Running: Causes, Symptoms, and Prevention of Shoulder Blade Pain

Can running hurt your shoulder blades?

While running is primarily a lower-body activity, it can indeed contribute to shoulder blade pain, often stemming from poor upper body mechanics, muscle imbalances, or referred pain.

Understanding the Shoulder Girdle in Running

Though the legs power propulsion, the upper body plays a crucial role in running efficiency and injury prevention. The shoulder girdle, comprising the scapulae (shoulder blades), clavicles (collarbones), and humerus (upper arm bone), along with their intricate musculature, contributes to balance, arm swing, and core stability. A properly functioning shoulder girdle ensures an economical gait and helps dissipate forces throughout the kinetic chain.

How Running Can Lead to Shoulder Blade Pain

Pain in or around the shoulder blades during or after running is not as common as lower body complaints but can be a persistent issue. Several factors can contribute to this discomfort:

• Poor Posture/Form:
  • Forward Head Posture: Carrying the head too far forward strains the upper trapezius and levator scapulae muscles, which attach to the shoulder blades and neck.
  • Slumped Shoulders: A rounded upper back (thoracic kyphosis) pulls the shoulder blades forward, lengthening and weakening the scapular retractors (rhomboids, middle trapezius) and tightening the pectorals.
  • Excessive Arm Swing: Overly vigorous or uncontrolled arm movements, especially across the body, can place undue stress on the shoulder joint and surrounding musculature, including those stabilizing the scapula.
  • Shrugged Shoulders: Running with chronically elevated shoulders can lead to tension in the upper trapezius and levator scapulae, causing localized pain or muscle knots.
• Muscle Imbalances:
  • Weak Scapular Stabilizers: Muscles like the rhomboids, serratus anterior, and lower trapezius are crucial for holding the shoulder blades in an optimal position. Weakness here can lead to scapular dyskinesis (improper movement or positioning of the scapula), causing instability and pain.
  • Tight Chest Muscles (Pectorals): Overly tight chest muscles can pull the shoulders forward, contributing to a rounded posture and putting increased strain on the posterior shoulder muscles.
  • Upper Trapezius Dominance: Over-reliance on the upper trapezius during arm swing can lead to tightness and pain, often accompanied by weakness in the lower and middle trapezius.
• Overuse and Repetitive Strain:
  • The repetitive nature of running, even with subtle postural flaws, can accumulate microtrauma in the muscles and connective tissues surrounding the shoulder blades, leading to inflammation and pain.
  • Increased mileage or intensity without adequate preparation can exacerbate existing imbalances.
• Referred Pain:
  • Pain originating from the neck (cervical spine issues like disc herniations or nerve impingement) can refer to the shoulder blades.
  • Trigger points in muscles like the infraspinatus or subscapularis (rotator cuff muscles) can also refer pain to the scapular region.
• Equipment/Environment:
  • Ill-fitting Hydration Packs/Backpacks: Carrying weight incorrectly or having straps that rub or press on the shoulder blades can cause direct irritation.
  • Running on Uneven Terrain: Constantly adjusting posture and balance on trails can place additional, unaccustomed demands on the upper body and core stabilizers.

Common Symptoms of Running-Related Shoulder Blade Pain

Symptoms can range from mild discomfort to sharp, debilitating pain and may include:

• Aching or burning sensation between the shoulder blades.
• Sharp pain with specific arm movements or during arm swing.
• Stiffness or restricted movement in the upper back or neck.
• Tenderness to touch around the scapula.
• Muscle knots or trigger points.
• Radiating pain or tingling (less common, but indicates potential nerve involvement).

Preventing Shoulder Blade Pain While Running

Proactive measures focusing on form, strength, and mobility can significantly reduce the risk of shoulder blade pain.

• Optimize Running Form:
  • Relaxed Shoulders: Keep shoulders down and back, avoiding shrugging.
  • Neutral Head Position: Gaze forward, not down, maintaining alignment with the spine.
  • Efficient Arm Swing: Arms should swing forward and back from the shoulders, not across the body. Elbows bent at approximately 90 degrees, hands relaxed.
  • Engage Core: A strong core supports the entire kinetic chain, including the upper body.
• Strengthen Supporting Musculature:
  • Scapular Retractors: Exercises like rows (dumbbell, cable, or resistance band), face pulls, and prone Y/T/W raises strengthen the rhomboids and trapezius muscles.
  • Serratus Anterior: Push-up plus, serratus punches, and wall slides help stabilize the scapula against the rib cage.
  • Rotator Cuff: Internal and external rotations with light weights or bands improve shoulder stability.
  • Core Strength: Planks, bird-dog, and dead bugs enhance overall trunk stability.
• Improve Thoracic Mobility:
  • foam rolling the upper back, cat-cow stretches, and thoracic rotations can counteract stiffness from prolonged sitting and improve the spine's ability to extend and rotate.
• Address Muscle Imbalances:
  • Incorporate stretching for tight muscles like the pectorals (doorway stretches) and upper trapezius.
  • Prioritize strengthening the weaker, often lengthened, posterior chain muscles.
• Proper Warm-up and Cool-down:
  • Dynamic stretches before running (arm circles, torso twists) prepare the muscles.
  • Static stretches after running help restore muscle length and reduce post-exercise stiffness.
• Listen to Your Body:
  • Do not push through pain. Gradual progression of mileage and intensity is key.
  • Incorporate rest days to allow for recovery and adaptation.

When to Seek Professional Help

While many cases of shoulder blade pain can be managed with self-care and form adjustments, it's important to consult a healthcare professional, such as a physical therapist, sports medicine physician, or chiropractor, if:

• Pain is severe or worsens over time.
• Pain is accompanied by numbness, tingling, or weakness in the arm or hand.
• Pain does not improve with rest and self-management within a few weeks.
• You suspect a more serious underlying condition, such as a nerve impingement or rotator cuff injury.

Conclusion

Running, while a fantastic form of exercise, demands proper biomechanics throughout the entire body. While shoulder blade pain may seem counterintuitive for a lower-body dominant activity, it's a clear signal that your upper body mechanics or muscle balance needs attention. By understanding the intricate role of the shoulder girdle, addressing postural flaws, and committing to targeted strength and mobility work, runners can effectively prevent and alleviate discomfort, ensuring a more efficient, pain-free, and enjoyable running experience.