That is probably because there are so many reasons why a person has this problem. The key is good assessment first.

So let me add a few as well....

after proper analysis looking at the whole muscle chain would be my first option.

I have found that in MOST cases, the trapezius is not the main issue but a muscle weakness elsewhere.

Another totally different approach could be teaming up with the acupuncturist. It is amazing what they can do. A number of important meridians are located in this area...

On assessment, there is a reduced muscle length of upper trapezius in many patients,and stretch weakness in middle and lower trapezius,scapula gets tipped anteriorly and abducted,leaving shoulder protacted with pectoralis muscle shortening,what can be done

In such a case (thinking locally only for a moment) I would strengthen the weak muscles and do some coordination exercising. Get the whole scapular rhythm back to normal.

You can have icing tens ,us massage therapy to relax or decrease spasm but stretching is very important in order to release ms.

Dear shakeel, what do you mean by ms?

Hi all

Why is the UFT strained would be my first Q and an assessment of the shoulder girdle mechanics is essential. Graded exposure to stretches could be appropriate as could soft tissue mobilisation. However I cant see the relevance of electrotherapy in this type of case unless this patient is being seen within the first 72hours post trauma (if a trauma is involved) or at all if this is an overuse or chronic problem. If there is research to indicate otherwise please let me know.

Muscle energy techniques, Cyriax Deep friction massage, Kinesiotaping or taping, posture correction exercises and may more.All give wonderful results when used in moderation

Esther ....ms means muscle .... (wonder why kids write it this way now a days)

Along with physical therapy treatment in clinic, home plan for isometrics of neck and shoulder musculature will help for long run.

Kinesiology taping can be a very good complement, given relaxation and pain relief.

Stretch the muscle and tape without stretch in the tape, you may also try pain cross if there is trigger points.

Trapezius Strain is very simple to treat and responds really well when the correct sequence applied. The basis is treatment is based on the history of having a burning pain to one side of the mid thoracic spine that came on insidiously. In actual fact, this is characteristic of a train or tear that occurs as a result of overstretching. The mechanism is one where the head/neck is rotated to the left while the right arm is outstretched to reach for something causing an overstretch of the md trapezius. This is especially present in persons whose thoracic kyphosis is exaggerated.

The treatment is 1- transverse massage to the affected muscle (Cyriax) for a few minutes onr until the acute symptom is lessened. This is done three times going deeper each time. (Tender at first, but as the transverse massage continues, the pain decreases) 2- Manual trigger point therapy to the mid trapezius on the top of the shoulder. 3- Ice packs- 25 minutes at one time applied directly to the skin done 3 to 5 time per day for 2 days. 4- trapezius exercise 20 reps three times per day for 4 days (8 inches from wall...leaning against the wall and pushing body away from the wall with outstretched arms.

I have used this for 40 years and it works every time, except in cases where this is a pathology beneath the symptom.

Thank you for all the answers

Hi Ponmathi,

From the above discussions I got some points to comment. I think the length of pectoralis (major & minor), biceps, latisimus dorsi, teres major muscle might have been altered. This assumption is based on how you have described the scapular position. I am suggesting you to try to correct the scapula in static as well as dynamically. I have treated more than 350 patients by adjusting scapula which complaints are similar with the one you are presenting and it gives wonderful result too. In short correcting the kinetic chain utilizing the concept of biomechanics, exercise therapy, manual therapy. If you require some electromodalities might also use as an additional not as a primary treatment.

Regards

Ratan

Why don't we try yogic approaches, especially incorporating breathing

Hi

Maybe the works from LL Andersen and colleagues are helpfull (one of them below).

regards

stig

Muscle activation during selected strength exercises in women with chronic neck muscle pain.

Andersen LL, Kjaer M, Andersen CH, Hansen PB, Zebis MK, Hansen K, Sjøgaard G.

Phys Ther. 2008 Jun;88(6):703-11. doi: 10.2522/ptj.20070304. Epub 2008 Mar 13.

PMID: 18339796 [PubMed - indexed for MEDLINE]

kindly check the scapulohumeral rthym. According to me there should be some force couple muscle imbalance. So you need to treat the cause 1st and then locally go for deep friction with cryotherapy.