Rhomboids

The rhomboid muscles are two flat muscles on each side of your upper back, lying between the spine and the inner edge of the shoulder blade. There is a larger rhomboid major and a smaller rhomboid minor, and together they pull the shoulder blade back and help hold it steady (Farrell & Kiel, 2023).

Where are the rhomboid muscles?

• Rhomboid minor starts on the spinous processes of the last neck vertebra and the first thoracic vertebra (C7 and T1). It attaches to the inner edge of the shoulder blade, level with the bony ridge across its back.
• Rhomboid major starts on the spinous processes of T2 to T5 and attaches lower down the same edge, between that ridge and the bottom corner of the shoulder blade.

(TeachMeAnatomy)

Both are supplied by the dorsal scapular nerve and the dorsal scapular artery (Farrell & Kiel, 2023). They sit over the upper thoracic spine, in the same superficial group of back muscles as the trapezius and the levator scapulae (TeachMeAnatomy).

What do the rhomboids do?

They retract the shoulder blade, drawing it back towards the spine, and rotate it (TeachMeAnatomy). The middle fibres of the trapezius share the job of pulling the shoulder blades back (Kenhub). The rhomboids also help keep the shoulder blade and shoulder girdle stable during arm movements (Farrell & Kiel, 2023).

On the front of the chest, the pectoralis minor does roughly the opposite, drawing the shoulder blade forwards and down against the chest wall (TeachMeAnatomy).

Surgery on the rhomboids is rare, and the conditions linked to them in medical references are rhomboid palsy and a “winged” shoulder blade (Farrell & Kiel, 2023).

Is pain between the shoulder blades from the rhomboids?

Sometimes, but not always, and this is the most useful thing to know about this part of the back. Pain between the shoulder blades often gets blamed on the rhomboids, yet several other structures can send pain to the same place:

• The neck. In 50 people having surgery for a single compressed nerve root in the neck, pain between the shoulder blades was most often linked with the C7 or C8 root. In 70% of them, the neck or shoulder blade pain came before any symptoms in the arm or fingers (Tanaka et al., 2006).
• The upper back itself. Pain in the thoracic spine is common in the general population and is linked with other musculoskeletal pain, posture, and psychological and lifestyle factors (Briggs et al., 2009).
• The nerve to the rhomboids. Entrapment of the dorsal scapular nerve is uncommon, but it can cause pain along the inner edge of the shoulder blade and weakness of the rhomboids, and it is easily mistaken for neck or shoulder problems (Afshar et al., 2026).
• The chest. The NHS lists chest pain with back pain as a reason to call 999 (NHS).

If your pain is a dull ache that builds through the working day, the full guide to pain between the shoulder blades goes through the common causes.

Does a rounded posture strain the rhomboids?

A rounded upper back does change where the shoulder blades sit. In 50 people without shoulder problems, the group with a shorter pectoralis minor differed from the group with a longer one in how rounded the upper back was and how far the shoulder blades turned inwards (Borstad, 2006). That shows a link between posture and shoulder blade position. It does not show that the posture overloads the rhomboids or causes pain, and Borstad himself noted that a direct link between posture and shoulder problems had been theorised but not supported by evidence. Physiotherapy researchers have made the wider point that the common belief that pain comes from sitting or standing “incorrectly” lacks strong evidence (Slater et al., 2019).

If you are curious about your own upper back, the wall posture test is a simple self-check.

When should you see a doctor?

The NHS advises seeing a GP if back pain is coming from the top of your back, between your shoulders, rather than your lower back. Also see a GP if it is worse at night or doesn’t improve with rest, comes with weight loss you can’t explain, or hasn’t improved after a few weeks (NHS). Call 999 if back pain comes with chest pain, or if chest pain spreads to your arms, neck or jaw (NHS). Pins and needles or a cold arm alongside neck or upper back pain should be checked too (NHS).

Stretches and mobility work for the area between the shoulder blades are part of Bavelu’s upper back sessions, designed and filmed by physiotherapists.