Trapezius Pain While Running: Causes, Prevention, and When to Seek Help

Why do my traps hurt when I run?

Trapezius pain during running often stems from a combination of poor biomechanics, muscle imbalances, excessive tension, and training errors that overload the upper back and neck muscles responsible for stabilizing the head and shoulders.

Understanding the Trapezius Muscles

The trapezius is a large, triangular muscle spanning from the base of your skull down your upper back to the middle of your spine and out to your shoulder blades (scapulae). It's divided into three main parts, each with distinct functions crucial for running:

• Upper Trapezius: Elevates the scapula (shrugging), rotates the head, and extends the neck.
• Middle Trapezius: Retracts (pulls back) the scapula.
• Lower Trapezius: Depresses and rotates the scapula downward.

During running, these muscles work synergistically with other core and shoulder girdle muscles to maintain posture, stabilize the head and neck against repetitive impact, and facilitate efficient arm swing. When they become overstressed or dysfunctional, pain can arise.

Common Causes of Trapezius Pain During Running

Several factors can contribute to trapezius discomfort or pain while running:

• Poor Running Biomechanics and Posture

  • Forward Head Posture: Leaning your head forward places excessive strain on the upper trapezius and neck extensors, as these muscles must constantly work to counteract gravity and prevent your head from dropping further.
  • Shoulder Shrugging/Tension: Holding your shoulders high and tight, often unconsciously, during a run leads to chronic contraction and fatigue of the upper trapezius. This can be a stress response or a learned habit.
  • Inefficient Arm Swing: An overly rigid, high, or cross-body arm swing can translate tension up into the shoulders and neck. Conversely, a lack of arm swing may force the upper body to compensate for stability.
  • Shallow/Accessory Breathing: Relying on upper chest breathing (thoracic breathing) instead of diaphragmatic breathing can cause the neck and shoulder muscles (including the upper traps) to overwork as accessory breathing muscles, leading to chronic tension.

• Muscle Imbalances and Weakness

  • Weak Core and Scapular Stabilizers: A weak core (transverse abdominis, obliques) compromises trunk stability, forcing the upper body, including the traps, to compensate. Similarly, weak lower and middle trapezius, rhomboids, and serratus anterior can lead to the upper trapezius becoming overactive and dominant in stabilizing the shoulder blade.
  • Tight Pectorals and Upper Traps: Desk work, prolonged sitting, and certain strength training regimens can lead to tight chest muscles and overactive upper trapezius, pulling the shoulders forward and upward, exacerbating postural issues during running.

• Overuse and Training Errors

  • Rapid Increase in Volume or Intensity: Suddenly increasing mileage, speed, or hill training without adequate conditioning can overload muscles not accustomed to the new demands, leading to fatigue and pain.
  • Lack of Recovery: Insufficient rest, poor sleep, and inadequate nutrition hinder muscle repair and recovery, making muscles more susceptible to strain and pain.

• Equipment and Environmental Factors

  • Improper Footwear: Shoes that don't provide adequate support or cushioning can alter your gait, potentially transmitting impact forces up the kinetic chain to the upper body.
  • Backpack or Hydration Vest Issues: An ill-fitting or excessively heavy running pack can pull on the shoulders and upper back, directly stressing the trapezius muscles.
  • Cold Weather: Running in cold weather can cause muscles to tense up involuntarily, increasing stiffness and pain in the neck and shoulders.

• Stress and Tension

  • Emotional and psychological stress can manifest as physical tension, particularly in the neck and shoulders. This chronic muscle guarding can be a significant contributor to trapezius pain, even during activities like running.

• Underlying Medical Conditions

  • While less common as a sole cause during running, conditions like cervical spine issues (e.g., disc herniation, nerve impingement), thoracic outlet syndrome, or rotator cuff pathology can refer pain to the trapezius area.

Strategies for Alleviating and Preventing Trapezius Pain

Addressing trapezius pain requires a holistic approach, focusing on biomechanics, strength, flexibility, and recovery.

• Improve Running Form and Posture:

  • Relax Your Shoulders: Consciously drop your shoulders away from your ears. Imagine a string pulling your head upwards, elongating your spine.
  • Maintain Neutral Head Position: Gaze about 10-20 feet ahead, keeping your chin parallel to the ground. Avoid looking down at your feet.
  • Optimize Arm Swing: Keep your arms relaxed, elbows bent at approximately 90 degrees, swinging forward and back from the shoulders, not across your body. Hands should be loosely cupped.
  • Practice Diaphragmatic Breathing: Focus on breathing deeply into your belly, allowing your diaphragm to do most of the work, rather than relying on your upper chest and neck muscles.

• Strengthen Key Muscles:

  • Core Stability: Incorporate exercises like planks, bird-dogs, and dead bugs to improve trunk stability.
  • Scapular Stabilizers: Strengthen the lower and middle trapezius, rhomboids, and serratus anterior with exercises such as face pulls, band pull-aparts, Y-raises, and push-up pluses. These help draw the shoulder blades down and back, reducing upper trap dominance.
  • Rotator Cuff: Ensure balanced strength in the rotator cuff muscles for overall shoulder health.

• Address Muscle Tightness and Mobility:

  • Upper Trap Stretches: Gentle neck stretches, such as tilting your head to the side and then gently pulling it with the opposite hand, can relieve tension.
  • Pectoral Stretches: Doorway stretches can help open up the chest and counteract rounded shoulders.
  • Foam Rolling/Myofascial Release: Use a foam roller or lacrosse ball on your upper back, shoulders, and even pectorals to release trigger points and improve tissue mobility.
  • Thoracic Spine Mobility: Exercises like cat-cow, thread the needle, and thoracic rotations can improve mobility in the upper back, which is often stiff in runners.

• Optimize Training Load and Recovery:

  • Gradual Progression: Follow the "10% rule" – do not increase your weekly mileage, intensity, or duration by more than 10% to allow your body to adapt.
  • Incorporate Rest Days: Allow adequate time for muscle repair and recovery.
  • Prioritize Sleep: Aim for 7-9 hours of quality sleep per night.
  • Nutrition and Hydration: Fuel your body with nutrient-dense foods and stay well-hydrated to support muscle function and recovery.

• Consider Equipment Adjustments:

  • Running Shoes: Ensure your running shoes are appropriate for your foot type and gait, and replace them regularly (typically every 300-500 miles).
  • Hydration Gear: If using a pack, ensure it fits snugly and distributes weight evenly. Test it on shorter runs before long distances.

• Stress Management:

  • Incorporate stress-reducing techniques into your daily routine, such as meditation, yoga, deep breathing exercises, or spending time in nature.

When to Seek Professional Help

While many cases of trapezius pain can be managed with self-care and training adjustments, it's important to seek professional evaluation if:

• The pain is severe, persistent, or worsening.
• You experience numbness, tingling, or weakness in your arms or hands.
• The pain is accompanied by other symptoms like fever, unexplained weight loss, or changes in bowel/bladder function.
• Pain interferes significantly with daily activities or sleep.
• Self-management strategies do not provide relief after a few weeks.

A physical therapist, sports medicine physician, or chiropractor can provide an accurate diagnosis, identify specific biomechanical faults, and develop a personalized treatment and rehabilitation plan.