Muscles
Latissimus Dorsi Trigger Points
Symptom Area: Torso
Latissimus Dorsi Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. Extends, adducts and internally rotates the shoulder; pulls the trunk to a fixed arm.
Where you feel it
When the Latissimus Dorsi holds active trigger points, you usually notice it as mid-thoracic back pain. Where the pain spreads: Inferior angle of the scapula, mid-back, and down the medial arm to the ulnar fingers. What often sets it off: Pull-ups with poor form, kayaking, climbing, frozen shoulder.
Overview
Extends, adducts and internally rotates the shoulder; pulls the trunk to a fixed arm. Trigger points here are common in everyday and athletic populations and frequently contribute to the referred pain patterns described below.
Trigger point locations
Posterior axillary fold and along the lower thoracic insertion.
Referred pain pattern
Inferior angle of the scapula, mid-back, and down the medial arm to the ulnar fingers.
Palpation & testing
Palpate the muscle belly along its accessible course. Reproduction of the patient's familiar pain on palpation supports involvement.
Common causes
Pull-ups with poor form, kayaking, climbing, frozen shoulder.
Self-care & clinical treatment
Doorway stretches, foam roll axilla. Clinically: needling and pin-and-stretch.
Treatment protocol
For Latissimus Dorsi, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Palpate the muscle belly along its accessible course.
Regional precaution for clinicians: Over the rib cage the only safe needling direction is tangential or onto a rib; perpendicular needling of an intercostal space risks pneumothorax.
Primary Symptoms
Secondary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
- Burning pain between the shoulder blades at the desk: the trigger points that cause it
- Hands that go numb at night: the trigger points that imitate carpal tunnel syndrome
- Mid-Thoracic Back Pain: which trigger points cause it and how to treat them
- Thoracic Back Pain: which trigger points cause it and how to treat them
- Dorsal Finger Pain: which trigger points cause it and how to treat them
References
- • Travell & Simons — Myofascial Pain and Dysfunction
- • Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2013;43(9):620-34
- • The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2017;47(3):133-49
- • Effectiveness of trigger point dry needling for multiple body regions: a systematic review — J Man Manip Ther 2015;23(5):276-93
- • A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points — J Bodyw Mov Ther 2019;23(3):539-46
- • Physiologic effects of dry needling — Curr Pain Headache Rep 2013;17(8):348
- • Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm — J Pain Res 2019;12:1899-911
- • Myofascial trigger points then and now: a historical and scientific perspective — PM R 2015;7(7):746-61
- • Pertinent dry needling considerations for minimizing adverse effects — Int J Sports Phys Ther 2016;11(5):651-62
- • Adverse events associated with therapeutic dry needling — Int J Sports Phys Ther 2020;15(1):103-13
- • Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response — Am J Phys Med Rehabil 1994;73(4):256-63
- • Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.) — Williams & Wilkins, Baltimore
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
