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Muscle strength deficits in the lower trapezius muscles are also a common clinical finding in patients with rounded shoulders as it has been speculated to restrict zygapophyseal extension in the middle to lower thoracic spine. [36] Therefore, RSP treatment often targets the symptoms or root causes associated with these problem areas.
An example of trapezius function is an overhead press. When activating together, the upper and lower fibers also assist the middle fibers (along with other muscles such as the rhomboids) with scapular retraction/adduction. The trapezius also assists in abduction of the shoulder above 90 degrees by rotating the glenoid upward.
Strengthening, especially of (1) the middle and lower back support muscles and scapula retractors, and (2) the longus colli and the deep neck flexor muscles. [35] Stretching muscles that cause neck protrusion, especially of the upper fibres of the trapezius muscle. [36] Lower cervical flexors: sternocleidomastoid, anterior and middle scalene ...
There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]
As it courses downwards, the nerve pierces through the sternocleidomastoid muscle (approximately 1 cm above Erb's point) while sending it motor branches, then continues down until it reaches the trapezius muscle (entering at the junction of the middle and lower third of the anterior border of the trapezius) to provide motor innervation to its ...
The two muscles most commonly inhibited during this first part of an overhead motion are the serratus anterior and the lower trapezius. [10] These two muscles act as a force couple within the glenohumeral joint to properly elevate the acromion process, and if a muscle imbalance exists, shoulder impingement may develop.
[24] [14] Predominantly, the serratus anterior and middle and lower trapezii muscles are affected; [4] the upper trapezius is often spared. [14] Trapezius weakness causes the scapulas to become downwardly rotated and protracted, resulting in winged scapulas, horizontal clavicles, and sloping shoulders; arm abduction is impaired.
TOS can involve only part of the hand (as in the pinky and adjacent half of the ring finger), all of the hand, or the inner aspect of the forearm and upper arm. Pain can also be in the side of the neck, the pectoral area below the clavicle, the armpit/axillary area, and the upper back (i.e., the trapezius and rhomboid area).
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