Trapezius: Difference between revisions
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'''Lead Editors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | '''Lead Editors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | ||
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== | == Introduction == | ||
[[File:Trapezius animation.gif|right|frameless]] | [[File:Trapezius animation.gif|right|frameless]] | ||
The trapezius is a broad, flat, superficial [[muscle]] extending from the [[Cervical Anatomy|cervical]] to [[Thoracic Anatomy|thoracic]] region on the posterior aspect of the neck and trunk. The human trapezius muscle has an origin that is more extensive than that of any other body muscle.<ref>Lindman R, Eriksson A, Thornell LE. Fiber type composition of the human male trapezius muscle: Enzyme‐histochemical characteristics. American Journal of anatomy. 1990 Nov;189(3):236-44.Available: https://pubmed.ncbi.nlm.nih.gov/2148051/<nowiki/>(accessed 6.1.2022)</ref> | The trapezius is a broad, flat, superficial [[muscle]] extending from the [[Cervical Anatomy|cervical]] to [[Thoracic Anatomy|thoracic]] region on the posterior aspect of the neck and trunk. The human trapezius muscle has an origin that is more extensive than that of any other body muscle.<ref>Lindman R, Eriksson A, Thornell LE. Fiber type composition of the human male trapezius muscle: Enzyme‐histochemical characteristics. American Journal of anatomy. 1990 Nov;189(3):236-44.Available: https://pubmed.ncbi.nlm.nih.gov/2148051/<nowiki/>(accessed 6.1.2022)</ref> | ||
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In people who are chronically [[Stress and Health|stressed]] or anxious the trapezius suffers. Hunching the shoulders and holding tension in the shoulders and neck, puts constant strain on the trapezius. Hence the trapezius is a major source of [[headache]] pain, usually a [[Tension Headaches|tension headache]]. <ref name=":1">Weebly The Trapezius Muscle Available: https://trapeziusmuscle.weebly.com/interesting-facts.html<nowiki/>(accessed 6.1.2022)</ref> | In people who are chronically [[Stress and Health|stressed]] or anxious the trapezius suffers. Hunching the shoulders and holding tension in the shoulders and neck, puts constant strain on the trapezius. Hence the trapezius is a major source of [[headache]] pain, usually a [[Tension Headaches|tension headache]]. <ref name=":1">Weebly The Trapezius Muscle Available: https://trapeziusmuscle.weebly.com/interesting-facts.html<nowiki/>(accessed 6.1.2022)</ref> | ||
Tearing or [[Muscle Strain|straining]] the trapezius is uncommon, usually only happening in bodybuilders lifting too heavy a weight. They also occurs in high velocity accidents eg motor vehicle accident.<ref>Health line [https://www.healthline.com/health/no-weights-needed-4-trapezius-exercises 4 No-Weights Trapezius Exercises] Available: https://www.healthline.com/health/no-weights-needed-4-trapezius-exercises<nowiki/>(accessed 6.1.2022)</ref> | Tearing or [[Muscle Strain|straining]] the trapezius is uncommon, usually only happening in bodybuilders lifting too heavy a weight. They also occurs in high velocity accidents eg motor vehicle accident.<ref>Health line [https://www.healthline.com/health/no-weights-needed-4-trapezius-exercises 4 No-Weights Trapezius Exercises] Available: https://www.healthline.com/health/no-weights-needed-4-trapezius-exercises<nowiki/>(accessed 6.1.2022)</ref> | ||
Anatomy | |||
Take a look at this 2 minute video first.{{#ev:youtube|dCjs-Nshn7A}} | |||
== Origin == | == Origin == | ||
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**Ipsilateral side flexion of neck<ref name="Neumann" /> | **Ipsilateral side flexion of neck<ref name="Neumann" /> | ||
**Middle part: assists with ipsilateral side flexion and contralateral axial rotation of upper thoracic region<ref name="Neumann" /> | **Middle part: assists with ipsilateral side flexion and contralateral axial rotation of upper thoracic region<ref name="Neumann" /> | ||
== | == Physiotherapy == | ||
'''Palpation:''' Trapezius muscle is superficial and all three portions can be palpated. <br> | |||
Trapezius muscle is superficial and all three portions can be palpated. <br> | |||
# Hold the sloping superior lateral portion between fingers and thumb and palpate from<br>origin, toward the clavicle/acromion, and its insertion. | # Hold the sloping superior lateral portion between fingers and thumb and palpate from<br>origin, toward the clavicle/acromion, and its insertion. | ||
# With patient standing: abduct shoulders to 90 degrees and retract shoulder girdle. | # With patient standing: abduct shoulders to 90 degrees and retract shoulder girdle. | ||
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Upper traps is frequently involved in neck injuries | Upper traps is frequently involved in neck injuries | ||
'''Length Tension Testing''' | |||
Patient: Positioned in supine lying with the arms resting by the side and the knees flexed.<br>Therapist: Standing at the head of the bed.<br>Action: The therapist supports the posterior aspect of the head with both hands and then passively flexes the craniovertebral joint. The right hand stabilizes the lateral one third of the patient’s right clavicle and acromion palpating the muscle. The therapist then gently and slowly flexes, left side flexes and right rotates the mid and lower cervical spine with the left hand. The hand stabilizing and the hand moving the body part senses the tension in the muscle. The amount of range and the end feel is assessed and the reproduction of any symptoms is noted. This test is then repeated on the contralateral side and compared. <ref>http://activepotentialrehab.com/docs/pdf/sample_upperextremity11_21.pdf</ref> | |||
'''Treatment''' | |||
Below are some treatment ideas. | Below are some treatment ideas. | ||
[[File:Barbell.jpeg|right|frameless]] | [[File:Barbell.jpeg|right|frameless]] | ||
Exercises | |||
1. Shoulder blade squeeze | 1. Shoulder blade squeeze | ||
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4. Pushup | 4. Pushup | ||
Stretching | |||
Sit upright in a chair and make sure that your posture is correct. These stretches can be done in repetitions of 15-20 every hour to decrease trapezius muscle pain. Begin by rolling the shoulders back so that the shoulder blades feel like they are being pinched together. Then raise your shoulders up towards the ceiling and lower them down gently. You can then bend your neck from side to side by tilting your head towards your shoulder and counting to 3, then repeating in each direction. | Sit upright in a chair and make sure that your posture is correct. These stretches can be done in repetitions of 15-20 every hour to decrease trapezius muscle pain. Begin by rolling the shoulders back so that the shoulder blades feel like they are being pinched together. Then raise your shoulders up towards the ceiling and lower them down gently. You can then bend your neck from side to side by tilting your head towards your shoulder and counting to 3, then repeating in each direction. | ||
Massage | |||
Pain in the shoulder and neck can be prevented or reduced with massage.It is possible to reduce trapezius muscle pain through self-massage. Reach back with one hand and find your trapezius muscle. Beginning at the base of the neck, try to knead the trapezius muscles. [[File:Trap4567.jpg|alt=|right|200x200px]] | Pain in the shoulder and neck can be prevented or reduced with massage.It is possible to reduce trapezius muscle pain through self-massage. Reach back with one hand and find your trapezius muscle. Beginning at the base of the neck, try to knead the trapezius muscles. [[File:Trap4567.jpg|alt=|right|200x200px]] | ||
[[File:Trap4567.jpg|alt=|right|200x200px]] | [[File:Trap4567.jpg|alt=|right|200x200px]] | ||
Trigger Points | |||
There are six main trigger points of the trapezius, two in each portion of the muscle, plus one unusual one which causes only autonomic phenomena.<ref name=":1" />See [[Trigger Points]] | There are six main trigger points of the trapezius, two in each portion of the muscle, plus one unusual one which causes only autonomic phenomena.<ref name=":1" />See [[Trigger Points]] |
Revision as of 11:53, 6 January 2022
Original Editor - Daphne Jackson
Lead Editors - Lucinda hampton, Andeela Hafeez, Kim Jackson, Kai A. Sigel, Daphne Jackson, WikiSysop, Joao Costa, Rachael Lowe, Evan Thomas, Tarina van der Stockt and Kirenga Bamurange Liliane
Introduction[edit | edit source]
The trapezius is a broad, flat, superficial muscle extending from the cervical to thoracic region on the posterior aspect of the neck and trunk. The human trapezius muscle has an origin that is more extensive than that of any other body muscle.[1]
The muscle is divided into three parts: descending (superior), ascending (inferior), and middle[2]. The muscle contributes to scapulohumeral rhythm through attachments on the clavicle and scapula, and to head balance through muscular control of the cervical spine.
In people who are chronically stressed or anxious the trapezius suffers. Hunching the shoulders and holding tension in the shoulders and neck, puts constant strain on the trapezius. Hence the trapezius is a major source of headache pain, usually a tension headache. [3]
Tearing or straining the trapezius is uncommon, usually only happening in bodybuilders lifting too heavy a weight. They also occurs in high velocity accidents eg motor vehicle accident.[4]
Anatomy
Take a look at this 2 minute video first.
Origin[edit | edit source]
The muscle attaches to the medial third of superior nuchal line; external occipital protruberance, nuchal ligament, and spinous processes of C7 - T12 vertebrae[5].
Insertion[edit | edit source]
The muscle inserts on the lateral third of clavicle, acromion, and spine of scapula[5].
Nerve Supply[edit | edit source]
- Spinal root of accessory nerve (CN XI) (motor)[5]
- Cervical nerves (C3 and C4) (pain and proprioception)[5]
Blood Supply[edit | edit source]
Transverse cervical artery (cervicodorsal trunk)[5][2]
Function[edit | edit source]
The trapezius is a muscle made up of particularly long muscle fibers that spanning a large width of the upper back. Functionally, this enables the trapezius to assist in mainly postural attributes, allowing and supporting the spinal column to remain erect when the person is standing.[6]
Shoulder pain and dysfunction are among the most common orthopedic problems managed by physiotherapists, and the trapezius plays an important role in the shoulder.
- Appropriate kinematics of the scapula is crucial for optimal shoulder joint function, eg enabling repetitive movements of the hand over the head.
- Trapezius and Serratus anterior are the main muscles that optimize scapula position and scapulohumeral rhythm.
- If the scapula stabilizing muscles are weakened eg trapezius, the normal position and kinematics of the scapula become altered[7].
The trapezius muscle is also used for active movements eg side bending and turning the head, elevating and depressing the shoulders, and internally rotating the arm[6].
- Upper traps is frequently involved in neck injuries.
- Tearing or straining the trapezius is uncommon, usually only happening in bodybuilders lifting too heavy a weight.
Action[edit | edit source]
- Descending part: elevates pectoral girdle[2]
- Middle part: retracts scapula[2]
- Ascending part: depresses shoulders[2]
- Descending and ascending together: rotates scapula upwards[2]
- Bilateral contraction: extends neck[8]
- Unilateral contraction:
Physiotherapy[edit | edit source]
Palpation: Trapezius muscle is superficial and all three portions can be palpated.
- Hold the sloping superior lateral portion between fingers and thumb and palpate from
origin, toward the clavicle/acromion, and its insertion. - With patient standing: abduct shoulders to 90 degrees and retract shoulder girdle.
- Slightly bend the trunk forward so antigravity.
- Upper traps can also be seen with elevation and lower with depression [9]
Upper traps is frequently involved in neck injuries
Length Tension Testing
Patient: Positioned in supine lying with the arms resting by the side and the knees flexed.
Therapist: Standing at the head of the bed.
Action: The therapist supports the posterior aspect of the head with both hands and then passively flexes the craniovertebral joint. The right hand stabilizes the lateral one third of the patient’s right clavicle and acromion palpating the muscle. The therapist then gently and slowly flexes, left side flexes and right rotates the mid and lower cervical spine with the left hand. The hand stabilizing and the hand moving the body part senses the tension in the muscle. The amount of range and the end feel is assessed and the reproduction of any symptoms is noted. This test is then repeated on the contralateral side and compared. [10]
Treatment
Below are some treatment ideas.
Exercises
1. Shoulder blade squeeze
2. Shrug
3. Upright row
4. Pushup
Stretching
Sit upright in a chair and make sure that your posture is correct. These stretches can be done in repetitions of 15-20 every hour to decrease trapezius muscle pain. Begin by rolling the shoulders back so that the shoulder blades feel like they are being pinched together. Then raise your shoulders up towards the ceiling and lower them down gently. You can then bend your neck from side to side by tilting your head towards your shoulder and counting to 3, then repeating in each direction.
Massage
Pain in the shoulder and neck can be prevented or reduced with massage.It is possible to reduce trapezius muscle pain through self-massage. Reach back with one hand and find your trapezius muscle. Beginning at the base of the neck, try to knead the trapezius muscles.
Trigger Points
There are six main trigger points of the trapezius, two in each portion of the muscle, plus one unusual one which causes only autonomic phenomena.[3]See Trigger Points
References[edit | edit source]
- ↑ Lindman R, Eriksson A, Thornell LE. Fiber type composition of the human male trapezius muscle: Enzyme‐histochemical characteristics. American Journal of anatomy. 1990 Nov;189(3):236-44.Available: https://pubmed.ncbi.nlm.nih.gov/2148051/(accessed 6.1.2022)
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Moore KL, et al. Essential clinical anatomy. 4th ed. Baltimore, MD: Lippincott Williams and Wilkins, 2011.
- ↑ 3.0 3.1 Weebly The Trapezius Muscle Available: https://trapeziusmuscle.weebly.com/interesting-facts.html(accessed 6.1.2022)
- ↑ Health line 4 No-Weights Trapezius Exercises Available: https://www.healthline.com/health/no-weights-needed-4-trapezius-exercises(accessed 6.1.2022)
- ↑ 5.0 5.1 5.2 5.3 5.4 Department of Radiology, UW Medicine. Trapezius. www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas/upper-body/trapezius (accessed 27 January 2014).
- ↑ 6.0 6.1 Ourieff J, Scheckel B, Agarwal A. Anatomy, Back, Trapezius. StatPearls [Internet]. 2020 Apr 17.Available: https://www.ncbi.nlm.nih.gov/books/NBK518994/(accessed 6.1.2022)
- ↑ Hwang M, Lee S, Lim C. Effects of the Proprioceptive Neuromuscular Facilitation Technique on Scapula Function in Office Workers with Scapula Dyskinesis. Medicina. 2021 Apr;57(4):332. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067054/ (accessed 6.1.2022)
- ↑ 8.0 8.1 8.2 Neumann DA. Kinesiology of the musculoskletal system: foundations for rehabilitation. 2nd ed. St. Louis, MO: Mosby Elsevier, 2010.
- ↑ https://www.fgc.edu/wp-content/uploads/2011/12/palpation-of-muscles.pdf
- ↑ http://activepotentialrehab.com/docs/pdf/sample_upperextremity11_21.pdf