Do you get massive headaches or an aching jaw? Do you experience tingling fingers or shooting pain down your arm? Has anyone ever told you that your shoulders are uneven? Is your grip weak? All of these issues and more are caused by arguably the most common compensation of all – “overactive” upper trapezius (or traps).

The upper trap extends from ligaments near the first six cervical vertebrae to the top of your shoulder. The muscle normally functions to upwardly rotate the shoulder blade, elevating the scapula and extending, to help you raise your arm above 90 degrees. The upper trapezius muscle also rotates and side-bends the neck. When the upper trap functions as it should, all is good with the neck and shoulder complex.

What are some causes of “overactive” upper traps? If you have weak rotator cuff muscles along with weak scapular stabilizing muscles (rhomboid, middle trap, and lower trap), every time you raise your arm, whether overhead or out to the side, above 90 degrees or below, the upper trap jumps in to assist in your movement to allow you to do what you need to do and compensate for your weak stabilizers – those poor little guys!

Whether it’s reaching for a dish in an overhead cupboard, painting a ceiling, driving with your arm leaning on the door, or playing baseball in a summer rec league, you may feel like you’re doing just fine; but overuse of the upper trap muscle results in increasing muscle tightness, even while at rest. Subtle symptoms will start to occur, such as neck stiffness with prolonged computer work, headaches when driving, or shooting pain down the arm when holding an object. Even waking up with tingling-numb hands are all signs of an overused upper trap.

How do you know if this is the source of your symptoms? First, find a physical therapist who can diagnose the problem. When the upper trap is excessively tight, it frequently sends trigger points to the same side eye, which feels like a piercing pain going directly through your eye.

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When the upper trap is excessively tight, the levator and scalene tend to be tight as well, pulling the posterior first rib into an elevated position. This can compress the brachial plexus, a bundle of nerves that exits the cervical spine levels and extend to the muscles of the arm. The result is pain, numbness, tingling, and burning sensations down the arm, and even arm weakness if the nerve compression continues. These symptoms are often called a brachial plexus injury, Erb’s palsy, or brachial radiculitis. When in doubt get it checked out so you don’t cause nerve damage.

Stay tuned for further posts on helpful philosophies, exercises and stretches regarding the upper trapezius and its shoulder stabilizing friends.

References

[1] Am J Sports Med. 2007 Oct;35(10):1744-51. Epub 2007 Jul 2. Rehabilitation of scapular muscle balance: which exercises to prescribe? Cools AM1, Dewitte V, Lanszweert F, Notebaert D, Roets A, Soetens B, Cagnie B, Witvrouw EE.

[2] Clin Biomech (Bristol, Avon). 2014 Feb;29(2):201-5. doi: 10.1016/j.clinbiomech.2013.11.011. Epub 2013 Nov 26. Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula. Pizzari T1, Wickham J2, Balster S3, Ganderton C4, Watson L5.

[3] Clin Biomech (Bristol, Avon). 1994 Jan;9(1):44-50. doi: 10.1016/0268-0033(94)90057-4. Anatomy and actions of the trapezius muscle. Johnson G1, Bogduk N, Nowitzke A, House D.

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Kevin
Kevin
November 17, 2022 6:02 pm

I can’t lift anything hardly my right arm is so tight

Kevin
Kevin
November 17, 2022 5:56 pm

Tight trapezius on right side

Garrett
Garrett
October 13, 2021 6:10 am

A number of years ago when doing a muscle up, I had shooting pain down the left side of my neck and along my shoulder blade. Since then any pushup, row, or any push and pull has aggravated my neck. I also am unable to bend it as far to the right as the left side. Do you think this is related to your article? Thank you for writing this!

Richard Wagner
Richard Wagner
September 27, 2020 7:59 pm

Great article. But physical therapists are not trained in diagnosing. You should go to a Chiropractor, who can diagnose and treat you, or go to an orthopedist who can diagnose then refer you to a physical therapist.

Sally
Sally
January 21, 2021 11:20 pm
Reply to  Richard Wagner

Physical therapists receive a doctorate degree and are considered direct access for patient care. We are trained what to look for and how to diagnose pts with musculoskeletal issues or whether or not the pts required medical care is within our scope of practice- we can refer to other fields of healthcare if our eval shows they are not within our scope of practice. However, this person would most likely benefit most from physical therapy. Physical therapy offers a long term solution in this situation — muscle strengthening — strengthen the root of the problem (scap and rotator cuff weakness)… Read more »

George Piliouras
George Piliouras
January 23, 2022 10:18 am
Reply to  Richard Wagner

After my shoulder surgery and cervical fusion 4 years ago, I have developed more nerve pain in theses areas than before surgeries. The surgeons, and Dr’s specializing in all Muscle skeletal pain, and all related areas have offered no solutions other than saying that the multiple MRI’s Ive had show no damage. That doesn’t solve my pain. I’ve learned more about anatomy from my Physical therapists about than I have from any Dr in any capacity.

Ljas
Ljas
February 17, 2023 6:46 am
Reply to  Richard Wagner

I respectfully disagree. Not all chiros are created equal and some PT’s are way better at diagnosing at least in my case.

Jordan Byrne
Jordan Byrne
November 28, 2017 8:08 am

Hi, in your experience have you ever found overactive upper traps to cause a tingling sensation around the scapular area?

Falcon
Falcon
October 31, 2015 6:31 am

Great article, something very similar happened to me when my right upper trap became over excited after sleeping in a bad position after a squat session earlier that day, the trap has now released the neck and my shoulder but has managed to stretch the nerves causing some sort of brachial plaxopathy which has cause a wasting tricep which is almost useless now but thankfully after some PT and rest some sort of strength is returning yet there is sudden pain whenever the nerves are stretched trying out some nerve gliding work now hopefully this will fade away… just a… Read more »

Nathen Schram
Nathen Schram
April 3, 2015 2:35 pm

My upper traps used to be chronically tight but more balanced development seems to have helped. But now any front rack gives me brutal doms in the upper trap and neck. No one’s been able to figure this one out unfortunately so I’m starting to avoid cleans and barbell front squat (kb don’t cause it). If anyone had any ideas, thanks!

Melissa Hurley
Melissa Hurley
April 9, 2015 12:13 pm
Reply to  Nathen Schram

“Brutal doms” in the upper trap and neck? Can you tell me a little more? Just next day pain? Muscular tightness-fatigue?

Nathen Schram
Nathen Schram
April 9, 2015 1:07 pm
Reply to  Melissa Hurley

Never the day of, but next 2 days always require iburophen. Front squats & cleans (barbell front rack) only. From just above the scapula to base of skull will get very sore & result in headaches. It’ll happen from sets of 10 w/ 95, and it’s happened hitting 265 for a triple. Kettlebell front rack doesn’t do it, pressing doesn’t (elbows are lower / forearms vertical), deadlifting’s fine, etc. I’ve guessed mobility issue (can’t keep full grip in front rack), insufficient external rotation of shoulders, midback weakness that allows my shoulders to fold forward too much, nerve entrapment…? No idea,… Read more »

Nathen Schram
Nathen Schram
April 9, 2015 1:30 pm
Reply to  Nathen Schram

Also, don’t know if this is useful in diagnosing my weak links but my strict press and power snatch are both heavier than my overhead squat. Maybe that tells you something about the shoulder? Thanks again!

Melissa Hurley
Melissa Hurley
April 13, 2015 10:39 am
Reply to  Nathen Schram

Hey Nathen, I spoke with a colleague and he is on the same page as me. It sounds like multiple mobility issues and trigger points in your traps. It’s probably more from doing cleans and exacerbating any trigger points you might have in your upper traps than the shoulder mobility. It all tends to add up quickly however. We suggest you see a acupuncturist or other socialist who is trained in trigger therapy or dry needing.

Nathen Schram
Nathen Schram
April 13, 2015 10:45 am
Reply to  Melissa Hurley

Awesome, thanks! I did Friday’s workout by substituting power snatches for the cleans (8*5) and got normal trap soreness but nothing in the neck. I’ll see what I can do here, thanks for the help!!!

Ali Jones
Ali Jones
March 31, 2015 8:55 pm

Good stuff Mel!!!

Bridget
Bridget
March 31, 2015 3:56 pm

This is a great article, Melissa! Helpful info.

Anthony
Anthony
March 31, 2015 6:13 am

So helpful! I just started getting headaches and I feel like it’s my right upper trap. I’m going to the chiro tomorrow. I have been dx with uneven shoulder blades and a SLAP tear in my right shoulder. Hopefully a quick visit with the chiro will clear it up.

Melissa Hurley
Melissa Hurley
April 1, 2015 5:23 pm
Reply to  Anthony

I’m right there with you Anthony. Hopefully some of the future blogs I’m writing will help with the headaches and build that shoulder. Stay tuned

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