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Why pain or tightness in neck, shoulders and upper trapezius

Updated: Feb 10

In the upper trapezius, neck and shoulder, we have several small muscles that help us do different movements and adjustments. Among these muscles feature the rhomboideus minor, the rhomboidesus major, the superior posterior serratus, on the upper trapezius part and the levator scapulae, together with the sternocleidomaistoideus and the semispinalis capitis.

See this gallery images:

For shoulders, supraspinatus and infraspinatus are generally the most affected.


These muscles have a high correlation with the back muscles below "Erector Spinae", and this is due to the small size of these that get very quickly involved in this tightness and because we use them very much by always moving our head, arms, neck etc. Even sitting for long hours makes us use these muscles because they contribute to maintaining posture and movements. For this reason, they don't get much rest. Therefore the combination of having stiff muscles along the spine and the daily use and contraction of these muscles will make them get very tight. People undergoing high mental stress, who tend not to relax, will be affected by increased back and lateral neck muscles.

This is due to the anatomic structure of our peripheral nervous system, which passes through our neck; therefore, all these nerves get affected by the muscles tightness.

Another sensitive muscle is the serratus anterior, which is located about under our armpit (axillary)

Serratus anterior
Serratus anterior

After this overview, let's talk about a very common tightness which I call "morning pain".

Why do we sometimes wake up in the morning and feel great pain on one side of the back of our neck so that we can hardly rotate our heads in the opposite direction?

All of us, or maybe 99% of us, experience the "morning pain".

Firstly let's go back to our body nature: probably, when it was invented, the creator didn't consider that at one point of our body evolution, we would start using a pillow while sleeping, and indeed never really dreamed that some people would use two pillows one on top of the other.

During our night sleep, we move our body and sometimes we actually turn our head from one side to the other very rashly without knowing it, and we might also sleep in a position that puts our head under pressure against the wall or the bed panel.

By doing these unpredictable rashly movements and remaining in a bent neck position, maybe even for a few hours, our levator scapulae

Levator scapulae
Levator scapulae

will be put into a very stretched contorted position and, therefore, we wake up with a feeling of extreme pain that makes it hard to move our head.

Why is this muscle getting that bad?

If you look at the image, you will notice that the levator scapulae is not one single muscle but is made of several muscular stripe muscles that insert in the middle-upper part of the scapulae blade and originates from our cervical vertebrae (in the neck region), precisely between C01 and C04.

C01 to C04 vertebra
C01 to C04 vertebra

The anatomy of this muscle or muscles has/have already a stretched nature because the main job or purpose is to be an elevator; therefore, it is always affected by greater tension than many other muscles – even while we sleep. Moreover, putting this muscle for an extended period in a very contorted stretched position will cause severe strain.

Nonetheless, the fact that the levator scapulae is composed of several muscle stripes makes it easy to understand why, after a clumsy movement, one or more of these muscle stripes get crossed partially; when this scenario happens, if we don't get manually treated as soon as possible, we will most likely feel pain and experience reduced mobility when rotating the head, with significant discomfort and pain that can even last two weeks or more.

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