The Neck Pain Saga –Part 1 – The Trapezius

    The trapezius muscle originates at the base of the skull as well as from a thick ligament (ligamentum nuchae) that arises from the neck vertebrae and from the spinous processes of thoracic vertebrae.  It is a large muscle that is theoretically divided into three parts because its fibers lie in three directions and move differently.  The upper portion’s fibers insert on the lateral (outer) third of the clavicle.  The middle portion’s fibers insert on the acromion process (outer top portion) of the scapula.  The lower portion’s fibers insert on the spine of the scapula.  The upper trapezius (traps) works to elevate the scapula (shrug the shoulders upwards).  The middle fibers of the traps retract the shoulder blades (pull the shoulder blades back and together).  The lower fibers of the traps depress the scapula.   These actions set the shoulders in their proper position. In their proper position, the shoulder blades (the scapulae) form a support like a cup to cradle the head on top of the body.  So it is the trapezius muscle that forms this support meant to hold the head in an erect posture.  When we thrust our head forward we render the trapezius fairly useless of this major duty.   With our head forward, we use the muscles of the neck to support the head instead, dangling it in front of our shoulders.  These neck muscles are not meant to work this way.  Their fibers are aligned in other directions so that their optimal forces pull down toward our shoulders and chest not to push upwards toward our head.  When we use the muscles improperly, they fatigue, and even become damaged and this is the source of so much neck muscle pain and pathology commonly seen.  To correct, or better, avoid developing unhealthy posture and neck pain, one should maintain a healthy trapezius muscle.  Attention must be devoted to all three portions of the muscle.  Shoulder shrugs are a common exercise, well known to most that will exercise the upper traps.  Reverse flys are an example of an exercise that strengthen the middle trapezius though care must be taken to elevate the arms in a “Y” pattern and not simply extend them behind them horizontally because this will emphasize working the rhomboid muscle.  It is harder to find examples of exercises to strengthen the lower traps.   There is an excellent example pictured on the website :(http://www.staceyjaffmd.com/trunkwork.html) Standing with knees bent, slightly flexed at the waist with a straight back, keeping both arms straight, you hold a single weight in both hands and then raise and lower the weight for 12- 16 repetitions.  In the exercise pictured a simultaneous squat is performed to maximize the work accomplished.  There are other trapezius exercises as well, these are just examples. 

      With a strong, healthy trapezius you set yourself straight, literally, correcting, at least, one plane of your posture.