The Upper Traps, over assessed, over blamed, & very misunderstood!

PainShoulders
adammeakins
By adammeakins

There is a strong culture within physiotherapy to blame a specific structure when things are sore and painful for our patients, be that a muscle, a tendon, a nerve, some fascial sling or even adhesions. The Upper Trapezius/Traps muscle is one such structure that gets an awful lot of blame for many things, but rather unfairly and incorrectly in my opinion.

I regularly hear physio’s telling patients that their Upper Traps are too tight or too ‘over active’ and the reason they have neck or shoulder pain. I hear them explaining they can feel the Traps are knotted and tense, and how it needs to be released, loosened and stretched. I also see and hear many therapists carefully choosing exercises to help reduce the upper traps work, so as not to over work or strain them them.

I think this nonsense and I think the exact opposite approach is needed for painful Upper Traps.

Most, if not all painful upper traps I see are not tight, knotted or short, yes of course they can ‘feel’ tight and tense, but they ‘feel’ this way because they are fatigued, over worked and unable to tolerate the positions and loads they are exposed too. Hence, I don’t think we need to be stretching or massaging upper traps, I think we need to be strengthening the hell out of them, which is completely alien and counter intuitive for most therapists and patients to hear.

I argue that weak, fatigued, load intolerant Upper Traps are often the culprit for a lot of shoulder and neck pains, and I argue that most Upper Traps need to be strengthened NOT stretched or massaged.

Lets first look at the anatomy and function of the Upper Traps to help us understand them a little better. The Trapezius muscle is a large flat muscle that is located on the back of your neck, top of your shoulders, and running down the middle of your spine. It is the most superficial muscle of the upper back and runs from the base of your skull all the way down to the middle of your back, see image below.

It is commonly described as having three portions, the upper, middle, and lower fibres. These sections are often described in the text books as having differing functions on the action of the shoulder blade (the scapula). The lower fibres are described as depressing it, the middle fibres retract it, and the upper fibres elevate and upwardly rotate it.

However, this is a very simplistic way to look at any muscle. Firstly, no muscle works in isolation, as all muscles work in synergy with others, and one muscle certainly doesn’t work just in isolated parts, albeit some parts working harder than others during different movements.

How a muscle affects movement is also not just due to its insertions and origins, but also the orientation and angle of its muscle fibres. This is what Johnson and Bogduk looked at in the Trapezius muscle in their 1994 paper here.

This study questions the commonly held thoughts and explanations of how the Trapezius functions for many, but despite this paper being over 20 years old these findings are still not that well known and so many myths about the Traps still exist.

Johnson and Bogduk describe the angle and orientation of the upper fibres of Trapezius are unable to create ANY significant elevation of the scapula when the arm is in neutral. They also show that the upper fibres need the assistance of the lower and middle fibres to upwardly rotate the scapula, highlighting that they do not function in isolation. They also found that the Trapezius muscle is insufficient to rotate or elevate the Scapula alone, instead it is its coupled action with other muscles such as the Serratus Anterior that does.

The action of the Serratus Anterior pulling the scapula laterally around the chest wall at about 30° of arm elevation is when the lower Trapezius muscles fibres first start to resist the movement, which then starts to cause the scapula to tilt into upward rotation. Once this upward rotation of the scapula has started then the upper Trapezius fibres further assist in its upward rotation and elevation.

So the Upper Traps fibres only really contribute to Scapula upward rotation and elevation once the arm is in abduction!

This I think has some implications on some the exercises and movements given by physios and trainers that are thought to influence the Trapezius muscle. For example does standard shrug when the arm is in neutral really work the Upper Traps that much? It doesn’t appear so!

Shrugs don’t work the Upper Traps!!!

Well they do, anyone who has shrugged will tell you they do. But its only really when the arm is in > 30° of abduction and the scapula has already started to rotate do they really kick in!

With the arm in a neutral position, another scapula elevator muscle is working, the appropriately named Levator Scapulae. However, as the Levator Scapulae also attaches onto the medial superior pole of the scapula, it also creates downward scapula rotation.

Now what about those studies showing ‘over activity’ in the Upper Traps and suggesting that we need to reduce it for shoulder problems such as those done by Ann Cools et al 2007.

Well as much as I respect and admire Ann Cools and her colleagues work, I think in regards to the Upper Trapezius they are mistaken to blame them and partly to blame for the large anti Upper Traps culture in physiotherapy.

First thing to consider is these studies look at the Upper Traps activity using surface electromyography or EMG, which can be a useful tool and give insight into a muscles level of activity during movement. But they do have issues, and are not infallible to error, and so information taken from such studies has to be used with caution.

For example despite normalisation procedures designed to limit the effect of cross talk between other muscles when using EMG equipment, there is always some, especially with surface EMG, and I suspect at the point often used for reading upper Trapezius activity it also picks up the Levator Scapulae activity underneath. I have a suspicion that Levator Scapulae cross talk maybe producing the so called higher EMG readings from Upper Trapezius.

I also think the EMG readings of the Upper Traps can be ‘misinterpreted’ as too high or ‘over active’ in those with shoulder pain and dysfunction due to another forgotten and overlooked action of this muscle!

A primary role of the Upper Traps are to distribute forces and loads away from the neck.

The majority of the Upper Trapezius muscle fibres actually attach to the distal third of the clavicle and due to the orientation of these fibres, when they contract they rotate the clavicle medially. This rotation of the clavicle compresses the sternoclavicular joint, and is a rather useful action.

In fact it’s a bloody marvellous action and is probably the most beneficial and often overlooked action of the Upper Traps. The compression of the sternoclavicular joint by the upper Trapezius allows forces and loads from the arm and shoulder to be transferred down through the collar bone, into the sternum, rib cage and axial skeleton. Pretty damn useful, and maybe good to know for those with over loaded neck issues?

How many physios give Upper Traps strengthening exercises for those with neck pains or problems?

Not many, most are often too busy with silly little underloaded Deep Neck Flexor exercises. Finally, as I said earlier, nearly all the Upper Traps I see clinically are struggling to cope with the loads and positions they have to endure. It is this struggling of a weak and fatigued muscle that I also think causes the ‘over active’ readings on EMG studies.

So instead of stretching, rubbing, poking sore and painful Upper Traps, lets get them stronger, more resilient, more robust.

It just seems daft to me to ask a muscle that wants to lift and elevate the scapula AND off load the neck to work less! Of course get the Lower Traps and Serratus Anterior working, but why not ALSO get the Upper Traps to stronger as well?

In my opinion and clinical experience when the Upper Traps become more resilient, more robust, and stronger it only seems help those I see with shoulder and neck pains, not hinder them.

I think more people need more Upper Trap exercises NOT Lower Traps 

I regularly give out exercises with an ’emphasis’ on strengthening the Upper Traps to patients with long standing neck and shoulder problems who have tried everything else such as manual therapy, postural correction, stretching, scapula setting etc… without any significant benefit seen.

Often after 4-6 weeks of Upper Trap ‘focused’ work they begin to report less pain, less stiffness, less tightness in them. A common misconception is that stiffness and tightness means a muscle is stiff and tight, it can also mean its just tired and fatigued.

Some examples of exercises I use for Upper Traps are over head shrugs see picture below, I sometimes prefer the elbow a little more flexed so the arm isn’t too high in elevation as this can be a bit uncomfortable or un-achievable for some people

Another exercise that I often give is one I’ve lovingly called ‘Monkey Shrugs’ these are done by holding your arms down by your sides then sliding them up the side of your body, up to about waist height so your elbows are bent slightly out to the side. I then ask the patient to shrug from this position. This really targets the Upper Trap muscle as the scapula is already in slight upward rotation and the arm is in approx 30-45° of abduction.

Here is a link to some videos I have done of the monkey shrugs and overhead shrugs

Now these are just some of the Upper Traps targeted exercises out there and they may not be suitable for all, and there are other Upper Traps targeted exercises such as a simple Lateral Raise, Upright Row, Face Pulls, even the good old Y or W lifts, which have all been found on EMG studies to get high Upper Traps activity.

So in summary I hope I have given you some food for thought about the poor old Upper Traps muscle and that you will not be as quick to blame this poor misunderstood muscle quite so often, and maybe think twice before you dive in so quickly with massage, stretches or needles!

I hope you can see that by actually strengthening and improving the function of the Upper Traps it can help a lot of neck and shoulder problems, and that you might consider giving Upper Trap focused exercises for your patients more often.

As always thanks for reading
Happy healthy exercising
Adam

PS: NEWS FLASH, since writing this piece over a year ago there has been some research here supporting my opinions on the upper traps, hoooraaah! It shows that a modified shrugging action, with the arm in approx 30° abduction creates better scapula upward rotation but also greater upper and lower traps activity.

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  1. Nice one Adam!
    Usually I related “UT pain” to excessively elongated trapezius, as some people, like ballerinas, tend to have depressed shoulders. Your view about the suprascapular nerve added some food for thought. Some people usually see pain and say lets do some massage or stretching but we should check why it actually is painful.
    I usually aplly the shoulder shrugh exercise you mentioned, never thought about the other one with the ropes.
    Great article!
    Cheers,
    Claudio

  2. Very insightful piece. Good work.
    For the exercises you mention it would be nice to see a vt of them. Just in case someone went off on a whim and injured themselves

  3. […] The Sports Physio on the Upper Traps “But what about those studies suggesting that we need less UT activation compared to MT or LT such as the work done by Ann Cools et al 2007. ” The delicate balance in working with the shoulder girdle. “Truly well-meaning instructors taught you to teach compression rather than dynamic stability. Compression is absolutely one form of stabilization and strength, but it limits mobility and can de remarkable destructive to joints and all that run through and around them.” […]

  5. Hey Adam, nice post.
    I agree too much time is spent on “tight upper traps” and time should be spent engaging them as per Janda’s upper cross pattern.
    My biggest negative for too much upper traps is more the anterior tilt it provides the scapula leading to impingement/poor scap and shoulder mechanics. Lower trap provides post tilt, thus increasing sub acromial space and that’s my understanding of the main reason for working it preferentially to upper traps. This comes from Kevin Wilk, a well know American baseball researcher.
    Love to get your thoughts.

    • Hi Luke
      Thanks for your comments, and to answer your question yes i agree the upper traps does contribute to anterior scapular tilt, but just as a hair dryer contributes to a hurricane, the main ‘culprit’ of anterior scapular tilt is the pec minor, so in my opinion focusing on the upper traps for correction of anterior tilt won’t achieve much, instead correcting pec minor length and increasing lower traps are the main treatment options and yes possibly a bit of upper trap correction may assist a little but it’s a matter of priorities and this would be low on my list in this scenario.
      Thanks again for your comments
      Cheers
      Adam

  6. This is absolutely great stuff. I first heard about this UT importance from Shirley Sahrmann and Eric Cressey. This article is tremendous and goes over in depth of why we need to change our traditional shoulder rehab. I’ve been doing more of this in my practice and having a ton of success with shoulder patients. I found that your absolutely right, the levator scapulae is getting away with murder while the UT is being wrongfully accused.
    Just out of curiousity, do you use any verbal or tactile cues to increase upward rotation or scapula position (during exercises or postural)?
    Keep up the great work! Your blog is making physical therapists better.

    • Hi Aaron
      Thanks for your comments, tactile cues I don’t tend to use to much, I think if u coach the correct movement u dont need to touch them
      Verbal cues can be useful but again I keep it simple and give them instructions to perform the exercise correctly rather than give specific instructions
      I try and remember that I’m not going to be around the patient athlete all the time they do the exercise so they have to ‘internalise’ it rather than rely on external cues, also I like to remember that the body only knows movement not specific muscles so train the movement not the exercise
      Cheers
      Adam

  8. Hi Adam,
    Whilst I agree that too much time is spent trying to release upper traps instead of focusing on the smaller cervical/head extensors such as lev scap, splenius, semispinalis, the suboccipitals (for headaches more so) etc…I disagree that the trapezius do not contribute to elevation of the scapula during shrugging (with the arms by the side).
    “For example if we just elevate the scapular with the arms down the sides (ie shrugging), are the upper traps working? NO they are not, its the Levator Scapulae (LS) doing the scapular elevation combined with downward rotation which is usually the exact movement we are looking to avoid with shoulder impingement problems.”
    Not only is the contraction easily palpable and readable on EMG, it is also a fundamental exercise for bodybuilders in developing the upper trapezius.
    Secondly, the lower trapezius attach to T12 (if they even go down that far, as it can have many variations in populations). It does not contribute to posterior pelvic tilt…
    “Yes get the lower traps working for increased posterior tilt etc etc, but also get the upper traps going and stronger too for increased scapular elevation, especially in arm positions of 90° or more”
    Posterior pelvic tilt involves the posterior superior iliac spine moving posteriorly and inferiorly. So even if this is a typo and you meant to say ‘anterior tilt’ the muscle simply cannot contribute to this action as its only attachment to the pelvis (being a miniscule portion of thoracolumbar fascia) would be far too small to have any effect.

    • Hi Chris
      Thanks for your comments… But…
      Firstly your totally getting your anatomy mixed up my friend, this is a post in the shoulder and scapular not the pelvis
      The posterior/anterior tilt I’m talking about is that of the scapular NOT the pelvis, to think the upper traps can rotate the pelvis is just plain crazy by any stretch of the imagination or kinetic chain!!!
      Next the upper traps DO NOT elevate or upwardly rotate the scapular with the arm in neutral, the fibre orientation and attachment points make this impossible, please read the paper I posted by Johnson and Bogduk 1994 some of the best anatomists around for more information, if you disagree with them, then I guess you are cleverer than me, and as I also said in my posts surface EMGs can be misleading and liable to cross talk of all those other muscles you so expertly mentioned
      Finally you state need to focus on the smaller muscles around the neck especially in headaches, I say why and how can you focus on these small specific muscles, the body can’t do it, it just knows movement, this whole blog was also indirectly about the nature of us physios creating these specific anatomy / function based issues due to some papers or research, I ask the opposite, keep it simple, keep it based on movement not anatomy
      Thanks
      Adam

      • Sorry Adam, But you are both right and wrong!…..The upper traps primary function is to stabilize the scapula in relation to the cervical spine. Now, maybe it’s because you have been working on dysfunctional people and have never seen upper traps working in their optimal form!? but inhibiting the upper trapezius and other muscle groups using myofasical release techniques WILL and DOES turn the tonus down in the upper traps to instigate a better response from the middle traps and rhomboids during scapula retraction. So you are right in saying it’s job is not to elevate the scapula…but the upper traps have a massive EMG result in stabilizing the shoulder through levatae scapula elevation in relation to the position of the cervical spine!
        I think you need to get more experience working with functional (although there is hardly any) athletes and perform tests on them. I happen to be a structural integrator and movement specialist, and i can tell you when do a single arm shrug, i can feel the upper traps stabilize and fire.
        You need to remember that 95% of the western world are completely dysfunctional and researchers and conducting these tests that you are relating to on dysfunctional subjects.
        Try stepping outside the physio world and into the world of Strength and Conditioning…it maybe a good eye opener
        regards
        Andy

      • Hi Andy, thank you for your comments
        I’m sorry, but your mistaken on a number of counts, first and foremost with regards to me stepping out into S&C world as you put, I was / am a qualified S&C coach before I became a physio, and although I do work predominately with injured people nowadays I also work with those who are not!
        Next your statement that 95% of the western world are dysfunctional is just blatantly erroneous, inaccurate and by the sounds of it made up, do you have any evidence for this claim and what to you mean by dysfunctional and according to who?
        Working in this industry I come across lots of people making ridiculous, uneducated and scaremongering claims like these without a shred of justification or evidence to back them up, so I’m sorry Andy unless you can show me a scrap of evidence your credibility to discuss movement, functional or dysfunctional is low, even if you are a structural integrator?
        I don’t think you have fully understood my article or read the Johnson paper, as I mention shrugging with the arm in the pendant position ie down your side doesn’t produce much activity in the upper traps, the angle and orientation on there fibres means it’s just not possible. I’d argue what you feel when you shrug here is predominately the Levator scapulae. Shrugging with the scap in upper ward rotation such as with the arms in >30° of abduction such as when on a trap bar does produce much more activity in the upper traps, hence my argument shrugging with arms down by the sides isn’t a good exercise.
        Finally in regards to your claim that myofascial release WILL & DOES inhibit upper traps and so making middle traps and rhomboids work better, again I’m afraid is nonsense that is based I’m assuming on your own experience anecdotal evidence and so confirmation bias, I have read A LOT around MFR and haven’t seen any compleling evidence that it turns ANYTHING off or on, it only gives a sensation of ‘release’ via neuro modulation effects!
        Once again thanks for your comments but you make a lot of logical fallacys and I would respectfully ask that you try some further reading on neuro science, manual therapy techniques, biomechanics and kinematics
        Regards
        Adam

    • Oh one other point to answer that you made Chris…
      Shrugging as a fundamental exercise for weight lifters upper traps development is flawed and recognised by many as not the best way to develop them
      Instead higher MVIC and better ‘development’ in the upper traps is seen with exercises such as overhead presses, lateral arm raises and face pulls etc
      Cheers
      Adam

  9. Hi Adam,
    I just wrote an article on the activation of the trapezius and and I made reference to your great explanation of upper trap function.
    I’m wondering if it’s even possible to preferentially recruit a specific region of the trap. When therapists say there is an imbalance between the UT and LT, this implies that each region can be activated with some degree of independence. I’m not aware of any muscle where we can strengthen one part while reducing activity in another as is often the case with exercises designed to target the lower trap and correct this claimed imbalance. If the trapezius is getting used, wouldn’t the whole muscle more or less have to contract?
    Regards
    James

    • Hi James
      Thanks for your comments and I’ll go and check out your article right after this.
      That’s a very interesting comment, my thoughts are that a muscle does have different portions that can be more ‘active’ than others when performing an exercise/movement, but you’re right we can’t just isolate said portions.
      My issue is the negativity surrounding the upper traps in favour of the lower traps, when there really is no need in my opinion
      Cheers
      Adam

  10. hI Adam, great post, however, just a quick thought. I have checked this issue in the past with therapists that are Janda trained and the answer to this could be that biomechanically you are correct, but from the Neuro standpoint, the Upper Trap is a muscle that shows a tendency towards overactivation. I think this is where Cool’s study points to. Will appreciate your take on this, David

    • Hi David
      Thanks for your comments, in my opinion I don’t think you can separate the two, neural ‘over’ or ‘under’ activity whatever that is will also create muscular over/under activity
      So I think answer your question is that I disagree with anyone that says the upper trapezius muscle is over activity neuro – muscularly if that’s even a word! Yes the lower traps normally need work in most with shoulder problems but so do the upper traps
      Cheers
      Adam

    • This is true- both levator and upper traps are tonic muscles rather than phasic. As for stretching for people who work at a desk, this is more to do with levator, upper traps, and the suboccipitals being tonic and creating cervical and capital extension rather than the protraction component (which would be better dealt with by inhibiting the tonic pectoralis muscles). Middle and lower traps tend to be phasic/inhibited which is why emphasis is put on strengthening them over upper traps. Of course the individual client needs to be taken into account as well as the specific biomechanical issues they are presenting with.

  11. Hi Adam. Thanks a lot for the article. Beginning last year I had some rotator cuff pain and impingement which has improved. I performed exercises like the wall plank and upward wall slides with elbow facing forward as I moved my hand up. These exercises among others I was introduced by Dr. Evan Osar. He has always made a lot of sense to me even though what he was saying was the opposite of what a lot of physios and chiros teach their patients(like it’s your upper trap, you need to pull your scapula down and back. He believes that with shoulder impingement and upper back and neck chronic tension, the problem is not the upper trap but rather the dominance of the downward scapular rotators namely the rhomboids, pec minor, and levator scap. Pulling shoulders down and back from what I’ve now learned puts the shoulder into and impingement position and only further increases the workload of the the already dominant and tight downward rotators. Instead he promotes the activation of the usually under utilized upward scapular rotators namely the serratus anterior and trapezius to improve impingement and scapular control…anyways although my rotator cuff pain has improved I still have a lot of tension in my upper back neck area (upper rhomboid and levator.) I’ve seen different chiros and they say you need to pull down and back and it just doesn’t help nor does it make sense to me. After a long day at work it’s like my muscles probably levator scapula is fatigued from carrying my arm around all day. However, if I raise my arms and shrug activating the upper trap, it’s not a problem. It actually feels good. Finally, do you think adding elevated arm shrugs to my workout is a good idea? I’m desperate to alleviate this tension I’ve been living with for over a year now and have seen multiple doctors and spent prob around 2000 dollars on this problem.

    • Hi Zack
      Thanks for your comments, I think the culture of physios and other therapists asking all there clients to stand up straight and pull their shoulders back and down for neck and shoulder pains and problems is a common problem based on poor understanding of biomechanics
      As you correctly say pulling back and down can, and often does increase scapular downward rotation, scapular upward rotation and posterior tilt are key for nearly every shoulder compliant I know especially sub acromial impingement, so working the muscles that help this can only be a good thing that’s the Serratus Anterior, Lower Fibres of Traps, but also the Upper Fibres as well
      I do like over head shrugs for upper trap strengthening but they can sometimes be uncomfortable if the arm is to straight, so try them but keep arm slightly bent and if any pain stop
      Hope that helps
      Cheers
      Adam

      • Thanks for the reply Adam,
        My tension is usually triggered from standing up straight for long periods of time, and simply having my arms hang down really tightens up that whole levator upper rhomboid area. Also sitting without being able to use the back rest can make the muscles really tight and fatigue. If I’m laying down or reclining there is no tension nor is there much of a problem with exercising as long as it doesn’t involve a lot of neck movements( I had to quit playing hockey). Even though chiros have warned me not to perform overhead exercises, they don’t irritate the tension at all. So I plan on trying to incorporate some overhead shrugs into my workout routine. However, if the upper trapezius is only activated during upward rotation of the scapula, would I see any benefit from strengthening the upper trapezius? I ask this because my tension is often engendered by standing with arms hanging, and I presume the levator and rhomboid are tightening due to simply carrying the weight of the arm. Also I’m curious as to what your thoughts on stretching the levator and rhomboid. My chiro said for my case it would be like pulling on a knotted rope or rubber band and stretching would release the muscle but just make it tighter.
        Zack

  12. Adam,
    Great article! I have been dealing with headaches and neck/upper trap pain for 10 months now. I have a headache everyday stemming from the neck. My traps are ridiculously sore throughout the day but primarily in the morning. A slight roll backwards in my shoulders brings a stabbing sensation to the traps.
    I have tried everything, neurologist, brain MRI, spine MRI, spine specialist, physical therapy, massage, chiropractor, rest, etc. and nothing has worked. I have a headache every morning when I wake up until I fall asleep at night.
    I found your article interesting in that it is in a different perspective than most articles you read. Are you suggesting that I should try and exercise these muscles rather than rest them? The rest hasn’t brought any relief, I am open to any suggestions. Thanks for your help!
    Stefan

    • Hi Stefan
      Its obviously very difficult to give advise and diagnosis without assessing you, but it might be worth giving the strengthening exercises for the upper traps a go as nothing else has worked
      Let me know how it goes
      Cheers
      Adam

  13. Hey Adam, I’ve been struggling with a trap issue for a couple of years now, so I’m wondering if you know how to help me out. My traps are either over or under compensating when I do many exercises (anything to do with the arms, chest, or shoulders like curls, push ups, pull ups, dips, db bench press, military press etc.). On my left arm my traps really strong and I can’t even flex my bicep without my trap flexing as well. This is making my arm weaker, or so it seems, and not letting my left bicep, pec, tricep, and forearm strengthen. On my right arm, my trap is much smaller and weaker than the left one, however my bicep, tricep, forearm, and pec are larger and stronger. This is a problem as well because I’m having difficulty strengthening my right trap without my arm doing all of the work. I have tried correcting my form (it is good) and doing other stuff to fix the problems, but nothing works and the problem continues to worsen. I’m not sure wether its my left or right trap that has a problem, or both. So I would really appreciate it if you could explain to me what the issue is and what to do to fix it. Stuff like exercises or stretches. Thanks

    • Hi Gus
      I’m really sorry but diagnosing and assessing you online just isn’t possible, if have to see you and watch you move and lift etc
      My advise is try and get a sports Physio to assess you fully
      Sorry again
      Cheers
      Adam

  14. Hi Adam,
    Any overhead movement brings on my shoulder impingement so I was interested in your “monkey shrugs” however I cannot find the on google and I fear I will get it wrong from your description. Any chance of a video or picture?
    Many thanks,
    Alex

  15. Hey man great post, i am no physio but feel i have been misdiagnosed like somany others! i Have scapula winging, after so long focusing on lengthening other muscles i feel this has been waste and get most tenstion buildup and a bit of pain in my upper shoulder to my neck on my left side. Its so overpowering any push pull movements feel like their prime mover is where the tension lies..if that makes sense. Would you suggest using the exercices above? My current routine:squat, overhead press, bent over row, deadlift. P.s if there are ny thoer special exercices for muscles groups which can combat the levator scapulare that would be great!

    • Hi Daniel
      It sounds like you’ve got a good routine! Remember your winging scapular may have nothing to do with any shoulder issues, I see some winging scapular that don’t cause any problems, but also some that do?
      You could give the upper trapezius strengthening exercises a go and see if they help, here is a link to some videos of them I have done http://youtu.be/koPahzAfLMU
      Kind regards
      Adam

      • Thanks mate i have tried and cant really feel my left upper trap like i can my right. This is such a problem for me as my winging stops me from performing push/pull exercices well ass i cant activate and use the muscles on the left side so trying anything and everything to help, my scpaula on my left side is just stuck in downward rotation for most of the time, What would you suggest just the stuff you previously mentioned as obiously the overhead shrug is hard to do as i cannot get full upward rotation my scapula doesnt fully roatate on my left side which stops upper trap activation. Any advice thanks

  16. Hi Adam,
    First thanks for the great info. I have been dealing with tight traps and pain the the thorasic vertabrae for the last six months. I started when I believe to have torn my traps performing shrugs with a trap bar. I have been to doctors, chiropractors and all in search of a cure and not a temporary pain relief. Of course rest was applied, muscle relaxers, anti-inflammatories and ice but here I am 6 months later with the pain. I have lost a lot of strength in the traps and sometime one of my thorasic vertabraes feels as if its swollen and bruised. Like if I pulled a muscle attaching to the vertabrae. No doctor has recommended x-rays or mri :-(. They say its just a muscle strain but this is 6 months now. Any advice on what I should do in this case.
    Thank you so much for your time,
    Regards,
    Phillip

    • Hi Phillip
      I’m afraid its really hard to give good accurate advice online, but I can assure you that your vertebrae cannot be swollen or bruised!
      Where and what is causing the pain can be tricky to determine, remember that pain isn’t always a sign of damage and that it can be felt in different parts of the body what’s called referred pain, my advice is to see a good respectable physio for a full assessment and hopefully some answers, I hope that helps a bit
      All the best
      Adam

      • Thanks for the quick reply Adam! The pain in my vertabrae is hasnt come in a while but the traps are still very tight and painful at times. Shrugs make them feel better though but the first few reps hurt.

  17. can you not just look at the position of the scapular (upwardly or downwardly rotated) and then decide up upper traps or LS are responsible for the tightness?

    • Hi Dan
      So many things act and influence the position of the scapular that we can’t just use its resting position to give us any useful reliable information I’m afraid
      Thanks
      Adam

  18. Adam,
    Thanks for posting your article, I have been slowly coming to some of these conclusions over time with treating shoulder pain clients and seeing that just stretching the UT’s just wasn’t the trick. I have recently been trying to specifically release the lev. scap. without further stretching the upper traps and have been training the serratus but I think you may of just filled in the gap in my approach. UT training it is!
    Thanks again, you’ve made a positive difference to me and and my patients with your work.
    Kindest regards
    Doug

  20. your way is what we learn at my school in copenhagen, as the “right” way, (im finish in 4 month). Its interesting to see how things change over time and what is considered a good treatment changed with new studies etc.

  21. Hi,
    I’ve a internally rotated shoulder and constant trap inflammation as a result. It also causes the nerve to trap resulting in numbness in the neck, ear, arm and fingers. I’ve been a weightlifting for many years but it seems as though the muscle memory in the lower trap (right) is shot. I’ve been struggling with this injury for many years and see many physios. They all give me the same exercises, face down on the floor, then pull shoulder back and down – sadly to no avail. Can you recommend any exercises?
    Do you have a contact number/email to arrange a possible consultation?
    Regards and thanks for the great post.
    Dan

  22. A really nice article! This was mentioned in counterpoint to this article: http://breakingmuscle.com/mobility-recovery/the-dynamic-duo-of-shoulder-impingement
    The subject of shoulder impingement syndrome is near and dear to my heart, as I’ve been dealing with it for some time now in one shoulder, and went from zero to burn in very short order in 2013 in the other shoulder. I just recently had shoulder decompression surgery to address this in the latter shoulder (removed a couple of bone spurs in the process, amongst other details), and during the procedure the surgeon discovered that my supraspinatus tendon was sufficiently torn to require an immediate repair. That would explain the pain that no amount of mobility work could help to eliminate.
    Fwiw, during my search for pain relief, I did learn a bit about brachiating, as described at the following link. (Disclaimer: the site reads a bit like an infomercial, but the information is out there, and you can glean some of the info from this site directly.): http://www.kirschshoulder.com/
    …
    Minor quibble, since this sort of thing tends to leap off the screen and punch me in the nose:
    – scapular – adjectival form of scapula, or alternatively this: http://en.wikipedia.org/wiki/Scapular
    – scapula/scapulae (noun) as described here: http://en.wikipedia.org/wiki/Scapula

    • Hi Jim thanks for your comments, first of all I never knew about the spelling of scapula/scapular meant different things, I thought it was just a US v UK thing, like skeptical v sceptical so thanks for that, every day is a school day.
      Secondly I glad to see my blog is being used to ask questions around the commonly held belief that upper traps are tight and over active, rarely do I find this is the case!
      I will look into brachiating not heard of it before, and I wish you a speedy recovery after your shoulder operation.
      Kind regards
      Adam

      • Hi Adam, no worries on the -a/-ar variation, I had a suspicion you were in the UK. I’m a Canadian expat and my wife is from New Zealand. She’s brought similar linguistic variations into conversations (both spoken and written). The best example of this is when we were discussing Cuba Gooding Jr, she spelled his name as “Coober”. 🙂
        Had my second physio appointment today. ROM on Tuesday was about 100º, today it’s at 130º. Prediction for next week is 90% of max ROM or better, assuming due diligence with my ‘homework’.
        Cheers,
        Jim

    • Thanks for the link Kevin, having only a quick scan of the abstract my initial thoughts are its a small study, and not compared against a sham Rx or any other manual therapy so we can’t rule out positive effects due to patient expectations and attention of receiving the treatment opposed to any true effects. My other issue is the reliability of what is a trigger point and finding them is extremely poor so can’t even say we are ‘treating’ them if we can’t find them!
      Thanks again for the paper will read fully soon
      Regards
      Adam

  24. Nice article. Quick question, would snatch grip barbell shrugs provide enough upward rotation due to the widened grip to be of benefit/reduced lev scap invovement in your opinion?
    Pretty much any shoulder elevation with my arms in neutral, and recently even when doing rowing exercises now, is eliciting an uncomfortable sensation in my left lev scap. Overhead shrugs I get next to no range of motion so I am guessing my upper traps are pretty dormant!

  25. Hi Adam:
    I am coming a bit late to this excellent and instructive page.
    In the same order of thinking, any chance that you might devote a full article to the LEVATOR SCAPULAE, with nice diagrams, full explanations, and your thoughts about stretching those muscles, and strengthening them as well. With descriptions of your preferred exercises, and also your usual critical comments.
    A full article on the levator scapulae would be a boon to many of us.
    Hoping that you find this subject of interest and can insert it in your writing agenda.
    ROO BOOKAROO, June 2, 2014

  26. Adam,
    Great article! It gave me a different view of looking at my pain.
    I am having right levator scapulae pain for two months now. I just don’t get why only right side of this muscle stays activated(??). My chiropractor and I don’t see my right shoulder is lower than left, but right shoulder is slightly rounded. I had been doing exercises for my lower, middle trap, rhomboids, and rotator cuff strength, but not seen any improvement on my pain. Then I read your article and most of the comments here today. I found that Zach(commented here) and I have similar problem. So I started overhead shrugs to reduce use of levator scap and strength upper trap. Actually, it feels good and relieved little bit.
    I just want to clarify some stuff with you and ask you a question..
    So your thought is that there is pain on levator scap becuase people try to put their scapular down and back position which makes it too depressed? and is that why our levator trying to hold the scapular up position?
    and are we supposed to exercise our upper trap to support our scapular up instead of using too much of levator? ( I hope I understood right….)
    And last question, do you know why my right side of upper trap is bigger than left when I am having pain on my right levator scap?
    Thanks again for this awesome article!

    • Hi Bowtie
      Thanks for your comments
      The levator scapulae is a strong downward rotator of the scapula and does often get short, tight often in those that weight train and do heavy standard shrug, it also gets problematic in those that hold their shoulder in static positions for long times
      The upper fibres of traps are the opposing muscle to the levator scap and is a strong upward rotator of the scapula, and so a balance between them must be found
      Most upper traps exercises aren’t that good at addressing that balance most target levator scapula and so the one i suggest are a simple way to address this
      As to why one shoulder is higher than the other or shoulder is more rounded, there are a million reasons but in my experience most of the time its normal, as humans we are not symmetrical, everything we do day to day is asymmetrical and so asymmetries appear quite normally quite naturally and have nothing to do with peoples pains or problems
      Of course I cant comment on you as I haven’t seen you, but i find differences in shoulder daily and 99% of the time they are not the issue
      Hope this help
      Cheers
      Adam

      • Thank you for the reply, Adam!
        May I ask you one more question?
        I have damaged my rotator cuff 3 years ago. I’ve had cortisone injection 3 times so far, pretty much once a year. Now I just want to actually fix it. I have not done any MRI or X-ray to see if I really had had injured it.
        I did some research and seem to have torn rotator cuff partially. I don’t think mine is torn too much so I have to have a surgery, because the pain is not too much. It just bothers me.
        So my question is, let’s say that my tear is not as much as that I have to consider surgical treatment, if I should do rotator cuff isometric exercises and prone Y. Or should I just not do it until it is completely fixed.
        I’m planning on getting PRP injection about two months later. I have to do push ups until then…… for my job… T T
        I really appreciate what you do here on this website.
        Gunbae!
        Bowtie

  28. I’ve had HUGE knots on my upper traps for years. NOTHING works to ‘release’ them. Chiro, massages, trigger point therapy, needling, stretching, nothing. Massaging only makes the headaches worse. I started thinking that they’re not in fact TRULY tight. They are tight because they are overstretched. My theory is that I spent a life of slouching at the computer. The traps were overstretched and in response, the muscles in the upper traps contracted and developed trigger points to prevent injury. How does that theory sound? Either way, I’m gonna try doing something I’ve never done, work out my traps.

  29. Evening Adam,
    Another very interesting and thought provoking article. You mention that activation of lev scap is possibly responsible for the higher emg readings found in UFT. I am just wondering if their are any articles which support this statement? I completely agree with your point but am unable to find any supporting literature and wondering if I am missing it. Most emg research shows figures of 0.65-0.9 ( probably part funded by emg suppliers) I would appreciate any info you have.
    Thanks a million,
    Alan

    • Hi Alan
      No I’m sorry don’t know of any papers that show what lev scap activity is like when recording upper traps, I have searched high and low and as I’m aware none have been done.
      It is just an observation and theory that I have based on seeing some upper trap EMG work being done and the location of the sensor, and the fact that no one has considered or placed a fine wire EMG into lev scap as they record upper trap.
      I have discussed this with some researchers doing EMG work on the traps and they just seem to dismiss it without even considering it as a potential confounder, if I had time and access to lab, I would do it, but alas I dont!
      Cheers
      Adam

  30. Adam:
    You could ask your question to
    Stuart McGill, Ph.D.
    Professor of Spine Biomechanics,
    Faculty of Applied Health Sciences, Department of Kinesiology,
    University of Waterloo
    [email protected]
    He is well-known in the US for his studies of the lower back problems, but he has done kinesiology EMG studies for all kinds of top athletes, including weight lifters, etc…
    He has a great lab, is well experienced, and might welcome the opportunity to add a new study to his abundant bibliography.
    It is worth asking him.

  31. We’ve had great results with “loosening” the upper trap after mobilizing the thoracic spine and re-educating the thoracic erectors. Reducing kyphosis and anteriorly rolled shoulders could possibly be eliminating overstretching of the traps? Seems logical…probably the first train of thought that explains this phenomenon!

  32. I was pawed in the face during light mma training. 6 months have passed with constant headaches, nausea, & dizziness. With trips to the neurologist, gp, 2 physio’s. Neuro said it was my vestibula. Physio said it was my spine out of alignment. Bending over with perfect posture still results in dizziness after all the rehab & a clear MRI. Neck bridges send me to bed for days with a throbbing migraine.
    I tried your shrugging exercise recommendations and noticed my headaches were no worse – which they usually are after weight training. They may have even lessened somewhat. I’m glad I happened across your web page and that you took the time to write about weak traps. I’m hopeful that by including these shrugs in my lifts, pull ups & dips ill strengthen this muscle pair and get rid of these symptoms.
    Cheers

  33. Hey, I’ve been struggling with neck pain for four years now. It’s never been strong enough to disable me and I still lift, but all I’ve been doing is stretching, getting trigger points with a lacrosse ball, strengthening lower traps, and mid traps, and leaving the upper traps alone cause they were already “too strong and overactive” I was told, and it seemed to make sense.
    I had a somewhat similar issue with my hip flexor, and I stumbled upon this article explaining how having a weak psoas major, which is stretched out to the max basically, causes all the other muscles doing the hip flexion to become really tight and full of trigger points to compensate for the psoas major being weak. Strengthening my psoas major and doing heavy hip thrusts solved that issue pretty quickly.
    So then I stumble upon the “same” thing, just with upper traps. This is just what it feels like to me, but my levator scapulae is VERY tight, and all these little muscles pulling shoulders forward. I’m thinking that they are compensating for my weak upper trap, and that if I strengthen it back up they can kick back and relax. And also doing all that strengthening on lats, pecs, basically everything but the upper traps, will increase the pulling on them. This led me to believe I just needed to stretch more, but it was the exact opposite.
    I’ve only worked upper traps about a week now but I already feel improvements. I’ve only done regular shrugs and boy I was weaker than I thought I’d be on those. Basically when I press or whatever, my upper traps can do the work they are supposed to do, without assistance from the other muscles, causing all that pain.
    Especially I have this “string” of tight muscle at front side neck, going “under” my collar bone, shooting down my arm and all the way down my to my thumb and little finger. It never did loosen up no matter how much I massaged it or what I did to it. And it is my belief that it had to be like that to compensate, and now finally it’s loosening up.
    It’s been very relieving and exciting to finally find the solution to this, like what if I had gone for years on thinking my upper trap was tight? Kept on stretching it and strengthening all the muscles, THE HORROR… If I’m clever enough to remember I’ll write back in a few months, hopefully it will all be gone then.
    Your article really helped me understand this, thank you.

  34. Hi Adam, I’m a professional guitarist and I’ve been struggling with upper trap pain for years. It constantly spasms and aches. I’ve seen countless acupuncturists, acupressurists, massage therapists, physios, orthopedic surgeons. You name it….. And it’s always the same deal…. Pinching, poking, stretching…. I’ve recently had 4 weeks of intensive cervical traction. Nothing helped. Woke up this morning with excruciating pain and a spasm in the upper traps. Turned the computer on and stumbled across your article. Picked up a couple of light weights and did 10 reps of the two shrug exercises that you’ve shown. Pain instantly reduced by 80%. I’m in bliss right now. Thank you!

  35. I have been dealing with shoulder impingement for years now. It occurs on the frontside of my shoulder near my collarbone. My shoulder is elevated and protracted compared to my other side which doesn’t give me problems. I have tried doing everything that is recommended online including: upper trap stretches, pec stretches, lower trap work, rear delt work, and serratus anterior work. But no improvement. Do you think if I started training upper trap strength it would help me?

      • Thanks for sharing your insights Adam.
        Have had left side upper trap issues (desk worker) and tried the usual posture, stretching and manual therapy with little relief over the years.
        Following your strengthening advice, have bought some weights and started the monkey shrugs. This works on multiple levels. Thanks for offering your alternative!

  36. I really enjoyed that article! As a therapist, I’ve had my share of success by focussing on the coordination of the entire shoulder girdle instead of stretching or massaging the upper trap. Your article reminds me other protocols I have thought about, but never actually tried, involving regular famers walks with heavy weights. I have always find that those were great for upper traps along with overhead pressing or shrugging. Thanks for sharing your thoughts on that!

  37. Only just got round to seeing this article – will ensure I subscribe !
    Great piece of writing and as a Pilates instructor I often hear ‘shoulders down’ “pilates ‘v’ for the lower traps” “relax your shoulders” and indeed no one taking their shoulders up to their ears – how can you reach high and overhead if you can’t do this pain free?
    One thing I’d like to add to the post is my thought there is also an importance of seeing how the scap moves and its timing – if you can’t see the rhythm you don’t necessarily know what needs to change either muscularly or patterning wise or both…
    thanks !

    • Scapula timing or rhythm is a big unknown, again a lot of people believe they know what should be normal, but when you read the evidence as I have there is so much variety of ‘normal’ pain free scapula movements that we don’t know what normal is so we certainly can’t say what abnormal is either! For example anterior scapula tilt and downward rotation has been shown to be both a risk and protective of shoulder problems… Go figure hey!
      Let scapula just be Scapulas let them wiggle, tilt shift around as they want, the human body/nervous system isn’t stupid, it normally knows what’s best for it without our meddling or interventions!

  38. If a patient has less subacromial space (as mentioned in your article), would doing e overhead shrugs in the scapular plane be effective?

  39. Hello Adam !
    I wanted to thank you for your blog, your commitment to good science and clearing the non-sense is very refreshing. I hope to read more of your high quality content in the future !
    Came here to try to get my shoulders/upper body in good health, since I’ve been experiencing some annoying “pop” sounds at the sterno-clavicular joint after going back to the gymnastic rings… If you had any advice on these injuries, or could do an article explaining the function of the clavicle, etc, it would be awesome ! I suspect of small, pain-free subluxation, but I’m clueless as to what I can do… Only physio consulted just released the “trigger points” in my shoulder, relaxing it for two days and then back to square one.
    Thanks once again 🙂

  40. Adam, I suffer from chronic pain in my upper traps and levator after a whiplash injury, plus radiating pain into my arms. Your upward shrugs are the only things that have helped for my dominant arm. May I ask how long these exercises need to be done for long term effect? I have to thank you for your help. Its awfully nice of you to put this info out to help people.

  41. Hi Adam, i am currently doing a study on corrective exercise into shoulder mobility, I’m with you’re thinking that the upper trapezius needs to be strengthened when tight, I’ve used shoulder shrugs to do this, however, ive been unable to back up with academic reference that supports doing retracted shoulder shrugs when the upper traps are tight. Do you have any that i can use to back this up.
    Kind regards
    James M

  42. You say that “upper traps ‘feel’ tight and tense, but they ‘feel’ this way because they are over loaded due to being weak”. In my view, upper traps are rarely weak and this is simply because they are used so much – not necessarily in scapular control but in head control. Most us spend a good part of every day with the head down peering down at what’s in our filed of vision. Oh! and included in that, into a computer. This is hard work for upper traps and any work for a muscle makes it stronger – in this instance often over-strong and shortened.

  43. How can a muscle remain weak if overloaded? surly the concept of overloading a muscle increases its strength? My understanding of trapezius pain is the balance between anterior chest muscles and posterior ones. unfortuntantly in this day and age, we can find any small study to confirm a hypothesis.

    • sorry but that theory is archaic. How can a muscle remain weak if overloaded? Yes if you do progresive overloading with resistance training a muscle will become stronger. However, try squatting hundreds of reps for hours a day, EVERY DAY. Eventually the legs will become weaker and break down and you will get injured, esentiialy over training.. Same with the traps. They become FATIGUED and DYSFUNCTIONAL. Research indicates a tonic muscle will BECOME WEAK WITH TENDON DEGENRATION and inflammatory biomarkers become highly prevalent!
      Same happens to hip flexors when sitting! they become fatigued, core muscles turned off.

  44. THANK YOU! I have been saying this for years and all my colleagues roll my eyes at me.
    It is similar for “tight calves” that magically enough improve when you do some calf strengthening. Wait.. what???
    I often see very poor trapezius (all fibres) activation leading to poor upward rotation/ elevation which contributes to a plethora of should issues and neck pain (especially with Lev Scap compensating).
    I find shrugging (at 30+ abd) against a red or green theraband tubing that loops around the foot and the scapula can be combined with cuff strengthening, shoulder presses or even sport specific like a forehand in tennis to improve their scapular mechanics while working on other pathologies.
    Thanks again Adam for blowing minds of the stale recipe book physio’s and challenging beliefs in our profession. We need more people like you!

  45. This is not so!! The masters (travell, simons, rachlin and gunn) of MF pain and misery teaches us to Heat, knead, needle, stretch, rehab, restore the person before you attempt to strengthen a sick muscle in a stressed person. The disease is still embedded in the muscle tissues so the muscle will still act erratic. This may make a sick muscle more powerful to choke you to death and further overload the systems.

  46. Wonderful read. With all due respect, however, I treat upper trapezius because I find a painful muscle is often inhibited and hard to activate correctly. Only after the symptom is addressed I strengthen the muscle, if it is indeed weak. And assess why there are issues to begin with.

  47. I agree! Upper traps is neglected and no muscle works in isolation. Also, perhaps strengthening of the upper traps also works because contraction will stimulate the golgi tendon organs and result in relaxation and improved circulation to the muscle etc etc PNF style.

  48. Great article. I recently had a day off and spent the day playing computer games. Like all day stupidly. I noticed fatigue in the back of my neck/traps. Then I went to Wrestling practice (first one in two months due to an ijury of the foot) and I hurt my neck. Well, the tightness is in the left trap. I noticed doing handstands relieves the pain as it strengthens the trap.
    And when you do these excercises, you are increasing blood flow to those particular muscles, which always helps with healing. I find sometimes when I have an injury a light bodybuilding high rep slow controlled tempo workout will “enrich” the muscles with bloodflow and light inflammation which starts the healing process
    For me, long story short is, in my body STRETCHING NEVER WORKS. I ALWAYS HAVE TO STRENGTHEN FIRST! THE BODY WON’T ALLOW A CHANGE IN MUSCLE LENGTH IF IT’S TRYING TO PROTECT THAT MUSCLE IN THE FIRST PLACE BECAUSE IT@S TOO WEAK TO GO INTO THAT RANGE!
    I was also a brekadancer, lots of handstands and heavy upper trap work. NEVER HAD A NECK INJURY OR SHOULDER PROBLEM UNTIL I STOPPED !

  49. First of all thank you Adam for posting such a wonderful article. 2 years ago i was tasked with lifting heavy objects and after that i had constant tension headaches like something is pulling my head muscles down. After months of therapy(traditional heat therapy and stretching of upper traps) the condition only worsened. Thank god i came to your article and what i did right away was grab two dumbells and started monkey shrugging. I was really afraid to do this because i was hammered by many doctors that dont ever shrug them again. After i shrugged 8 reps, i felt like a new man. All the tension was gone away. However some tension is still left but its going away as the time passes by and i continue shrugging. I couldnt find a reason why lifting heavy objects caused tension headache and why strengthening traps caused my headaches to go away. Keep in mind that i had depressed shoulders from lifting too heavy objects.
    Once again, thank you.

  50. Adam – while I enjoyed reading through your perspective, I have to greatly disagree and here is why. I did my Master’s research in scapular positioning associated with scapular dyskinesis. There are many, many more articles than you cite that prove Ann Cool’s theory about over (and early) activation of the upper trap. I think you bring up a fair discussion point with possible signal from the levator scapulae, however, unlike the upper trap, the levator is a downward rotator of the scapula, though not a very strong one. I think your argument would be valid if the patient you were evaluating had correctly positioned scapulas, but my symptomatic patients often present with Type I or Type II scapular dyskinesis, indicative of a resting upwardly rotated and/or protracted (or internally rotated) scapula. This positioning would lengthen the levator which would make the argument that it is actually underactivating.
    We can all appreciate that the trapezius is a very complex muscle. I am of the belief that even though it has three different directional fibers, all fibers should have equal strength to maintain equilibrium. And yet, probably over 90% of my patients with shoulder pain are significantly weaker with middle and lower trap manual muscle testing than upper trap. Our society has become lax on promoting good posture. Overactivation of the upper trap would encourage that somewhat hunched position and shoulders closer to ears (like we naturally do when we are cold). Obviously there are other factors in poor posture as well (i.e. spinal mechanics, pec minor length, etc), but without equal pull from all three fibers of the trapezius, an imbalance creates havoc for the scapular positioning – thereby increasing potential for bad posture, decreased neck and shoulder mobility, and (possibly) injury.
    In a previous comment, you also asked about assessing for tightness in the upper trap. Muscle energy research has created a test that assesses the firing pattern of shoulder musculature (check out Greenman and Chaitow). It actually somewhat falls in line with your argument about upper trap activating above 30 degrees of abduction. The appropriate firing pattern for abduction should be 1. supraspinatus 2. deltoid 3. infraspinatus 4. middle and lower trap 5. contralateral quadratus lumborum. This test has the patient abduct to 90 degrees with the clinician keeping their hands on same side shoulder and opposite side QL. Dyfunctional testing would reveal activation of upper trap and early firing of opposite QL. Test it and you will see how many people fire upper trap when they aren’t supposed to. It is because the middle and lower fibers are not maintaining equal pull and control. I treat this dysfunction with a number of techniques, then reassess using this test. I often find an almost immediate change in the firing pattern. Point here being, the upper trap actually should not be activating with abduction – at least until above 90 when the scapula really begins to upwardly rotate. And yet, it often is because either it is trying to make up for the weakness in the other fibers of the trap, or it overpowers the supra and deltoid.
    I think the point that your article should be making is that maybe upper trap is blamed too often without assessing other potential factors. Upper trap hyperactivity may be present, but it may not be the CAUSE of pain or dysfunction. Care should also be given to anterior 1st rib elevations, cervical and upper thoracic spine compensatory rotations, and posterior rib dysfunctions. However, upper trap overactivation is absolutely an issue. Care and focus should be directed at balancing all structures (particularly addressing equal pull in all fibers of the trap). The article you link at the end of your post by Pizzari confuses me because they conclude that “upward rotation shrug might be useful to address scapular dyskinesis involving drooping shoulders and reduced scapula upward rotation”, yet they don’t seem to do a good job defining what “reduced scapula upward rotation” means. To me, I would interpret that as the scapula already starts in an upwardly rotated position – which would prove the point that the upper trap would be ‘tight’. If the scapular starting position is correct and upward rotation is still decreased, I would argue there are confounding factors, like injury or dysfunction to the glenohumeral joint, as the strength of the musculature does not determine the available range of motion.
    Thanks for your insight and discussion!

    • Hi Andrew, thanks for your in depth comments and thoughts. I’m afraid to say that I dont agree with anything you say. For the sake of brevity I dont want to go through all the points you made but I will comment on the belief that you can palpate the correct firing sequence of muscles during movement. First there is simply no way anyone without complex EMG equipment will be able to detect the sequence and timing due to the very short latent times between these muscles firing. This approach smacks of the outdated beliefs with had with Trans Abs, Multifidus and even VMO in the quads, all these have now been abandoned due to lack of reliability and validity, and unless you can direct me otherwise I have not seen any data to support the clinical reliability to assess the firing sequence of the muscles you mention during scapula movement.
      In my opinion, this thinking is outdated and lacking plausibily but more importantly any scientific support
      Kind regards
      Adam

    • LACK OF UPWARD ROTATION could indicate there is some sort of LAG, due to a motor control deficit. I also wholeheartedly disagree with you.
      Upper traps are largely a postural muscle. With seated posture and restricted THoracic mobility in most patients I always see fatigued upper traps. Research indicates that a muscle held in a tonic position (and this is the cause in many rotator cuff injuries) will build calcium deposits in the tendon, increase inflammatory biomarkers and cause degradation of the muscle tendon.

      • Nonsense… calcium deposits in tendons are not fully understood but evidence points to either increased compression forces and hormonal and endocrine factors! Not sustained postures!

  52. Hi Adam ? Thankyou for sharing your thoughts. As a licensed massage therapist over 14 years I beg to differ. Massage
    IS absolutely NECESSARY to loosen up the traps, neck and shoulder areas. I have had NOTHING but success in my business! I have massaged MANY professional athletes and gym goers .. and EVERYTIME I succeed in loosening up their troubled spots ! I am just speaking from personal experience over the course of my massage career. ?

    • Hi there, well as a chartered physiotherapist for over 15 years and a shoulder specialist I will have to beg to differ, and strongly disagree with you, but hey thats what makes the world go round!
      And one thing I have learned is NOTHING works EVERYTIME… EVER ;o)

  53. Thank you for your valuable article, Adam.
    Hope that there are more eye opener articles from you.
    Good job=)

  54. I believe you’re right!!
    While I can’t boast your credentials, I was a massage therapist for years long ago and while the therapies I provided were good, staved off surgery and helped to promote health and relaxation in many, there were also many clients who came every week for the same deep tissue upper trap treatment and *never* got better. The above MT who posted a dissenting opinion may have been working on more athletes and active people. I saw them improve more so than my base clientele who were office workers. Sadly I did not know this at the time.

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