Episode Summary: Trapezius Myalgia – Understanding Upper Trap Pain and How to Treat It

In this episode of the Rehab Science podcast, Dr. Tom Walters, DPT, breaks down one of the most common sources of neck and shoulder discomfort—trapezius myalgia. Often experienced as persistent tightness or aching in the upper trapezius muscle, this condition affects individuals who spend long periods sitting, working at a computer, or holding static postures under stress.

Dr. Walters discusses the underlying anatomy and biomechanics of the trapezius, highlighting how postural overload, fatigue, and nervous system sensitization contribute to chronic discomfort. He explains why passive strategies like stretching alone may be insufficient, and emphasizes the role of progressive resistance training in improving muscle function and reducing symptoms. The episode concludes with practical movement strategies, rehab principles, and key behavioral tips for lasting relief.

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1. Andersen LL, Jørgensen MB, Blangsted AK, et al. Effect of physical training on pain sensitivity and trapezius muscle morphology in females with trapezius myalgia: randomized controlled trial. J Appl Physiol (1985). 2008;105(4):1128-1134. doi:10.1152/japplphysiol.90391.2008

2. Larsen CM, Hansen M, Hansen EA. Effectiveness of strength training versus stretching exercises for the treatment of trapezius myalgia: a randomized controlled trial. Scand J Work Environ Health. 2013;39(2):143-150. doi:10.5271/sjweh.3320

3. Blangsted AK, Søgaard K, Hansen EA, et al. The effect of physical coordination training on posture, muscle activation, and musculoskeletal symptoms in office workers. Scand J Work Environ Health. 2008;34(1):55-65. doi:10.5271/sjweh.1194

In this episode of the Rehab Science Podcast, Dr. Tom Walters discusses proximal hamstring tendinopathy (PHT), a common condition affecting athletes, particularly runners and lifters. He explains the anatomy, biomechanics, and causes of PHT, emphasizing the importance of understanding the condition as a sensitivity issue rather than inflammation or a tear. The episode covers diagnostic strategies, effective rehabilitation techniques, and treatment options, highlighting the significance of gradual loading and physical therapy in recovery.

Takeaways

Proximal hamstring tendinopathy (PHT) is common among active individuals.
Chronic mechanical overload is a primary cause of PHT.
Symptoms often worsen with activities involving hip flexion and knee extension.
Diagnosis is typically clinical and does not require imaging.
Physical therapy is the cornerstone of PHT treatment.
Gradual resistance training is essential for tendon healing.
Rest alone will not lead to healing of tendinopathies.
Education and movement-based care are crucial for recovery.
PHT can be frustrating but responds well to proper rehab strategies.
Most individuals can return to full activity without surgery.

YouTube Link

Amazon Book Link

Chapters

00:00 Introduction to Proximal Hamstring Tendinopathy
02:55 Understanding the Anatomy and Biomechanics
06:09 Signs, Symptoms, and Diagnosis
08:49 Rehabilitation and Treatment Strategies
15:08 Medical Interventions and Final Thoughts

In this episode of the Rehab Science Podcast, Dr. Tom Walters interviews Dr. John Rusin, a physical therapist and injury prevention specialist. They discuss the concept of pain-free performance, which is a movement system designed to help individuals transition from pain to optimal performance.

Dr. Rusin shares his background in professional athletics and how it shaped his approach to training and rehabilitation. The conversation delves into the importance of individualized training, movement quality, and the six foundational movement patterns. They also explore the significance of movement screens and assessments, the six-phase warm-up sequence, and the structure of Dr. Rusin's new book on pain-free performance.

In this conversation, John Rusin and Tom Walters delve into the intricacies of movement patterns and performance training. They discuss the importance of creating a comprehensive movement program that caters to individual needs, assessing movement patterns for optimal performance, and the significance of a non-dogmatic approach to training. The conversation emphasizes understanding movement quality, spinal neutrality, and the necessity of individualized training to liberate movement and enhance overall performance.

Visit the links below to learn more about John's certification program and his new book:

Pain Free Performance Specialist Certification

Pain Free Performance Book