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Latissimus Dorsi Muscle: Differences Between Trigger Point Pain and Muscle Strain Pain
Latissimus Dorsi Muscle 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.
Trigger points in the lat muscle cause and contribute to pain in the middle and lower back and the front of the shoulder. It refers pain to the inside of the upper arm that descends into the elbow, wrist, hand, and into the little finger.
Pain caused by a muscle strain is more localized to the area of the strain. The muscle may be sore, but there will be an area that is 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 Muscle Control?
- Pulls arm down when the arm is lifted above the head
- Moves arm 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 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
- Tilting hips forward, back, and side to side
What Are The Signs and Symptoms of Latissimus Dorsi Trigger Points?
Trigger points (TrP) in the latissimus dorsi can cause pain throughout the upper body. Most commonly 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. Pain on the side of the ribcage is also common.
Trigger points can also refer pain to the front of the shoulder and down the arm. This pain is often diagnosed as cubital tunnel syndrome.
The signs and symptoms are:
- 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 of the ribs and or mid-back similar to a side stitch
- Numbness, tingling and/or aching that extends down the arm to the little finger and occasionally the ring finger
- Pain while reaching forward with the arms
- Pain when lifting arms overhead
- It can contribute to breathing difficulty
Trigger points are small knots found in the muscle that when pressed increase pain in the area or send referred pain to another area of the body. To learn more about trigger points read Muscle Trigger Points and How They Contribute To Muscle and Joint Pain.
What Causes Trigger Points To Develop In The Latissimus Dorsi Muscle?
- Activities that require continuously or repeatedly raising the shoulders
- Throwing or pitching a ball
- 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.
The latissimus dorsi is known as the swimmer's muscle.
How To Avoid Development of Trigger Points In The Lats
- 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
Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice to relieve pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)
Latissimus Dorsi Trigger Point Treatment
Latissimus dorsi trigger points are fairly easy to treat. Physical therapists, massage therapists, or a chiropractor trained in trigger point therapy can show you how to find and how to treat them.
Another option is to 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 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.
The best resource to learn how to treat small painful knots is The Trigger Point Therapy Workbook. The authors explain trigger points and their effects in everyday language, not medical speak. I recommend this book to anyone interested in learning to treat their own muscle pain.
The Thera Cane is a tool used in the Trigger Point 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.
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 treatment and recovery time will take longer. 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 for 1-2 minutes per treatment until it is gone.
Interesting facts about the lats:
- 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 is often taken from the latissimus dorsi.
Latissimus dorsi muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:
- C6 C7 or C8 radiculopathy
- Thoracic Outlet Syndrome
- Brachial Plexus Entrapment
- Adhesive Capsulitis (frozen shoulder)
- Ganglion cyst
- Lateral Epicondylitis (tennis elbow)
- Bicipital tendinitis
- Ulnar Neuropathy
- Charcot’s joint
- Rib Pain
- Slipped Rib Syndrome
- Gallbladder Pain
- Spleen Pain
- Liver Pain
- Kidney Pain
Other muscles that should be considered and examined in conjunction with the latissimus muscle:
- Serratus Posterior Inferior
- Teres Major
- Teres Minor
- Pectoralis Minor
- Serratus Anterior
- Interior and Exterior Obliques
Associated satellite trigger points
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
- Triceps brachii
- Rectus abdominis
- Serratus anterior
- Serratus posterior superior
- Serratus posterior inferior
- Rhomboid Major
- Rhomboid Minor
Latissimus Dorsi Muscle Strain Pain
Strains are a result of tears in the muscle or tendon fibers. Latissimus dorsi strains can happen anywhere in the muscle but are most common where the muscle connects to the upper arm. A strain can cause pain in the middle and lower back, shoulder, and upper arm.
If you suffer a mild strain you will experience a pulling sensation and mild pain. It may cause some discomfort but you will most likely be able to continue your activity. Most mild strains do not affect daily activities.
Moderate strains produce a sharp pain and may be accompanied with a tearing or popping sensation. The pain will make you stop whatever activity you were doing. Moderate strains can affect daily activities because of pain and stiffness.
If you suffer a severe strain you will feel immediate and excruciating pain with a tearing or popping sensation. If the stain occurs where the muscle and tendon attach to the upper arm, you may not be able to move your arm.
Severe strains can be serious. Over half of the muscle or tendon fibers are torn. It may be what is known as an avulsion in which the muscle is ripped in completely in half or the tendon is torn away from the bone both of which will require surgery.
If you think you have suffered a severe strain, you need to seek medical care.
Signs of a lat strain:
- A pulling or tearing sensation with pain or cramping
- Redness or bruising where the strain occurred
- Swelling around the area
- Back strains cause pain when twisting side to side and taking deep breaths.
- Strains occurring near the shoulder and arm cause pain when trying to pull the arm behind the body, moving the arm up and down, and lifting the arm out to the side of the body. If it is a severe strain you may not be able to move your arm.
What Causes A Latissimus Dorsi Strain?
Lat strains happen when the muscle is stretched past its capacity or becomes exhausted and weakened due to repetitive motion and overuse.
Swinging motions with the arms and hard-throwing motions stress the muscle. Repetitive motions such as lifting your arms overhead or out in front of the body can overwork the muscle and cause a strain.
Competitive and long-distance swimmers experience lat strains due to the repetitive motion of the arms along with the stress of pulling the body through the water.
Overdoing chin-ups, pull-ups, pull-downs, and other similar exercises can cause latissimus dorsi strains in the back, shoulder, and upper arm.
Labored breathing and "gulping" in air is often an overlooked cause of lat strains.
Sports and activities that contribute to lat strains:
- Baseball pitching and batting
- Chopping wood
- Swinging a sledgehammer
- Exercises: chin-ups, push-ups, pull-downs
- Inhaling large amounts of air when out of breath
Repetitive movements such as boxing, pitching a ball, raking, shoveling, push-ups and chin-ups can cause muscle fiber tears in the lats.
Latissimus Dorsi 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 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. Keep in mind you will need to elevate both the shoulder and upper arm to reduce pain and swelling.
Use this protocol for the first 24-48 hours.
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 cold and hot treatments back to back.
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.
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.
Pro-Choice Back Support is not a well-known brand to those outside the equestrian world, but it 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.
How Long Does It Take A Latissimus Dorsi Strain To Heal?
A mild strain (Grade I) can heal in 1-3 weeks.
A moderate (Grade II) will usually heal in 4-12 weeks.
A severe (Grade III) may take several months to a year to fully heal depending on the severity of the muscle and tendon fiber tears.
Note: Grade II strains with a lot of swelling and pain and all Grade III strains should be monitored by a medical professional.
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
- Use correct form when doing exercises
- If you are exercising or doing strenuous activities take breaks and rest when out of breath
- If muscle soreness sets in or you experience an injury, take the needed time off to recover
Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.