Trigger Points – Sharp Pain in Front of Shoulder

Client’s Description

lattissimus dorsi - lower ribsPeople complain of pain in the shoulder that is sharp and sudden when reaching up and/or forward. This may occur during a tennis serve or when getting something off of a high shelf. This can also occur when a dog yanks them forward on a leash. This creates sharp pain in the shoulder at the end of the stretch created in exercises like pullovers and seated triceps extensions.

These people may complain of pain in the shoulder while sleeping on that side, especially when the arm is pulled up and forward so that the border of the lat is pressed into the ribs. Some talk about the “only position” in which they can get comfortable to sleep as the low back pain may wake them as well.

The referral in the low back is usually described as “stiffness” or some sort of restricted motion when bending to the opposite side. It is seldom described as pain, except when this becomes very active or when the muscle is compressed by sitting in a hard-back chair or sleeping on it.

Self Care

57195ce37fc444c4265c4b74b045d637Some relief can be achieved by stretching.These trigger points are along the visible edge of lats that extends from the low back up toward the arm pit. Simply reach up and over using the ice and stretch method. Stroke the ice from the low back along lat that wraps around the side and into the arm pit.

Avoid things that yank on this muscle like cranking the lawnmower or letting that dog jerk the leash. Avoid compressing the lat against your ribs it by sitting in chairs with a hard back that presses into your side or sleeping on that side with the shoulder in front of you.

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

Therapy Notes

oit-latissimus-dorsiWhen you look at this origin/insertion illustration, it is clear that latissimus dorsi is connected to many bones and joints in the back and shoulder girdle. Addressing displacements in the glenohumeral joint is key to releasing trigger points in the lat. The lower ribs are close to this trigger point and need to be checked next.

This muscle is often missed in the assessment of shoulder problems and low back problems as it is not thought of as being either. Also, this is one of those muscles, like sartorius, that is long and easy to keep loose by unconsciously adapting posture. When the right combination of moves occurs this muscle unexpectedly stretches and the referral is experienced.

Lats have 3 main bellies. This trigger point occurs in the ropy lateral belly that runs along the side. It attaches to the last 4 ribs and thoracolumbar fascia. This edge can be more difficult to stabilize for long massage strokes. It is often pre-released with ice and stretch, joint work and/or hot stones before using compression to workout any remaining taut fibers.

Similar Patterns

Click on these categories to see if there is a referral pattern that better describes your concerns.

tags-shoulder tags-stiff-back tags-low-back


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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