Wht is trapezius muscle?

Trapezius Muscle

Introduction

The trapezius muscle is a broad, flat, superficial muscle located in the upper back and neck region. It plays a crucial role in various shoulder and neck movements, including shrugging, rotating, and retracting the scapula. Often overlooked in routine assessments, the trapezius is vital not only for postural stability but also for functional activities involving the upper limb. Due to its extensive anatomical span and complex fiber orientation, this muscle requires a nuanced understanding for effective clinical assessment and rehabilitation.

Anatomy of Trapezius Muscle

Origin

Insertion

  • Lateral third of the clavicle

  • Acromion process

  • Spine of the scapula

Nerve Supply

Function

The trapezius muscle has three functional parts:

  • Upper fibers: Elevate the scapula (e.g., shoulder shrug)

  • Middle fibers: Retract the scapula

  • Lower fibers: Depress and assist in upward rotation of the scapula
    Together, these fibers coordinate to stabilize the scapula during arm movements, contributing significantly to overhead and lifting actions.

Assessment of Trapezius Muscle

Palpation

  • Position: Patient seated or standing

  • Procedure: Ask the patient to shrug their shoulders. Palpate the upper fibers at the base of the neck. For middle and lower fibers, palpate between the spine and scapula during shoulder retraction or depression.

Power Testing

  • Upper fibers: Ask the patient to shrug shoulders against resistance

  • Middle fibers: Have the patient lie prone and horizontally abduct their arm with the thumb upward. Apply resistance.

  • Lower fibers: Same position as middle fibers, but with arm raised diagonally (in line with scapular plane)

Length Testing

  • Upper fibers: Supine position. Laterally flex the neck to the opposite side while depressing the shoulder to test for tightness

  • Middle/lower fibers: Usually assessed functionally during posture observation or scapular dyskinesia testing

Strengthening and Stretching Exercises

Upper Trapezius Strengthening

  • Position: Standing

  • Procedure: Hold dumbbells in each hand and perform shoulder shrugs

Middle Trapezius Strengthening

  • Position: Prone

  • Procedure: Horizontal abduction with scapular retraction ("T" raises)

Lower Trapezius Strengthening

  • Position: Prone

  • Procedure: Perform "Y" raises by elevating the arms in line with the scapula

Stretching

  • Upper fibers: Side bend the head to one side while depressing the opposite shoulder; hold for 30 seconds

Trigger Points

  • Commonly located in the upper fibers, particularly near the base of the skull and medial border of the scapula

  • Referred pain can manifest as tension headaches, neck pain, and upper shoulder discomfort

Related Injuries and Conditions

  • Muscle strain due to repetitive overhead activity or poor posture

  • Cervicogenic headaches linked to chronic upper trapezius tension

  • Scapular dyskinesis due to weakness in middle and lower fibers

  • Accessory nerve injury leading to trapezius paralysis and scapular winging

FAQs

Q: What causes trapezius muscle tightness?
A: Poor posture, emotional stress, prolonged desk work, and overuse during lifting can all lead to tightness.

Q: How do I relieve trapezius muscle pain?
A: Stretching, trigger point therapy, posture correction, and strengthening exercises help reduce pain.

Q: Is the trapezius involved in neck pain?
A: Yes, especially the upper fibers, which often contribute to tension-type headaches and neck stiffness.

 References

  1. Physiopedia: Trapezius Muscle

  2. Kenhub: Trapezius—Anatomy and Function

  3. NCBI - Trapezius Muscle Anatomy

  4. TeachMeAnatomy: Trapezius Muscle

  5. Cleveland Clinic: Neck and Shoulder Muscles


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