Rhomboid Major Tendon

tendo musculi rhomboidei majoris

The rhomboid major inserts via a broad, flat tendinous attachment along the medial border of the scapula from the spine of the scapula to the inferior angle, covering the serrated costal surface attachment zone. The muscle transitions to tendon approximately 2-3 cm from the scapular border, with the tendinous fibres fanning out to attach along the full medial border length between the spine and the inferior angle.

Region: Shoulder

Clinical Relevance

Clinical Notes

Rhomboid major tendinopathy at its medial scapular border insertion produces a characteristic deep interscapular aching pain that is reproduced by resisted scapular retraction and is poorly localised. Trigger points within the rhomboid major refer pain medially and to the posterior shoulder. In serratus anterior palsy producing winging, the rhomboid muscles are unopposed and may hypertrophy. The rhomboid major is preserved as a recipient muscle for trapezius reinnervation in accessory nerve palsy reconstructive surgery.

Pathology

Common Injuries & Conditions

Rhomboid Major Strain

Acute strain of the rhomboid major at its medial scapular insertion from sudden scapular protraction forces or repetitive overhead loading produces sharp interscapular pain aggravated by retraction and reaching across the body, managed with relative rest, physiotherapy, and scapular stabilisation exercises.