Latissimus Dorsi Referred Pain Pattern

Latissimus Dorsi: Trigger Point Pain

The latissimus dorsi – also known as the lats- is the wide muscle that covers the lower half of the back, side of the ribcage, and the tip of the shoulder blade.

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 where the muscle fibers tear. The muscle may be sore, but there will be an area that is exceptionally tender where the muscle fibers have torn.

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    Latissimus Dorsi Muscle

    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?

    Primary Actions:

    • 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
    • Breathing
    • Tilting hips forward, back, and side to side

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

    Latissimus Dorse Trigger Points Symptoms:

    Trigger points (TrP) in the latissimus dorsi can cause pain throughout the upper body. Most of the pain is toward the bottom of the shoulder blade that angles over to the spine. This pain contributes to stiffness and pain when lifting the arm above the 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 sometimes diagnosed as cubital tunnel syndrome.

    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 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
    • Pain in the low back that sometimes wraps around the waist and goes into the lower abdominal area.

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    Biofreeze Professional Gel  is recommended for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain. Recommended by medical professionals and trainers. 

    What Causes Latissimus Dorsi Trigger Points To Develop?

    • 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

    How To Avoid Development of Trigger Points In The Latissimus Dorsi

    • 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 performing repetitive motions like shoveling snow or raking leaves

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    Cureve Hot Cold Pack can be used for warm and cold treatments. It is recommended that you use cold packs for injuries, swelling, and after a TrP treatment. Use a warm treatment when the muscle is tight and needs to relax.

    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 find 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.

    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 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:

    • 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 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)
    • Suprascapular Nerve Compression
    • Bicipital tendinitis
    • Ulnar Neuropathy
    • Bruised/fractured ribs
    • Slipped or separated ribs

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    Other muscles that should be considered and examined:

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

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    Latissimus Dorsi Strain

    Muscle 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 lat 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 penetrating pain and are at times accompanied by a tearing or popping sensation. The pain will make you stop whatever activity you were doing. Moderate lat 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 strain occurs where the muscle and tendon attach to the upper arm, you may not be able to move your arm.

    Severe strains are serious. Over half of the muscle or tendon fibers have 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 off from the bone, both of which will require surgery.
    If you think you have suffered a severe strain, you need to seek medical care.

    Symptoms of Latissimus Dorsi 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 attempting 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 Latissimus Dorsi Strains?

    • 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 rotation 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 latissimus strains:

    • Swimming
    • Baseball pitching and batting
    • Golfing
    • Tennis
    • Bowling
    • Boxing
    • Weightlifting
    • Climbers
    • Gymnastics
    • Chopping wood
    • Swinging a sledgehammer
    • Exercises: chin-ups, push-ups, pull-downs
    • Inhaling large amounts of air when out of breath

    Latissimus Dorsi Strain Treatments

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

    Use the R.I.C.E protocol

    • 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 low back, use a back brace for lower back pain. If the pain is in the mid-back or rib cage, use a rib wrap (Men wrap or Women wrap) The shoulder/arm area is a tricky area in which to apply compression. Pressure can be accomplished with an Ace bandage. If you wrap this area, be very careful not to wrap the bandage too tightly. This area has numerous nerves and blood vessels that can be damaged.
    • Elevation – if the injury is in the back or rib cage, you can lay on the unaffected side or tuck pillows under your back or rib cage to raise the area. The same is also true for the 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.

    Alternate Treatments

    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. You can do this as often as you like during the day.

    TENS units can help reduce the pain of muscle strains, and are recommended by doctors and therapists. Follow the insert directions for node placement and settings.

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    Doctors and physical therapists often recommend TENS to relax muscles and ease pain. The Belifu TENS Unit Muscle Stimulator is highly recommended shoulder, arm, and back pain.

    How long does it take a lats 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.