Trigger Points – Aching mid-back with tired triceps

Client’s Description

referral-latissimus-dorsi-posterior-croppedPeople complain of an area of aching pain at the base of their shoulder blade. They can’t reach it and may ask to trace the spot on my back or on the illustration that I have on the wall. It has a constant ache that unexpectedly becomes more painful on certain movements. It can be painful if a dog jerks on the leash or if they are using their arm to support their weight as they come down a ladder.

The referral down the arm is only present when they are involved in heavy weight training or rowing or involved in a pulling exercise like raking, weeding or water skiing. It is also present when this trigger point has become very active and chronic.

This referral makes the triceps ache with fatigue quickly during pullovers, lat pull-downs, or pull-ups and tasks like raking. It seems odd to the person that their triceps ache while doing lat exercises.

They often fail to find relief from bodywork as this muscle is overlooked and awkward to treat. The aching creates concern about kidneys or gallbladder which also create pain in this area. These should be checked by a medical doctor, especially if there are other indications.


Self Care

57195ce37fc444c4265c4b74b045d637Some relief can be achieved by stretching.These trigger points are along the visible edge of the shoulder blade near the arm pit. Simply reach up and over using the ice and stretch method. Stroke the ice along the outside edge of the arm pit.

Avoid things that yank on this muscle like cranking the lawnmower, raking or letting that dog jerk the leash. Exercise strength and stamina improve greatly when this is treated.

If this pattern has become active to the point that it is rchronic, simple stretch routines will only offer short-term relief. This will help you to manage the problem but doesn’t offer the relief that you would get from bodywork. See your trigger point specialist for lasting relief.

Therapy Notes

oit-latissimus-dorsiLatissimus 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 a simple and reliable for this. Lower thoracic vertebrae can also contribute to the activation of this trigger point.

line - black 400Similar Patterns

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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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