The inter-scapular region is the area between your two shoulder blades and it's home to two of the most important muscle groups in the upper body: the trapezius and the rhomboids.

The trapezius runs from the base of your neck, across your shoulders, and down to the mid-back. It works in three sections - upper, middle, and lower, lifting and depressing the shoulder blade depending on which part fires. The rhomboids sit underneath, pulling the shoulder blades back toward the spine.

Together these muscles form the shoulder girdle, the foundation that keeps your shoulder blade and shoulder joint stable through every arm movement you make. When they're not working properly, everything attached to them suffers.

Constantly. The shoulder blade itself is a very strong bone, but the muscles, ligaments, and nerves surrounding it are a different story. They're vulnerable to strain from a surprisingly wide range of causes.

I see inter-scapular problems from poor posture, overhead gym work, repetitive tasks like painting overhead, cervical disc injuries, facet and rib joint strains, and even vertebral compression fractures. The list is long because so many things feed into this region.

What I'd also stress is this: any shoulder joint injury, without exception, needs the inter-scapular region assessed and included in the treatment plan. You can't rehabilitate a shoulder properly without addressing what the shoulder blade is doing.

The signs are usually pretty recognisable once you know what you're looking for:

• Pain or tenderness around the shoulder blade - particularly along the top and the inner border closest to the spine
  
• Weakness in the arm on the affected side
  
• The arm feeling tired or 'dead' when you try to use it, even without much effort
  
• The arm fatiguing quickly with repetitive movements, especially anything overhead
  

If several of those sound familiar, the inter-scapular region is a good place to start looking, but get a proper assessment to rule out referred pain from the neck or thoracic spine, since those can feel almost identical.

Quite a few - which is exactly why this area needs a proper diagnosis before you start treating it. Pain between the shoulder blades is often secondary, meaning the source is somewhere else and it's referring into this region.

Neck problems, thoracic spine issues, and shoulder joint conditions can all generate pain that radiates into the inter-scapular area. Cervical disc disease is a common one - it can refer pain between the shoulder blades and also down the arm, which is why what feels like a tight upper back sometimes turns out to be a neck issue. Don't assume the pain is coming from where you feel it.

First, get an accurate diagnosis. This region has too many potential sources of pain to start treating it without knowing what you're actually dealing with. A physiotherapist or musculoskeletal specialist can sort that out quickly.

Once you know what you're working with, a typical management program covers four things:

• Thoracic mobility - a stiff upper back locks the shoulder blade into a poor position. A Posture Pro roller is the tool for this
  
• Lat flexibility - tight lats pull the shoulder blade down and forward. Stretch them out with a Stretchband
  
• Trapezius and rhomboid strength - these muscles need to be able to hold the shoulder blade stable under load. Powerbands are ideal for the resistance work
  
• Core stability - the foundation everything else sits on. Posture Pro Dome exercises build that deeper support
  

Do all four consistently and you're not just getting rid of the tightness, you're removing the reason it keeps coming back.