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The trapezius is a large, flat, superficial muscle that supports the upper body and helps to keep the spine straight when standing. It is divided into three parts: descending (superior), ascending (inferior), and middle. The muscle is involved in scapulohumeral rhythm and head balance through muscular control of the cervical spine. Tearing or straining the trapezius can cause symptoms such as pain, stiffness, decreased muscle strength, and decreased range of motion in the neck and shoulders. Testing the trapezius muscle typically involves manual muscle tests (MMTs) to assess the amount of force the muscle can produce and evaluate its strength and function. These tests are often performed by a licensed professional such as a chiropractor or physical therapist.
Testing the Trapezius Muscle
| Characteristics | Values |
|---|---|
| Muscle Composition | 3 parts: descending (superior), ascending (inferior), and middle |
| Muscle Function | Supports the upper body, stabilizes the neck, and stabilizes the shoulder blade during arm movements |
| Muscle Action | Shoulder girdle elevation on a fixed cervical spine |
| Muscle Testing | Manual Muscle Tests (MMTs) for Upper, Middle, and Lower Trapezius Regions (UTR, MTR, LTR) |
| Upper Trapezius Test | Elevate the shoulder with the arm abducted or resist shoulder abduction and head side flexion |
| Middle Trapezius Test | Patient in prone position with arm abducted to 90° and externally rotated, then apply resistance to horizontal extension |
| Lower Trapezius Test | Patient in prone lying position with arm abducted to 120° and shoulder externally rotated, apply resistance to diagonal extension |
| Symptoms of Tear | Pain, burning, stiffness, decreased muscle strength, decreased range of motion (in neck and shoulders), headaches |
| Treatment | Kinesiology tape for upper trapezius strain, heat, stretch, or massage (check with a doctor first) |
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What You'll Learn
Manual muscle tests (MMTs)
MMTs for the trapezius muscle are complex, as the muscle is often described as comprising three regions: the upper trapezius region (UTR), the middle trapezius region (MTR), and the lower trapezius region (LTR), each with distinct mechanical actions. Individual MMTs are used to selectively test each of these three regions. The MMTs for each region are assumed to preferentially recruit the corresponding muscle fibres and produce a maximal contraction; however, whether this is true is unknown.
A new MMT that assesses the whole trapezius in its role as an upward scapular rotator was found to be reliable and valid. This new trapezius MMT showed a very high maximal voluntary isometric contraction (MVIC) for the upper trapezius muscle and a high MVIC for the mid trapezius muscle. The LT-MVIC appeared to produce the greatest excitation of all trapezius regions.
MMTs are typically performed by a licensed professional such as a chiropractor or physical therapist who would be able to accurately assess your strength and function during these movements.
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Upper trapezius muscle test
The trapezius muscle is a large, trapezoid-shaped muscle that spans a large width of the upper back, starting at the base of the neck and extending across the shoulders to the middle of the back. The upper trapezius muscle test is performed to evaluate the strength and function of the muscle.
The patient is seated and asked to place their hands together over their head and maintain this posture. The examiner stands behind the patient and pushes the elbows forward, looking for the contraction of the three parts of the trapezius. The upper trapezius muscle can also be tested by elevating the shoulder with the arm slightly abducted or simultaneously resisting shoulder abduction and head side flexion. If the shoulder is elevated with the arm by the side, the levator scapulae and rhomboids are likely to be involved.
Symptoms of Upper Trapezius Issues:
Some symptoms of upper trapezius injuries or issues include limited mobility, decreased range of motion, and muscle weakness (difficulty shrugging the shoulders or raising the arm). Other symptoms may include neck and shoulder stiffness, swelling, bruising, or tenderness in the shoulders, neck, or back.
Treatment for Upper Trapezius Issues:
If you are experiencing issues with your upper trapezius muscle, it is recommended to consult a medical professional or a physiotherapist for a proper diagnosis and treatment plan. Treatment may include rest, ice, and anti-inflammatory medications to reduce any pain and inflammation. Physical therapy or specific exercises may also be recommended to improve strength, flexibility, and range of motion in the affected area.
It is important to note that this information is not a substitute for professional medical advice, and it is always advisable to seek the guidance of a healthcare provider for personalized recommendations.
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Middle trapezius muscle test
The trapezius is a large, trapezoid-shaped muscle located at the posterior aspect of the neck and trunk. Manual muscle tests (MMTs) are often used to assess the amount of force a given muscle can produce when evaluating the musculoskeletal system. The trapezius muscle is usually described as comprising three regions: the upper trapezius region (UTR), the middle trapezius region (MTR), and the lower trapezius region (LTR). Each of these regions has distinct mechanical actions.
The MTR contributes to scapular stabilization and retraction. To test the middle trapezius muscle, the patient should be in a prone position with the arm abducted to 90° and externally rotated. Resistance is then applied to the horizontal extension of the arm, while the examiner watches for retraction of the scapula and feels for the contractions. If scapular protraction occurs, it indicates weakness in the middle fibres of the trapezius.
Maximal voluntary isometric contractions (MVICs) can also be used to assess the middle trapezius. In a study, participants performed three repetitions of the MT-MVIC, where they were placed in the appropriate position and instructed to meet the manual force applied by the clinician for approximately five seconds. This allowed examiners to subjectively evaluate the patient's response in terms of strength and fatigue resistance.
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Lower trapezius muscle test
The trapezius muscle is a broad, flat, superficial muscle that spans a substantial area of the upper back and neck. It is divided into three parts: descending (superior), ascending (inferior), and middle. The lower trapezius is located in the lowest part of the trapezius muscle, extending down the spine from the lower scapula to the middle of the back.
The lower trapezius is responsible for several important functions, including scapular depression, upward rotation, and postural support. It assists in pulling the shoulder blades downward and works with the middle trapezius to draw the shoulder blades together toward the midline of the body. This can be observed during rowing movements. The lower trapezius also assists in upwardly rotating the scapula, which is essential for lifting the arm above the head. Additionally, it helps to maintain correct posture by supporting the shoulder blades in their proper position.
To test the lower trapezius muscle, one can perform a trapezius tear test. This involves having someone place their hands with firm pressure on your shoulders and trying to shrug. It is important to check for a balance of strength and any discomfort during this movement. These manual muscle tests are typically performed by licensed professionals such as chiropractors or physical therapists who can accurately assess strength and function. Any pain or weakness with resistance may indicate an issue that requires further medical attention.
Another way to test and strengthen the lower trapezius muscle is through specific exercises. One example is the cable Y exercise, which helps to isolate the lower trapezius by eliminating assistance from the hip muscles. To perform this exercise, sit on a seated cable row machine or pull a bench up to a cable pulley machine and attach two handles. Cross the handles to keep them close together during the movement. Engage your core to sit up straight with your palms facing down and your feet shoulder-width apart on the floor. Exhale and raise both hands above you until your biceps are in line with your ears. Focus on pulling your shoulder blades down and back. Hold this position for one count, then inhale and slowly lower the cables back to the starting position. Aim for 8 repetitions in 3 sets.
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Signs of a trapezius tear
The trapezius muscle is a large muscle that spans the upper back, shoulders, and neck. It is responsible for moving, rotating, and stabilising the shoulder blade and extending the head at the neck. A trapezius tear can cause pain, burning, stiffness, decreased muscle strength, and decreased range of motion in the neck and shoulders. Headaches can also occur as referred pain.
While a trapezius strain may only sideline you for a few weeks, a more serious muscle tear could limit the use of a shoulder or arm for months. A trapezius tear will likely cause severe pain and tenderness. There may also be a bruise, swelling, and discolouration. This is a serious injury that causes a complete loss of muscle function. You may notice an obvious dent or gap under the skin where the muscle has split.
Manual muscle tests can be performed by a licensed professional such as a chiropractor or physical therapist to assess strength and function during certain movements. These tests involve applying resistance to check for a balance of strength and any discomfort. However, it is important to note that a proper diagnosis may require a medical perspective.
If you are experiencing pain in your back, neck, or the back of your head that lasts for more than a week, it is recommended to visit a healthcare provider. Treatment for a trapezius strain may include rest, ice, and physical therapy. In some cases, surgery or injections may be required to alleviate symptoms.
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Frequently asked questions
The trapezius is a large, flat, superficial muscle that extends from the cervical to thoracic region on the posterior aspect of the neck and trunk. It is divided into three parts: descending (superior), ascending (inferior), and middle.
The trapezius muscle supports our upper bodies and helps to keep our spines straight when standing. It also stabilises the neck and the shoulder blade during arm movements.
A trapezius tear test is typically performed by a licensed professional such as a chiropractor or physical therapist. They will be able to accurately assess your strength and function during these movements. However, a simple test you can do at home is to have someone place their hands with firm pressure on your shoulders and try to shrug. Check for a balance of strength and any discomfort while doing so.
Tearing your trapezius muscle will likely cause pain, burning, stiffness, decreased muscle strength, and decreased range of motion (in the neck and shoulders). Headaches can also occur as referred pain.
