September 23, 2025
Pain around the shoulder blade—also known as scapular pain—is surprisingly common, yet often misunderstood. People may blame the wrong muscle, ignore deeper issues, or over-treat the wrong area.
In this post, we’ll unpack some of the most common misconceptions about scapular pain so you can better understand what’s really going on and how to find lasting relief.
Misconception #1: It’s Always a Muscle Knot
The truth: Not all scapular pain is caused by muscle tension or “knots.”
While tight muscles (like the rhomboids, trapezius, or levator scapulae) can certainly create discomfort, scapular pain can also stem from nerve irritation, poor posture, referred pain from the spine, or even internal organ issues.
If you’ve been chasing the same knot with massage guns or foam rollers without real relief, it might be time to consider other sources.
Misconception #2: It Must Be a Shoulder Problem
The truth: The scapula is closely connected to the neck, thoracic spine, and ribcage—not just the shoulder joint.
Pain in or around the shoulder blade is often referred from the cervical (neck) or thoracic (mid-back) spine. For example:
- A bulging disc in the neck may cause pain between the shoulder blades.
- A compressed thoracic nerve root can mimic a muscle strain.
Pro tip: If your scapular pain comes with tingling, numbness, or radiating sensations down the arm or into the chest, talk to a healthcare provider.
Misconception #3: Just Stretching the Area Will Fix It
The truth: Stretching may feel good temporarily, but it’s rarely a complete solution.
Most scapular pain comes from a combination of weakness and tightness, especially in the surrounding stabilizing muscles. For example:
- Overactive upper traps and underactive lower traps and serratus anterior can lead to scapular instability.
- Poor core strength or spinal alignment can cause postural compensation and strain in the scapular region.
What helps more? A smart mix of:
- Postural awareness
- Strengthening underused muscles
- Gentle mobility exercises
- Ergonomic adjustments
Misconception #4: It’s Just Muscle Pain — So It’ll Go Away on Its Own
The truth: Some cases of scapular pain do resolve on their own, especially with rest and posture correction. But chronic or recurring pain should not be ignored.
Ongoing scapular pain might be a signal that:
- You’re compensating for an injury elsewhere
- Your movement mechanics are off
- There’s an underlying joint, nerve, or spinal issue
Delaying care can allow dysfunctional movement patterns to become ingrained, making recovery longer and harder.
Misconception #5: Scapular Pain Can’t Be Serious
The truth: Most scapular pain is musculoskeletal — but in rare cases, it can signal something more serious.
Red flags include:
- Sudden, severe pain not related to movement
- Pain with shortness of breath, chest pressure, or arm numbness
- Persistent scapular pain following trauma
These may require medical evaluation to rule out cardiac, pulmonary, or neurological conditions.
So What Can You Do About Scapular Pain?
Here are a few first-line strategies to try (after ruling out red flags):
- Postural resets: Take regular breaks from sitting; reset your posture often.
- Mobility exercises: Thoracic extensions, scapular circles, wall slides.
- Strengthening: Focus on lower traps, rhomboids, and core stability.
- Breathing work: Diaphragmatic breathing helps reduce upper body tension.
- See a professional: A physical therapist or chiropractor can assess movement and identify root causes.
Final Thoughts
Scapular pain isn’t always what it seems. It’s not just a knot. It’s not just a shoulder issue. And it’s not something you always want to stretch away.
Understanding the bigger picture — posture, strength, nervous system, and mechanics — is key to lasting relief.
If you’re dealing with recurring pain in or around your shoulder blade, don’t settle for guesswork. A thoughtful, body-wide approach is often the missing piece.
To schedule your next appointment with one of our physical therapists click here.