Traditional Chinese medicine musculoskeletal trapezius muscles.
1. Overview of trapezius muscles.
The trapezius muscles are located under the skin of the neck and back, with a triangular shape on one side and an oblique shape on the left and right sides; The trapezius muscle, the most superficial muscle in the back, covers a wide, kite-shaped area that extends laterally from the base of the skull --- across the shoulder blades and then overlaps with the upper latissimus dorsi muscle at the spine. The trapezius muscle has three fibers in different directions, including the upper fiber, the middle fiber, and the lower fiber, which connects the shoulder girdle bone to the skull base and vertebrae, and acts as a suspension of the shoulder girdle bone. It is the largest and most functionally susceptible to disease, but it is also the easiest to treat a muscle.
2. Trapezius position.
Starting point: external occipital carina, superior cervical line, cervical ligament, all thoracic vertebrae spinous processes.
Insertion point: superior bundle fibers - lateral clavicle 1 3 and acromion; The middle and lower bundle fibers - the upper lip of the scapular spines and the trapezius muscle at the tip of the neck and back are located in the subcutaneous part of the neck, one side is triangular, and the left and right sides are oblique. It originates from the external occipital carina, the superior neckly line, the ligament, the 7 cervical vertebrae, and the spinous processes of all thoracic vertebrae. The fibers are divided into three parts: upper, middle, and inferior, which terminate at the lateral clavicle1 3, the scapula, and the acromion, respectively.
3. Trapezius innervation and blood supply.
The trapezius muscle consists of the 11th cranial nerve accessory nerve and the 11th pair.
3. Anterior branch innervation of the 4th cervical nerve; predominantly the transverse carotid artery, with some small minor arteries; Venous blood from the trapezius muscle, which returns to the external jugular vein and subclavian vein, mainly through the transverse jugular vein and suprascapular vein.
Fourth, trapezius function.
When near fixation, the convergence of the upper fibers causes the scapula to be raised, rotated, and retracted; The middle fibers contract, causing the scapula to retract and rotate upward; The lower fibers contract, causing the scapula to descend and rotate upward.
The upper fibers of the trapezius muscle run upwards and work synergistically with the levator scapulae and rhomboids to shrug the shoulders or lift the scapula; Head and neck extension, lateral flexion, and contralateral rotation can also be accomplished. The middle fibers run horizontally. Pull the shoulder blades in synergy with the rhomboid. The lower fibers run downward and descend the scapula. The upper and lower muscle fibers work synergistically to rotate the scapula upward. The whole muscle contraction brings the scapula closer to the spine.
When all trapezius fibers work together, the shoulder blades are pressed against the ribcage and toward the spine, providing strong support during weight bearing and pressing. When the upper limb is not fixed, the different fibers of the trapezius muscle and some other synergistic muscles work together to perform specific movements of the scapula, such as lifting, pulling, or descending the scapula. The function of the trapezius muscles to rotate the scapula upwards during overhead movements helps to maintain the proper position of the fossa and enhances the range of motion of the glenohumeral joint.
5. Adjust and palpate to determine the position by hand.
1.Upper trapezius muscle fibers.
The examinee lies on his or her side, facing the examiner. The examiner places the entire palm of the hand on the outside of the examinee's head and the other hand on her shoulder. The examinee is asked to lift the shoulder and bend the head ipsilaterally against the force of the examiner, and the upper trapezius fibers are displayed on the lateral part of the neck.
2.Central trapezius fibers:
The person being examined lies on his or her side with both shoulders flexed at 90°. The examiner applies pressure on the lateral aspect of the arm above the elbow. The examinee is instructed to abduct the shoulder horizontally to resist the examiner's pressure. The examiner's index finger refers to the central trapezius fibers.
The trapezius muscle attaches to the scapula and spine, the middle trapezius muscle fibers are horizontally attached to the acromion, and the oblique upward attachment is to the posterior border of the scapula and the trapezius tubercle.
At the level of the spine, the central trapezius muscle fibers attach to the spinous processes of the upper five thoracic vertebrae.
3.Lower trapezius fibers.
The examinee lies on his side with his shoulder and elbow flexed at 90°. The examiner presses down on the lateral aspect of the arm above the elbow with one hand and asks the person to abduct the arm horizontally; The examiner's other thumb and index finger pinch the muscle fibers of the lower trapezius muscles on both sides of the examiner from the outside. Note: These upward and lateral oblique muscle fibers gradually continue into a flat fascia that attaches to the medial end of the scapula.
6. Abnormal appearance of non-physical and physical injury of trapezius muscle.
1.Non-physical injury: long-term looking down at the mobile phone, working at the desk, sleeping on one side, the pillow is not appropriate, one side is elongated, the other side is shortened, and the symptoms of stiff neck will appear; Unilateral and bilateral trapezius fatigue causes a dull or tingling sensation in one or both shoulders, upper arms, neck, and upper back, which may spread to the arms; stiffness of the shoulder and back muscles, which reduces the range of motion of the head and shoulders; Trapezius pain may spread to the head, causing headaches or eye strain.
2.Physical injury: (1) Cold stimulation: The trapezius muscle is prone to spasmodic contraction when stimulated by cold air for a long time, and leads to abnormalities in the surrounding structures
As the course of the disease prolongs, the range of pain gradually expands, which can radiate to the radial side of the upper limb on the affected side and involve the middle of the upper arm, causing severe sharp pain if you want to increase the range of motion; Soreness due to turning over and moving the shoulder at night can still point out the pain point in the early stage, but the pain point cannot be accurately pointed out when the pain range expands in the later stage.
When one trapezius muscle is injured, there are symptoms of turning the head to the opposite side and shrugging the shoulder on the same side, weakness or inability; When both trapezius muscles are damaged, "shoulder collapse" occurs in addition to shrugging shoulders, bowing the head, and limited movement of the neck.
If trapezius muscle injury is accompanied by strain on other tissues in the shoulder quilt, resulting in frozen shoulder, there will also be limited movement of the shoulder joint, and in severe cases, the affected limb will not be able to comb hair, wash face, and buckle the belt.
2) Trauma: such as impact injuries, knife cuts and other trauma, which can easily lead to damage to the protective barrier and subcutaneous soft tissues, causing pain, bleeding, redness and swelling.
7. Daily maintenance and conditioning.
1.Avoid long-term bowed work or lifestyle habits;
2.Avoid sleeping on the side for a long time, pay attention to the height of the pillow;
3.Doing more exercises that involve the back will help to maintain it: 1) shrug your shoulders, and make sure your shoulders move up and down when doing this exercise; 2) Neck exercises; 3) upright rowing; 4) moderate push-ups; 5) The best exercise is swimming.
4.If you have abnormal symptoms, you need to massage, warm compress, physiotherapy, etc. in time.
Note: The development of this muscle during the teenage years can prevent and correct hunchback.
By understanding the muscles, we will be able to better grasp the strength and depth of the manual operation, and will also grasp the direction of their muscle fibers, the direction of joint movement and the limit of movement, so as to stretch and improve the tension of the muscles.
Long Xuanteng. February 5, 2024.
Note: References:
1."Basic Theory of Traditional Chinese Medicine" Author: Zhang Anling, Xu Yincong
2.Online article material about muscles and bones.
3."Human Anatomy" People's Medical Publishing House, author: Zhang Yusheng.
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