Trigger points are hyperirritable spots in taut bands of muscle—essentially, areas where muscle fibers have contracted and won't let go. They're painful, they refer sensation to other areas, and they respond well to massage and release techniques.
But if you're returning for treatment every three to four weeks with the same issue, you're treating the smoke, not the fire.
The real question isn't "how do I release this trigger point?" It's "why does this muscle keep developing trigger points in the first place?"

In clinical practice, the same underlying patterns emerge repeatedly in people with interscapular pain. For middle-aged and older adults, these are the primary drivers:

1. Postural Load and Muscle Fatigue
Your rhomboids and mid-trapezius muscles—the ones between your shoulder blades—are working overtime. Their job is to retract your shoulder blades and resist the forward pull of your chest and anterior shoulders.
When you're sitting at a desk, driving, reading on a tablet, or doing any prolonged forward-leaning activity, these muscles are firing constantly just to hold position. Not moving, just holding. For hours.
Eventually, they fatigue. And fatigued muscles develop trigger points.
Here's the kicker: "sitting up straight" often makes it worse if you don't have the muscular endurance to sustain that position. You're asking exhausted muscles to work even harder.

2. The Scapular Stability Problem
Your shoulder blades should glide smoothly across your ribcage during arm movements. When they don't—when they wing out, hike up, or move asymmetrically—other muscles compensate.
Guess which muscles take the load? The ones between your shoulder blades.
This happens when stabilising muscles like your serratus anterior and lower trapezius are weak or aren't activating properly. Your body doesn't just stop moving because these muscles aren't doing their job. It finds another way. And that "other way" usually involves overworking your rhomboids and mid-traps until they're constantly taut and tender.

3. Thoracic Spine Stiffness
Your mid-back (thoracic spine) should move into extension and rotation relatively easily. When it doesn't—when years of sitting have left it stiff and immobile—your body compensates by overusing muscles to create movement that should be coming from your joints.
Those muscles, working beyond their intended role, develop chronic tension. And chronic tension breeds trigger points.

4. The Breathing Connection
This one surprises people, but it's more common than you'd think. If you're a chest breather rather than a diaphragmatic breather, accessory muscles in your neck and upper back stay chronically active. Over time, this creates a baseline of tension that never fully releases.

Remedial massage and trigger point release play an important role in managing interscapular pain. When done skillfully they can reduce pain and improve local blood flow, break the pain-spasm-pain cycle that keeps muscles locked up, and address surrounding muscles that have been compensating.
The techniques are effective and the relief is genuine, however it is also important to address the underlying mechanical problems. If your shoulder blades aren't moving properly and your thoracic spine remains stiff, or your stabilising muscles stay weak the same trigger points will come back.

Research consistently shows that combined approaches—manual therapy plus exercise—produce better long-term outcomes than either intervention alone. A 2022 systematic review on chronic neck and shoulder pain found that programs combining soft tissue release with strengthening and motor control training resulted in sustained pain reduction, while manual therapy alone showed diminishing benefits within weeks.
The solution isn't choosing between massage and exercise. It's using both strategically.
Here's what that looks like in practice:
Phase 1: Release the Tension
When muscles are locked in spasm and loaded with trigger points, trying to strengthen them is like trying to train for a marathon with a stress fracture. You need to address the acute issue first.
Remedial massage and trigger point release create a window of reduced pain and improved tissue quality. This is your foundation—the state from which you can actually start making mechanical changes.
Phase 2: Restore Movement
Once acute tension is reduced, you need to restore mobility where it's been lost—typically in the thoracic spine. This might involve targeted stretching, foam rolling, or mobilisation exercises that gradually return extension and rotation capacity.
Without this step, your body will continue compensating with muscle tension because it has no other movement options available.
Phase 3: Rebuild Capacity
This is where most people stop short—and why pain returns.
You need to:

• Strengthen the stabilising muscles that have been underperforming (serratus anterior, lower trapezius)
• Build postural endurance in the muscles that fatigue under load
• Retrain movement patterns so your shoulder blades move efficiently during daily activities
• Progress load gradually so tissues adapt without becoming overloaded again

This isn't about doing endless rows or squeezing your shoulder blades together. It's about systematic, progressive loading that's specific to your deficits and adjusted as your capacity improves.

Most interscapular pain is mechanical and responds well to the approach outlined above. But some warning signs warrant medical evaluation:

• Pain that's progressively worsening despite treatment
• One-sided pain that's sharp and doesn't fit typical muscle pain patterns
• Pain that increases with deep breathing or coughing
• Radiating pain, numbness, or tingling into your arms
• Night pain that disrupts sleep
• Pain accompanied by unexplained weight loss, fever, or feeling unwell

If you're experiencing any of these, see your GP before beginning treatment.

If you're tired of the cycle of temporary relief and inevitable return, we're here.
Our integrated approach combines remedial massage and exercise physiology to address both the symptoms you're feeling today and the patterns that keep bringing them back.