Rhomboids

Original Editor - Naomi O'Reilly

Lead Editors - Naomi O'Reilly, Ilona Malkauskaite, Kim Jackson and Kai A. Sigel  

Description

The Rhomboids are two muscles - Rhomboid Major & Rhomboid Minor. The two rhomboids lie deep to trapezius to form parallel bands that pass inferolaterally from the vertebrae to the medial border of the scapula. Rhomboid Major is thin and flat and twice as wide as the thicker Rhomboid Minor which lies superior to it. Usually there is a small space between both rhomboid muscles, however in some cases one may find one single blended muscle instead.

Anatomy

Origin & Insertion

	Origin Proximal Attachment	Insertion Distal Attachment
Rhomboid Major	Spinous Processes T2-T5	Medial Border of Scapula from Level of Spine to Inferior Angle
Rhomboid Minor	Nuchal Ligament Spinous Processes C7 & T1	Triangular Area Medial End of Scapular Spine

Rhomboid Major

Nerve Supply

Arising from the anterior ventral ramus of the C5 Root of the Brachial Plexus

Occasionally with additional contribution from the C4 Nerve Root.

• Dorsal Scapular Nerve (C5)

Blood Supply

• Dorsal Scapular Artery

Function

Actions

• Scapular Retraction
• Scapular Elevation
• Scapular Rotation Inferiorly to Depress Glenoid Cavity
• Assist Serratus Anterior to Fix Scapula to Thoracic Wall and Fix Scapula during movements of the upper limb

Trigger Point Referral Pattern

The referral pattern of the Rhomboids is not as widely distributed but local to the muscles. The pain generally extends from the edge of the shoulder blades to the spine. Since the Rhomboids on both sides are almost always affected, this is a primary source of mid back tightness or aching between the shoulder blades.

Techniques

Palpation

Palpated together. Covered by trapezius so need to relax trapezius by placing hand in small of back. Palpate along vertebral border by placing fingers under it. Have patient lift hand off back (with resistance if needed) and the rhomboids push fingers out. 

Treatment

Massage & Myofascial Release

Exercise Prescription

Stretching

Foam Rolling

Taping

References