The rhomboid major inserts along the medial scapular border at the shoulder level, providing scapular retraction and medial rotation. Its scapular insertion is the site addressed in rhomboid trigger point therapy and in scapular winging assessment at the medial border.
| Origin | Spinous processes of T2-T5 (in Chest region) |
|---|---|
| Insertion | Medial border of the scapula between the scapular spine and inferior angle |
| Nerve Supply | Dorsal scapular nerve (C4, C5) |
| Blood Supply | Dorsal scapular artery |
| Actions | Retracts (adducts) the scapula toward the spine; Medially rotates the scapula — depresses the glenoid |
|---|
Rhomboid major insertion tenderness at the medial scapular border is a common cause of interscapular pain, reproduced by scapular protraction stretching. The insertion is the site of dry needling in myofascial pain syndrome. In total scapulectomy, the rhomboid major must be detached from the medial scapular border as a key surgical step. Rhomboid major function is tested by resisted scapular retraction against a wall.
Palpable along the medial scapular border during resisted scapular retraction, especially between the scapular spine and inferior angle.
Acute rhomboid major avulsion from the medial scapular border from forceful protraction producing medial scapular pain and weakness of retraction, managed conservatively or with repair in complete avulsions.
