Therapist Notes – Latissimus Dorsi

Effective relief starts with an understanding of the anatomy.

About the coloring of the illustrations…

Latissimus Dorsi, like sartorius, hangs loose. It can have active trigger points without creating a lot of pain until it is unexpectedly drawn taut through a reaching movement. That makes it easy to overlook this muscle as the cause of pain. It also makes it easy for the client to manage this until it becomes a level 3 trigger point.

This pattern comes from the fibers that cross over the lower border of the scapula where about 25% of lats attach. This means that it is the range of motion between the scapula and the humerus that matters.

Mobilizing the glenohumeral joint is key. The strain-counterstrain technique is simple and reliable for this. Lower thoracic vertebrae can also contribute to the activation of this trigger point.

Notes from Neuromuscular Assessment:


Mobilization for the lower releases the nerve roots that innervate the latissimus dorsi.

Mobilizing he humeral head also relaxes the latissimus by changing proprioceptive input from the local joint.

The lamina groove protocol releases local joints along the spine to improve proprioceptive input to the latissimus dorsi.

This protocol treats the latissimus dorsi, primarily through direct work in the muscle fibers. It can be a difficult muscle to treat as it easily slips out of the way during stroking movements. This routine solves that by treating it with compression while in a side-lying position.

This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.

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Can’t Reach the Pain
Under the Shoulder Blade

This pain and tension under the shoulder blade may be the most common pain pattern that I see. It isn’t always the primary complaint as people have gotten used to the constant ache.

It is usually combined with this pattern in the upper neck, which creates upper neck tension to go with the shoulder blade pain.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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