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Everything You Need to Know About the Rhomboid Tear Test

The day after an intense physical workout is always the worst. No matter how much fun you had, the next 24 to 48 hours are nearly always spent with tired limbs and sore muscles, reminding you of exactly how much your body was pushed to its limits.

Most of the time, these body aches and patches of soreness go away on their own after some rest and a good night’s sleep. However, in some cases, the back pain may persist well after the muscles were first stretched during physical activity. In this case, it may be possible that your rhomboids were torn or sprained leading to continual discomfort. 

To help diagnose the problem, it is best to perform The Rhomboid Tear Test as quickly as possible. This will ensure you get the treatment you need to help your body heal. Read on to find out everything you need to know about The Rhomboid Tear Test before it is too late.

What is a Rhomboid Muscle?

A person flexing his muscles

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The rhomboid muscles, often referred to as simply, “the rhomboids”, are a group of four skeletal muscles situated between the lower neck and upper back. They exist in two parts on either side of the spine, extending to the shoulder blades. Each part consists of two muscles known as the rhomboid major and the rhomboid minor. Together, they form a shape that looks similar to a rhombus, creating a parallelogram without right angles and with adjacent sides of unequal length.

The rhomboids play a significant role in supporting the posture of the upper back as well as in stabilizing the shoulders during physical activity. For example, when pulling a heavy object, or throwing a ball across a large field. 

Rhomboid Minor

The rhomboid minor is situated above the rhomboid major and is the smaller muscle of the two. It is cylindrical in shape and thicker than the rhomboid major.

Rhomboid Major

The rhomboid major is situated below the rhomboid minor and helps to hold the scapula onto the ribcage. It is quadrangular in shape and twice as wide as the rhomboid minor.

Causes of Rhomboid Muscle Tears/ Pain

Diagnosing the root cause behind a rhomboid tear is just as important as finding a Rhomboid pain solution. This will ensure you are able to prevent such an injury from happening in the future as well as possibly unmask any underlying medical conditions.

Physical Activity

The rhomboid muscles are located between the shoulder blades and the spine, which means they are activated during most common activities like walking, sitting, and throwing. If carried out too strongly, they may cause injury.

The following is a list of some of the common physical activities leading to rhomboid tears.

  • Rowing motions using either a machine or boat

  • Walking while carrying a heavy backpack on both or one shoulder

  • Pulling a rope attached to a heavy object

  • Reaching up to grab something heavy off a shelf

  • Making an overhead throw such as when serving in tennis

  • Pushups being done repeatedly and without pause (Read more on pike push-up muscles worked.)

  • Sitting with bad posture for a consecutive period of time

Sometimes you may be experiencing pain in your rhomboids despite having stressed the muscle. If this is the case, it is possible your rhomboid pain is a result of some underlying health condition that magnifies the pain in your joints and muscles.

The following is a list of common medical conditions leading to rhomboid pain.

Underlying Health Conditions

  • Arthritis

  • Rotator cuff tendonitis

  • Myositis

  • Polymyalgia rheumatica

  • Osteoarthritis

How Do I Know If My Rhomboid Is Injured?

Back injuries are not that uncommon, resulting from a wide variety of physical activities. The rhomboid muscles, however, are typically felt in the region near your spine and upper back.

There are some key symptoms which are associated with a rhomboid tear or spasm. The following are indications that your rhomboid may be injured and hence would benefit from a rhomboid tear test as soon as possible.

  • Pain increases when breathing heavily

  • Aching muscles

  • Pins and needles

  • Stiffness in neck

  • Shooting pain going down the back

  • Popping sound when moving shoulder blades

  • Swelling in the upper back near the spine

Step by Step: The Rhomboid Tear Test

Also known as the Rhomboid Strength Test or Rhomboid Manual Muscle Test, this evaluation is performed in order to assess the rhomboid muscle on whether it is performing to its utmost capability.

We will go through step-by-step instructions on how the Rhomboid Tear Test is performed. Whether you are a physical therapist learning about the test or a prospective patient unsure of what to expect, these guidelines on how the Rhomboid Tear Test works will be sure to provide benefit in one way or the other. Check out this similar video on a Rhomboid strength test.

Step 1: Position the Patient

The first step of the Rhomboid Tear Test is to position the patient properly. This is very important, as an incorrect position may result in erroneous test results or even unnecessary pain or discomfort to the patient.

Have the patient lie flat down on his stomach (prone-lying position) on an elevated table or bed. The head of the patient may be turned to either side based on his comfort. 

Make a note of which rhomboid is being tested for tearing/strength. If it is the right rhomboid muscle, have the patient take his right arm and place it behind his body so his hand is in line with his left back pocket. Similarly, if the muscle to be tested is on the left, the left arm will be used and placed in line with the right back pocket. 

The patient should flex his elbow to make sure he maintains this position. 

Step 2: Position the Therapist

Next, the therapist will take his position next to the bed of the patient. He will stand on the side of the bed where the patient is flexing his hand and the rhomboid muscle is being tested.

The therapist will then place one hand just above the elbow of the patient which is being flexed. This is the hand that will be used for giving resistance.

The index finger of the other hand will be used to palpate the medial border of the shoulder blade.

Step 3: Conduct the Test

After palpating, the therapist will place his index finger deep under the edge of the shoulder blade. He will then ask the patient to push his shoulder forward as the therapist’s other hand applies resistance above the elbow. 

The patient will then be asked to lift up his arm which was resting on his back pocket and move it away from his body. He can do this with a few repetitions, moving up and down near and away from the body while the therapist studies the movement of his index finger pressed against the patient’s shoulder blade.

If the rhomboid is normal, meaning without any tear or sign of weakness, the index finger which was pressed onto the shoulder blade will pop out as the arm of the patient is moved.

If the index finger does not pop out, that means the test is positive and the rhomboid being tested may be torn.

For a real-life demo on how the Rhomboid Tear Test is performed, you can watch the following video: Rhomboid Strength Test


How long are you out if you tore your rhomboid?

A rhomboid tear can be severely painful in some cases while causing only mild discomfort in others. This depends on how extreme the injury is as well as the level of pain being experienced.

Someone with a mild rhomboid tear as a result of throwing a serve too forcefully may feel his body improve within just a few days. This is not the same as someone else who may have gotten their rhomboid tear from carrying a heavy backpack for several consecutive hours at a time. In such a case, it may take weeks or even months to fully recover.

Can I still work out with a rhomboid tear?

Often, a rhomboid tear may be the result of working out. You may have been doing an exercise in the wrong position, with too much force, or without properly stretching out your muscles before and after the workout. 

If you are certain that you have a rhomboid tear, it is best to avoid strenuous exercise like weightlifting, competitive swimming, and sports which require you to make more use of your upper body.

Does a torn rhomboid require surgery?

After a rhomboid has been diagnosed with the help of the Rhomboid Tear Test, the treatment for it is most often non-invasive, involving activities like applying ice on the affected muscle, resting while lying down, as well as doing low-impact exercises as part of physical therapy.

In very rare cases, a torn rhomboid requires the use of surgery to surgically reattach the muscle before the healing process can begin.


comment 1 comment

Thomas Allen calendar_today

I am a patient and have read this article about the rhomboid tear test, and I have a meeting with a pain specialist next week.
After reading about the placement of the arm, left in my case, I have very little confidence that I can even be tested in this manner.
Almost any movement causes real pain, and the movement of my arm in that
matter is just not possible.
I have 3 cervical fusions, most recently in December 2022.
Is this a serious issue?
74 year old male in good shape otherwise. Non-smoker or drinker.

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