Rhomboid Major

Rhomboid Major: Anatomy, Function, and Dysfunction

Rhomboid Major

The rhomboid muscles comprise a large group of muscles located at the backside of your upper body. The rhomboids play an essential role in the movement of the upper limb and the stability of both; the shoulder girdle and scapula. Rhomboids on both sides are innervated by the dorsal scapular nerve and are supplied by the dorsal scapular artery. It consists of two parts:

  • The Rhomboid Major
  • The Rhomboid Minor

These muscles are also known as the rhomboids as they look like a rhombus and are located on either side of the scapula. Rhombus refers to a four-sided figure in which opposite sides and angles measure the same, and none of the angles is right. 

What is Rhomboid Major?

The rhomboid major is a skeletal muscle located on the backside of the body that connects the scapula to the spinal column’s vertebrae. In humans, it works with the rhomboid minor to hold the scapula against the thoracic wall and retract it toward the vertebral column.

Origin

Origination points are located in the second, third, fourth, and fifth thoracic vertebrae (T2 to T5)

Insertion

It inserts on the medial side of the scapula (from the inferior angle of the scapula to the level of the scapular spine). 

Innervation and Arterial supply:

A rhomboidal nerve is innervated by the dorsal scapular nerve, which comprises the root of brachial plexus C5. A branch of the rhomboidal nerve runs deep to the levator scapulae, to which this nerve also supplies and passes through the middle scalene. The nerve innervates the rhomboids from their deep surface. The dorsal scapular artery, which arises from the subclavian artery, supplies oxygenated blood to the major rhomboid muscle.

Functions:

The Rhomboid major performs the direct action of retracting and elevating the inner border of the scapula. It is also responsible for rotating the outer part of the scapula downwards. Along with it, the rhomboid major keeps the scapula pressed against the thoracic wall and rib cage and prevents the scapula from falling to one side. It is essential to stabilize the scapula and glenoid cavity to enhance the efficiency of the muscles located around the shoulder joint and improve the overall body health.

Dysfunction:

If the rhomboids have become weaker or if nerve function has been lost to them, there will be winging of the medial border of the scapula and inferior scapular angle rotation. Rhomboids play an essential role in pulling and grasping, and they have also been shown to play a pivotal role in throwing and overhead arm movements. Overall, rhomboid muscles play a significant role in the general posture and mechanics of the upper body. 

However, several factors contribute to poor upper body posture. In particular, the scapulae and the shoulders tend to become protracted, and this will often lead to pain in the upper back, specifically at the medial border of the scapulae. Strengthening the rhomboids responsible for scapular retraction will alleviate pain and improve upper body posture. In addition, rhomboid muscles can become dysfunctional from constant postural strain.

Consequently, the scapula and glenoid cavity cannot rotate superiorly, resulting in poor shoulder mechanics. As a result, the soft tissue in the shoulder region can be injured and painful, significantly while raising the arm above shoulder level. Sports such as tennis and volleyball are examples of such activities.

Reasons for Rhomboid Major Pain:

Rhomboid muscle pain and upper back or shoulder pain can be caused by an injury, a strain, or overuse. 

Several things can cause rhomboid muscle pain, such as;

  • Sprain: It is a type of injury where ligaments (bands of thick tissue connecting bones) are stretched or torn.
  • Stretching: Strain causes an overextension or rupture of a muscle or tendon, the connective tissue that connects muscles to bones.
  • Convulsion: It can also be caused by abrupt muscle contraction.

Symptoms of Rhomboid Major Pain:

Rhomboid injuries cause pain in the upper back, between your shoulder blades.

The pain may worsen with movement or breathing. Symptoms of rhomboid major are as follows:

  • Severe pain
  • Difficulty in moving arm
  • Numbness
  • Fever
  • Swelling
  • Bruising

Treatment of Rhomboid Major Pain:

Generally, a mild rhomboid strain heals within a few weeks. However, serious injuries, strains, and tears may take longer to heal.

If somebody has pain, it can be managed at home by doing the following:

  • Ice the shoulder.
  •  Heat the shoulder if it doesn’t swell.
  • Take acetaminophen to relieve pain.
  • Use NSAIDs (Non-steroid anti-inflammatory drugs).
  • Try to keep your arm and shoulder down.
  • Stretch gently.
  • Maintain a straight posture.
  • Apply a topical pain cream.
  • Massage your muscles.

Several different methods can try to stretch out muscles:

  • Tennis Ball: Do this by lying down on the floor and placing a tennis ball under the shoulder. Then slowly roll the shoulder up and down across the tennis ball. After a few repetitions, switch the positions.
  • Foam Roller: Lie on your back and roll your shoulder over the foam roller. It will help you to loosen the muscles and massage them.
  • A self-massaging tool: Massage the shoulder with an electric or battery-operated tool. Do not use a high setting that might cause pain.
  • Warm-up Stretches: While exercising or participating in sports, protect the muscles by warming up and stretching before and after exercise. If muscles are sore after an intensive workout, take some rest before focusing on a different set of muscles exercise.
  • Breaks are essential: Take frequent breaks if you work at a computer most of the day. Make sure to walk around, stand up, and stretch.
  • Improved posture: Sit back in an office chair with a high back and put the shoulders against the chair. In addition, feet can be placed on a stool to maintain an upright posture.

Whenever you experience rhomboid muscle pain, it is essential to cease whatever activity is causing it. For example, exercising or playing sports may worsen the condition. A rhomboid sprain or strain will heal with rest and time. Depending on how severe it is, it could take days to months for the injury to heal. If rhomboid muscles aren’t improving, you should see your health care professional or an orthopedic specialist. Severe injuries may require surgery or other interventions to heal.

References:

  • https://www.webmd.com/pain-management/what-to-know-about-rhomboid-musclepain#:~:text=Painful%20breathing,Causes%20of%20Rhomboid%20Muscle%20Pain,Rowing%20motions retrieved on March 16, 2022.
  • https://www.healthline.com/health/rhomboid-pain retrieved on March 16, 2022.
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