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Latissimus Dorsi Muscle: Shoulder, Arm, Low Abdominal, Pain

Latissimus Dorsi Pain

The latissimus dorsi - also known as the lats- is a large wide muscle that covers the lower half of the back, side of the ribcage and tip of the shoulder blade. The muscle narrows going up the side of the body to connect to the upper arm.

The trigger points in the muscle cause and contribute to pain in the middle and lower back, front of the shoulder, and pain that runs down the inside of the arm through the elbow, wrist, and into the hand into the little finger.

Pain caused by a muscle strain is more localized to the area of the strain. Much of the muscle may be sore, but there will be an area that is exceptionally more tender where the muscle fibers have torn.

Where is the latissimus dorsi muscle?

The latissimus dorsi attaches to the middle back vertebrae (T7-T12), the 9th-12th ribs, the hip bone (iliac crest), and the shoulder blade (scapula) to the upper arm (bicipital groove of the humerus).

 

What movements does the latissimus muscle control?

Primary Actions:

  • Pulls arm down when the arm is lifted above the head
  • Moves arm into toward the body and across the body
  • Moves arm back down to the side of the body when the arm is lifted out to the side
  • Pulls arm back down toward the body when the arm is lifted out in front of the body
  • Twists arm inward toward the body

Assists with these actions:

  • Bending and straightening of the trunk
  • Side bending at the waist
  • Breathing
  • Tilting hips forward, back, and side to side
Latissimus Dorsi Muscle

The  Latissimus Dorsi Anatomy page has origin, insertion, innervation, and blood supply information. Muscle actions are listed along with agonists and antagonists for each muscle movement.

Latissimus Dorsi Pain: Trigger Point Pain vs Muscle Strain

Trigger points (TrP) in the latissimus dorsi can cause pain throughout the upper body. The most common pain is felt toward the bottom of the shoulder blade that angles over to the spine. This will cause stiffness and pain when lifting the arm above shoulder level.

Trigger points can refer pain to the front of the shoulder and down the arm. This pain is often diagnosed as cubital tunnel syndrome.

Latissimus muscle strains are not common outside athletics and those who exercise. However, if it happens you will feel it immediately. If the strain occurs in the back you will feel a pulling sensation or a mild to moderate cramp.

If you strain the muscle or tendon connection into the arm you may feel a pulling, tearing, or popping sensation. Depending on the severity of the strain you may find it difficult or impossible to pull your arm back behind your shoulder and lift your arm.

Latissimus Dorsi Trigger Points Signs and Symptoms

  • Pain is felt in the mid-back especially below the bottom of the shoulder blade.
  • Pain is felt in the front of the shoulder.
  • Pain in the side and or mid-back similar to a side stitch.
  • Numbness, tingling and/or aching that extends down the arm to the little finger and often the ring finger.
  • Pain while reaching forward with the arms
  • Pain when lifting arms overhead
  • It can contribute to breathing difficulty.
  • Pain does not worsen with activity nor does it ease at rest, it is steady and constant.

What Activities Contribute To Trigger Points In The Latissimus Dorsi?

  • Activities that require continuously or repeatedly raising the shoulders
  • Gymnastics
  • Rowing
  • Throwing or pitching a ball
  • Swimming
  • Swinging a baseball bat
  • Swinging a tennis racket
  • Shoveling dirt or snow
  • Chopping wood
  • Exercise that requires pulling up (chin up) or pushing down (push-ups) with the arms
  • Reaching forward or overhead repetitiously

Trigger points often develop after an injury to the muscle.

How To Avoid Development of Trigger Points In The Latissimus Dorsi Muscle

  • Take a few minutes to warm-up and do some simple stretches before sports and strenuous repetitive movements
  • Don't do chin-ups, push-ups, or other shoulder stressing exercises to the point of exhaustion
  • Take breaks when doing repetitive motions like shoveling snow or raking leaves

Latissimus Dorsi Trigger Point Treatment

Latissimus dorsi trigger points are fairly easy to treat. You can find a physical therapist, massage therapist, or chiropractor trained in trigger point therapy to show you how to find and how to treat them.

You can also learn how to treat TrPs. The Trigger Point Therapy Workbook is an excellent resource to learn self-treatment. The book explains trigger points and includes diagrams showing where the trigger points are likely located as well as how to treat each area. With a little time and patience, you can learn how to locate and treat trigger points throughout your body.

If you use the workbook you will want to buy the Thera Cane Massager. The Thera Cane allows you to treat hard to reach areas like your back or bottom of your feet.

For trigger point therapy to be successful, you must be consistent in your treatments. Pressure should be applied to the TrP several times a day until it is gone.

Latissimus Dorsi Pain Pattern
Latissimus Dorsi Pain Referal Pattern

TWD Suggestions For Latissimus Dorsi Trigger Point Treatment

The Trigger Point Therapy Workbook will show you how to locate and treat TrPs. Once you have the knowledge you will be able to relieve muscle pain throughout the body. I highly recommend this book.

The Thera Cane is a tool used in the TrP Workbook to treat the latissimus dorsi muscle as well as many other muscles. If you are interested in TrP self-treatment, the Thera Cane is worth the investment.

Sombra Warm Therapy Pain Relieving Gel is highly recommended for trigger point and chronic pain relief. It relaxes the muscles without the burning heat of other creams. (not sold in stores)

Biofreeze Pain Relieving Gel cools the area much like ice discouraging inflammation. If you are dealing with burning and stinging sensations, Biofreeze may work better than warming gels.

How Long Before I Feel A Reduction In Pain?

The good news is that you will usually feel a reduction of pain and increased mobility after just a few treatments.

TrPs that have developed fairly recently usually deactivate after several treatments. If they have been in the muscle for months or years the treatment time will take longer.

You often feel a reduction in pain and stiffness in just a few treatments though it can take much longer for the trigger point to resolve.

Interesting facts about the latissimus dorsi muscle:

  • It is the widest muscle in the human body
  • It is known as the swimmer’s muscle
  • When a flap of muscle tissue is needed for reconstructive surgery, the tissue needed is often taken from the latissimus dorsi.

Satellite trigger points associated with the latissimus dorsi muscle:

TrPs in the latissimus dorsi can cause trigger points to develop in these muscles which will also need to be checked and treated.

  • Pectoralis major
  • Teres major
  • Subscapularis
  • Triceps brachii
  • Scalenes
  • Rectus abdominis
  • Iliocostalis
  • Serratus anterior
  • Serratus posterior superior
  • Serratus posterior inferior
  • Trapezius
  • Rhomboid Major
  • Rhomboid Minor

Other muscles that should be considered and examined in conjunction with the latissimus dorsi muscle:

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Latissimus Dorsi Muscle Strain

Latissimus dorsi strains are rare but can happen anywhere in the muscle.

Strains are a result of tears in the muscle or tendon fibers. They are graded mild, moderate, or severe depending on the number of fibers torn.

A Mild Strain or Grade 1 occurs when a small number of fibers tear.  You will usually experience a pulling sensation and mild pain. A mild strain may cause some discomfort but generally does not affect daily activities. Mild strains heal quickly usually within 1-3 weeks.

Moderate or Grade 2 strains a significant number of muscle or tendon fibers are torn. Sharp pain is sometimes accompanied with a tearing or popping sensation. Moderate strains can affect daily activities because of pain and stiffness. Moderate strains can take 4-16 weeks to fully heal.

Severe or Grade 3 strains can be serious. Over half of the muscle or tendon fibers are torn. An avulsion is when the muscle is ripped in half or the tendon is torn away from the bone and requires surgery.

If you suffer a severe strain you will feel immediate excruciating pain with a tearing or popping sensation. If the stain occurs where the muscle and tendon attach to the upper arm, moving the arm will cause extreme pain. If you think you have suffered a severe strain, you need to seek medical care.

Latissimus Dorsi Stain Signs and Symptoms:

  • Mild or mild Grade 2 strain will cause a pulling or tearing sensation with pain or a cramping sensation. Some bruising and swelling may occur.
  • Moderate strains pain is felt immediately. Redness is often seen within minutes of the injury. Swelling and bruising usually occur.
  • Severe strains cause immediate and severe pain. Redness, bruising and swelling is quickly evident.
  • Back strains cause pain when twisting side to side and taking deep breaths.
  • Stains occurring near the shoulder and arm cause pain when trying to pull the arm behind the body, moving the up and down, and lifting the arm out to the side of the body.
boxer

Repetitive movements such as boxing, pitching a ball, raking, shoveling, push-ups and chin-ups can cause lats trigger points.

What Causes A Latissimus Dorsi Strain?

Lat strains in the back happen when the muscle is stretched past its capacity usually due to a sudden side bend or a hard downward swinging movement with the arms where you bend at the waist like chopping wood or using a sledgehammer. Hard labored breathing where you bend over to catch your breath binds the muscle and can cause a strain. Another cause is an activity that requires repetitive lifting your arms overhead.

A strain that occurs around the shoulder and upper arm most often occurs during a swinging twisting motion with the arms straightened. Golfers, tennis players, and baseball batters are examples.

Athletes who throw a ball with force can also strain the lats at where the muscle connects to the arm, think baseball pitchers and shot putters.

Chin-ups, pull-ups, pull-downs, and other similar exercises can cause latissimus dorsi strains in the back and shoulder/upper arm.

Competitive and long-distance swimmers experience lat strains due to the repetitive motion and stress of pulling the body through the water with your arms.

Sports and activities that contribute to lat strains:

  • Swimming
  • Baseball pitching and batting
  • Golfing
  • Tennis
  • Bowling
  • Boxing
  • Weightlifting
  • Climbers
  • Gymnastics
  • Chopping wood
  • Exercises: chin-ups, push-ups, pull-downs

Latissimus Dorsi Muscle Strain Treatment

Most latissimus dorsi strains are mild to mild-moderate and can be treated at home using the P. R. I. C. E. protocol.  If you suspect a severe strain seek medical care.

  • Protect - limit movement for the first 24-48 hours. If the strain is in the back limit twisting and bending movements. If the strain affects the shoulder/arm, limit arm and shoulder movements.
  • Rest - this not only applies to the muscle but also extra sleep. The healing process depends on sleep.
  • Ice - using cold packs every 1-2 hours for 20 minutes per treatment to will help decrease pain and swelling. Do not use cold for longer treatments because damage to the skin and underlying tissues can occur.
  • Compression - applying pressure to the strain provides support, helps reduce swelling and provides some pain relief.  If the strain is in the back or ribcage area a back brace for lower back pain or rib wrap for mid-back and ribcage pain can be used. The shoulder/arm area is a difficult area in which to apply compression. It can be accomplished with an Ace bandage. If you wrap this area be very careful not to wrap too tightly. This area has numerous nerves and blood vessels that can be damaged if the wrap is too tight.
  • Elevation - if the injury is in the back or ribcage, you can lay on the unaffected side or tuck pillows under your back or ribcage to raise the area. The same is true for shoulder and arm. You will need to elevate both the shoulder and upper arm either by laying on the other side of the body or using pillows to prop the area up.

Use this protocol for the first 24-48 hours


For more about the PRICE Protocol check out: What Is The P.R.I.C.E. Injury Protocol?


Once the pain and swelling have stabilized you can start to alternate cold and warm treatments. Start with a cold treatment for 20 minutes and wait 1-2 hours and then apply a warm pack to 20-30 minutes. Do not apply treatments back to back.

When to see a doctor:

  • Intolerable pain levels
  • Rapid and excessive swelling and bruising
  • You are not able to move the leg or unable to put weight on the leg
  • Swelling, pain, redness, and heat have not lessened within 24-48 hours

TWD Suggestions For Latissimus Dorsi Strains

Cureve Hot Cold Pack can be used for warm and cold treatments. It is a good choice for lats treatment because it is large enough to treat the entire muscle.

Biofreeze Pain Relieving Gel cools the area much like ice discouraging inflammation. Provides excellent pain relief between cold treatments. Recommended by medical professionals and trainers.

Pro-Choice Back Support is not a well known brand but is an excellent brace for low back and abdominal support. A wideband with adjustable side straps allow you to adjust compression to your comfort level. Highly recommended.

If your lat strain affects the mid-back or side of the ribcage the Braceability Rib Brace will provide compression and support. Different styles for men and women.

Tips To Avoid Latissimus Dorsi Strains

  • Always take a few minutes and warm up before sports and exercises
  • Be aware of your conditioning level and don't push too far past your limits
  • Do not push your body to complete exhaustion.
  • If you are exercising or doing strenuous activities take breaks and rest

Muscles With Similar Pain Patterns As The Latissimus Dorsi

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