How Strength Training Can Help Relieve Trapezius Knots and Tension Headaches
If you've ever experienced persistent tightness in your neck and shoulders, or headaches that seem to start at the base of your skull and travel up into your head, you know how frustrating recurring muscle tension can be.
These symptoms are common, particularly among people who spend long hours sitting, working at computers, and/or managing chronic stress.
While massage therapy, stretching, and relaxation techniques can help manage discomfort, one often-overlooked strategy is strength training. And its benefits go well beyond building stronger muscles.
Regular exercise can also influence how your nervous system processes pain, improve your tolerance for physical activity, and help you feel more comfortable and confident in your body.
Understanding the Role of the Trapezius
The trapezius is a large, superficial muscle that spans the upper back, neck, and shoulders. It plays an important role in moving and stabilizing the shoulder blades, supporting the arms, and assisting with movements of the neck.
The upper trapezius is a common area of muscular tenderness and tension. Stress, prolonged positions, repetitive activities, and physical demands can all contribute to discomfort in this region.
You may also experience sensitive areas commonly called “knots” or trigger points. These tender spots can sometimes produce referred pain, meaning discomfort is felt somewhere other than the area being pressed.
Although neck and shoulder tenderness can accompany tension-type headaches, headaches have multiple possible causes. Not every headache originates in the trapezius, and muscular tension isn't always the primary problem.
Why Strength Training Helps
Strength training does more than increase muscle size. It improves strength, endurance, coordination, and our ability to tolerate the physical demands of everyday life. Perhaps most importantly, regular exercise can also help change how we experience pain.
1. Improves Muscular Strength and Endurance
Our neck, shoulders, and upper back work throughout the day, whether we're sitting at a computer, carrying groceries, or holding our arms in front of us. When these muscles lack the strength or endurance required for our daily activities, certain tasks may feel more physically demanding.
Strength training helps build the capacity to perform these activities with less effort and potentially less discomfort. The goal isn't to achieve perfect posture or force certain muscles to stop working. It's to develop a stronger, more adaptable musculoskeletal system.
2. Supports Healthy Movement and Coordination
The trapezius doesn't work alone. It coordinates with the serratus anterior, rhomboids, rotator cuff, and other muscles to move and stabilize the shoulder blades.
Strengthening these muscles can improve movement control and expand the range of activities your shoulders can comfortably perform. Exercises such as rows, reverse flys, and overhead presses challenge different muscles of the upper back and shoulders. Rather than trying to eliminate the involvement of your upper traps, the goal is to help the entire shoulder complex become stronger and more capable.
3. Helps Modulate Pain Sensitivity
This is one of my favorite benefits of exercise, both professionally and personally.
Pain isn't simply a measurement of what's happening in our muscles and joints. It's a complex experience influenced by the nervous system, stress, sleep, previous experiences, and many other factors.
Regular physical activity can influence how we experience pain, sometimes reducing pain sensitivity and improving our ability to tolerate movement. Researchers sometimes refer to a temporary reduction in pain sensitivity following exercise as exercise-induced hypoalgesia.
This response varies from person to person, and not everyone experiences immediate relief. But it helps explain why movement can sometimes make us feel better long before we've developed measurable increases in strength.
4. Supports Nervous System Regulation
Stress and pain often influence one another. When we're under prolonged stress, we may notice increased muscle guarding, changes in breathing, disrupted sleep, or greater sensitivity to sensations that normally wouldn't bother us.
Regular exercise can support stress management, improve sleep quality, and help regulate our physiological responses to stress. Strength training also gives us opportunities to experience physical effort in a controlled, manageable way. Over time, becoming more comfortable with movement may help reduce the fear that sometimes accompanies recurring pain.
5. Builds Long-Term Physical Resilience
A stronger body is generally better prepared to handle physical demands. Whether you're lifting something overhead, carrying a backpack, working at a desk, or enjoying recreational activities, improving strength and endurance can make everyday movement feel easier.
Strength training isn't a guarantee against future headaches or muscle tension. However, it can be an important part of a broader approach to managing recurring discomfort and maintaining physical function.
A Little Movement Can Make a Big Difference
I've noticed something interesting in my own life. When I start experiencing more neck and shoulder pain or tension headaches, it's often a sign that I've been neglecting my own exercise routine.
And while I know that Rome wasn't built in a day, I also know that I don't have to wait weeks to start feeling the benefits of getting back into the gym.
Frequently, even one 30-minute workout leaves me feeling noticeably better. Sometimes a lot better!
That doesn't mean I've suddenly corrected a muscle imbalance or built significant strength in half an hour. But movement can have more immediate effects on how we experience pain, including changes in pain sensitivity, mood, and stress.
Building strength takes time and consistency, but feeling better doesn't always have to. Sometimes the most important step is simply getting moving again.
Don't Be Afraid to Strengthen Your Trapezius
One misconception I frequently encounter is that people with tight upper trapezius muscles should avoid exercises that activate them. But your trapezius isn't the enemy!
It's a powerful, hardworking muscle that plays an essential role in healthy shoulder movement. Exercises such as overhead presses can help develop strength and coordination throughout the shoulders and upper back. They also challenge the trapezius to help the shoulder blades rotate upward as the arms move overhead.
The goal isn't necessarily to avoid loading these muscles. It's to find exercises and resistance levels that allow them to become stronger without consistently aggravating symptoms. Heavier isn't automatically better.
A muscle can feel tight, tender, and overworked without necessarily being too strong. Sometimes what that muscle needs is an opportunity to gradually become stronger and better prepared for the demands placed upon it.
Your Upper Traps Might Be a Lot Like My Australian Shepherd
I have a miniature Australian Shepherd named Roxie. If you know anything about Australian Shepherds, you know they're working dogs. They're bred to herd, solve problems, and stay busy.
For a long time, Roxie was primarily a house pet. She had plenty of love and attention, but she wasn't getting the kind of structured physical and mental work her breed thrives on. And you know what? She had a hard time settling down!
Once we started taking her to classes and agility training, something interesting happened. Having dedicated periods of physical and mental work actually helped her relax more effectively at home.
She had opportunities to work, followed by opportunities to rest.
I sometimes think of our upper trapezius muscles in a similar way.
These are hardworking muscles. They help support and move our shoulders, stabilize our shoulder blades, and participate in countless activities throughout the day.
But many of us spend hours asking them to perform relatively low-level tasks without giving them much opportunity to experience more challenging, purposeful movement.
And when those muscles become tender or uncomfortable, our instinct is often to stretch them, massage them, or try to get them to stop working.
But what if, instead of always trying to convince our upper traps to relax, we gave them opportunities to get stronger?
Much like Roxie benefits from having structured periods of activity and recovery, our muscles benefit from appropriate physical challenges followed by adequate rest.
Of course, muscles don't have minds of their own, and strength training doesn't literally teach them when to switch off. But it does help improve their capacity to handle physical demands, while regular exercise can also influence how our nervous system experiences pain and tension.
Sometimes the answer isn't less activity. It's finding the right balance between meaningful work and recovery.
And if Roxie has taught me anything, it's that being asked to do a little more work can sometimes make relaxing a whole lot easier.
Strength Training Tips for Trapezius Tension
Start light and progress gradually. Give your muscles and nervous system time to adapt to new demands.
Strengthen the upper back and shoulders. Rows, reverse flys, and supported pulling exercises can develop strength and endurance.
Include neck and trunk strengthening. Building strength throughout the body supports everyday activities.
Don't be afraid to strengthen your upper traps. Shrugs and overhead exercises aren't inherently harmful, although you may need to modify them based on symptoms.
Prioritize comfortable, controlled movement. There isn't one perfect posture or movement pattern everyone needs to achieve.
Be consistent. A manageable routine performed regularly is often more useful than an intense workout followed by days of inactivity.
Some temporary muscle soreness is normal when beginning a new exercise program. However, exercise shouldn't consistently provoke significant headaches or worsening symptoms. If it does, modify your routine and seek guidance from a qualified healthcare professional.
One Exercise I Wouldn't Recommend Starting With: Lateral Raises
If you're new to strength training and already dealing with neck and shoulder tension, there's one exercise I would encourage you to hold off on initially: lateral raises.
You know the exercise. Hold a dumbbell in each hand and lift your arms out to the sides until they reach approximately shoulder height. Looks simple enough, right? Not necessarily!
In my massage therapy practice, I've worked with many clients experiencing pain where the neck meets the shoulders, sometimes accompanied by headaches, who tell me they've been prescribed lateral raises as part of their exercise routine. Unfortunately, some report feeling even more uncomfortable afterward.
When I ask them to demonstrate the exercise, I frequently notice that they're struggling to control the movement, using more weight than they can comfortably manage, or lifting their shoulders toward their ears as they raise their arms.
And here's the thing: even with good technique, lateral raises can be surprisingly challenging.
The exercise requires coordinated movement of the shoulder joint and shoulder blade, along with enough strength and control to manage the weight. For someone already experiencing neck and shoulder discomfort, lateral raises may not be the most approachable place to begin.
That doesn't mean lateral raises are bad exercises, or that your upper trapezius shouldn't be working during them. Your trapezius plays an important role in healthy shoulder movement, including natural upward rotation and elevation of the shoulder blade.
My recommendation? Start with exercises you can perform comfortably and confidently, such as light rows or supported upper-back strengthening movements. Build strength and coordination gradually before introducing more challenging shoulder exercises.
If your physical therapist has prescribed lateral raises, let them know if the exercise is aggravating your symptoms. They can assess your technique and adjust the weight, range of motion, or exercise to suit your needs.
What Does the Research Say?
Research suggests that strengthening the neck and shoulders can help people experiencing chronic headaches, sometimes providing greater benefits than stretching alone.
In a 2010 randomized controlled trial involving 180 women with chronic neck pain, researchers reported that headache severity decreased by 69% in the strength-training group, compared with 58% in the endurance-training group and 37% in the stretching group after 12 months. The strengthening group also performed stretching, so this wasn't a comparison of strengthening alone versus stretching alone. [1]
A 2023 randomized controlled trial involving 40 people with chronic tension-type headaches found that a 12-week exercise program reduced headache intensity and duration. Participants also demonstrated changes in deep cervical muscle measurements and pressure sensitivity in areas including the upper trapezius and temporalis. [2]
Another 2023 trial involving 116 women with chronic headaches found that a progressive neck-and-shoulder exercise program reduced headache frequency from approximately 4.5 days per week to 2.4 days per week over six months. [3]
A 2025 systematic review and meta-analysis examining physiotherapy approaches for chronic tension-type headaches reported encouraging findings for strengthening and relaxation-based interventions. However, the certainty of evidence was limited, and additional high-quality research is needed. [4]
These studies involve different headache populations and exercise programs, so the results aren't a guarantee that strengthening will relieve every headache. But they support an important point: if your neck and shoulders frequently feel tight or painful, strengthening them may be every bit as important as stretching or massaging them.
How Massage Therapy and Strength Training Work Together
Massage therapy and exercise don't have to be competing approaches to managing discomfort. Massage can provide temporary relief from muscular tenderness, support relaxation, and help people feel more comfortable in their bodies.
Strength training offers different benefits by improving physical capacity, building confidence in movement, and potentially influencing pain sensitivity over time. I think of these approaches as complementary tools.
Massage may help you feel better today, while regular movement and strengthening can help you develop the capacity to feel and function better over the long term. Neither approach needs to do all the work on its own.
The Bottom Line
Strength training isn't only about building muscle. It's also about developing a body that feels capable, adaptable, and more comfortable with movement.
If you're dealing with recurring trapezius tension or tension-type headaches, incorporating regular strengthening exercises may be a valuable addition to your wellness routine.
The goal isn't to achieve perfect posture, eliminate every muscle knot, or avoid using certain muscles. It's to build strength, improve your relationship with movement, and give your nervous system more opportunities to experience physical activity without unnecessary discomfort.
As both a licensed massage therapist and Pilates instructor, I believe some of the most valuable things we can do for our bodies happen outside the treatment room.
Movement is one of the tools we have to help manage pain, and building strength can be an important part of that process.
References
[1] Ylinen, J., et al. (2010). Effect of neck exercises on cervicogenic headache: A randomized controlled trial. Journal of Rehabilitation Medicine, 42, 344–349. https://doi.org/10.2340/16501977-0527
[2] Martín-Vera, D., et al. (2023). Efficacy of a strength-based exercise program in patients with chronic tension type headache: A randomized controlled trial. Frontiers in Neurology, 14. https://doi.org/10.3389/fneur.2023.1256303
[3] Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial. (2023). https://pubmed.ncbi.nlm.nih.gov/37097883/
[4] Onan, D., et al. (2025). The efficacy of physiotherapy approaches in chronic tension-type headache: A systematic review and meta-analysis. Journal of Oral & Facial Pain and Headache, 39(1), 34–48. https://doi.org/10.22514/jofph.2025.003
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Laura Gehant, LMT
lauragehant.com