Diagnosis Explanation:

A rhomboid muscle strain occurs when the rhomboid muscles (located between the shoulder blades) are overstretched or torn, often due to poor posture, overuse, heavy lifting, or sudden pulling motions. Symptoms include sharp or aching pain between the shoulder blades, tightness, spasms, and discomfort when moving the shoulders.

Specific Work Modifications:

• If your job requires standing or walking: Maintain good posture, avoid slouching, and take breaks to stretch the upper back.
• If your job involves lifting: Avoid heavy lifting, pulling, or reaching behind the back. Use both hands when possible.
• If your job is desk-based: Keep the shoulders relaxed, use lumbar and arm support, and take posture breaks every 30 minutes.
• Avoid: Hunching forward, repetitive pulling motions, heavy lifting, and prolonged static postures.

Specific Activity Modifications:

• If you play sports: Avoid rowing, throwing, and repetitive arm motions until pain subsides.
• If you do weightlifting: Avoid pull-ups, rows, shrugs, and overhead presses; instead, focus on pain-free, controlled movements.
• If you do yoga or Pilates: Modify poses to avoid deep shoulder retraction and excessive stretching of the upper back.
• Avoid: Heavy pulling exercises, jerky movements, and activities that strain the upper back.

Recommended Supplements:

• Collagen Peptides – 10g daily for muscle and tendon repair.
• Magnesium – 300-400mg daily to relax muscles and prevent spasms.
• Vitamin C – 500mg daily to promote collagen synthesis.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for natural pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to aid muscle healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to keep muscles supple.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to prevent muscle tightness and support recovery.

Home Exercise Prescription (Rehabilitation for Rhomboid Muscle Strain)

Early Phase (0-2 Weeks, Reducing Pain & Relaxing the Muscles):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression (gentle massage), Elevation.
• Shoulder Blade Squeeze (Gentle Activation) – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
• Upper Trap Stretch – Gently tilt head to the opposite side, hold 20 seconds, repeat 3x/day.
• Foam Rolling (Upper Back, Gentle Pressure) – Roll over a foam roller, 1-2 minutes, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Mobility & Strength):

• Wall Angels – Stand against a wall, raise arms up and down, 10 reps, 2x/day.
• Seated Rows (Resistance Band) – Pull band toward chest while keeping back straight, 10 reps, 2x/day.
• Thoracic Extension Stretch (Using a Chair) – Hands behind head, gently arch backward, hold 10 seconds, 3x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Improving Posture):

• Reverse Flys (Light Dumbbells or Resistance Band) – Slowly pull arms outward, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
• Posture Training (Seated or Standing with Core Engaged) – Maintain an upright posture for 1 minute, 2x/day.

Helpful Books:

1. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief – Clair Davies, NCTMB.
2. Overcoming Back and Neck Pain: A Proven Program for Recovery and Prevention – Lisa Morrone, PT.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.