Understanding where we are rolling can be very important and help you perform the exercises below with more intent and finesse.
These exercises are trying to “loosen up” the muscles between the inside edge of your shoulder blade (scapula) and the spine. Some of these muscles include the rhomboids, middle and lower trapezius, and paraspinal muscle group. A lacrosse ball works best for this, because it doesn’t slide away from you, is small enough to dig into the areas we’re targeting and is very firm. Depending on your case, I may have recommended focusing on a particular area but these videos covers them all and teaches you how to do the exercise.
The reason these muscles are tight, sore and dysfunctional in the first place can be quite complex. We may not necessarily be treating the root cause of the issue with this exercise, but it is still important to address these muscles with rolling. Sometimes some rolling can help alleviate your symptoms and make other exercises more tolerable. Often times I will want you to do this rolling before we start strengthening.
What you should feel
You will be rolling over the “tight and sore” spots between the inside edge of your shoulder blade and your spine. These spots are myofascial trigger points (muscle knots) that you will be trying to loosen up. You can expect this to be a little bit sore, but it needs to be tolerable. You have to be able to relax while you do these exercises. Too much pain will cause you to tense up and will reduce the effectiveness of the rolling. When you are rolling, you can expect it to feel like a massage (if you’ve had one). It should be a combination of relieving and sore at the same time!
Stop this exercise if you are unsure about what you are feeling or if it is painful in an unexpected way.
Medial Scapula (Shoulder Blade) Rolling
Here are the instructions and there is a video below that explains it all:
- A lacrosse ball is preferred, because it is very firm, it doesn’t slide away easily (it sticks to the wall a bit) and it is small enough to get into the areas we are targeting.
- Cross the arm of the side you’re rolling to the other side of your body (grab your opposite shoulder).
- Place the ball against the wall and the inside edge of your shoulder blade of the arm that is crossed over.
- You will stay between your spine and the inside edge of your shoulder blade. Don’t cross over to the other side of the body. One side at a time!
- Roll up and down and side-to-side between the inside edge of your shoulder blade and your spine.
- You’re probably going to have to divide this exercise into an “upper half” and “lower half” as it might not be possible to cover the entire area at once. Reposition the ball manually if it is difficult to access an area.
- Roll until you find the “tight and sore” spots that we’re looking for. I most likely identified one or two spots in the clinic for you to roll!
- When you find a spot, spend some extra time doing smaller amplitude rolling over the spot. You need to apply enough pressure that you’re doing something (massaging it) but not so much pressure that you’re tensing up due to pain. There is a “sweet zone” that you need to find.
- You may need to adjust your pressure over some areas to keep it tolerable.
- How long you spend on each sore spot depends on your case, but I usually recommend about 1 minute. After 1 minute, keep rolling around until you find another spot and repeat.
- You’ll probably find 2-3 “spots” to roll out!
mdkPHYSIO provides specific parameters to all patients. In general, 1-minute per trigger point (tight and sore spot) is spent. After you’re done, you will have probably spent 2-4 minutes doing this. The frequency (times per day) is also dependent on your case. Too much can cause a flare-up, while too little may not do enough!
Medial Scapula Rolling Modification
This is a modification to the exercise above, adding movement into the exercise. This works well for some people, but may not be recommended if you are unable to get a good release with this exercise or it is too painful.
In this variation, you will be rolling as you did in the Medial Scapula Rolling exercise; however, you’ll be “pinning” muscles down with the ball and then bending your neck and/or reaching across your body with your arm to get a “stretch” out of the muscle. The video explains it all, so watch that to see!
This should feel like a stretch, a pull and/or a release. It may be a bit sore at the same time, but the soreness should be tolerable and overall the exercise should feel good. If it is not relieving, then stop and let me know. We may get you doing the rolling only version of the exercise.
- If you’re doing this exercise for a neck muscle: You’ll have to start with your arm crossed over, roll close to the shoulder blade to find the sore muscle, pin it down, then bend your neck forward and to the opposite side to feel a stretch / pull through that muscle.
- If you’re doing this exercise for a shoulder blade muscle: You’ll have to start with your arm resting at your side, roll along the spine or close to the inside edge of your shoulder blade to find the sore muscle, pin it down, then reach across to your other shoulder to feel a stretch / pull through that muscle.
mdkPHYSIO provides specific parameters to all patients. In general, 4 arm or neck movements per “tight and sore spot” is recommended.
If you feel unexpected pain or sensations, or this is reproducing symptoms, it is best not to do this exercise right away. I will likely ask you to just stick with the rolling exercise (first video on this page), but hold off for now and let me know.