The Latissimus Dorsi muscle is a large and superficial muscle
Taking its origins from the thoracolumbar fascia, which is attached to spinous processes of lower six thoracic vertebrae and all lumbar and sacral vertebrae, (T7– S5) and to intervening supraspinous ligaments. I also runs to the posterior part of iliac crest, the lower three or four ribs and in most people, the Inferior angle of scapula. All of that energy is focused into one area – the insertion on the floor of the intertubercular sulcus (bicipital groove) of humerus. The Latissimus Dorsi muscle has two main zones for trigger points the upper – axillary and lower lateral. In terms of pain maps, the Latissimus Dorsi muscle trigger point pain maps are the Axillary trigger point: a 5–10 cm zone of pain at inferior angle of scapula, with diffuse pain radiating into medial upper extremity into ulnar aspect of hand. Lower lateral trigger point: triangular pattern from trigger point into brim of pelvis and regimental badge area. Here an image of the Lower trigger point pain maps for Latissimus dorsi, note the anterior shoulder pain pattern.
An extensive and often forgotten pain map, the Latissimus Dorsi may be involved in a range of conditions from Lower to mid back to shoulder pain. The Latissimus may have a proprioceptive function (as in birds) and studies have demonstrated a larger density of proprioceptors than expected. We recently had a very interesting case of an acute Latissimus Dorsi trigger point problem. The patient was a video maker with a twist! Literally, his job was videoing at a skydiver business, holding/hanging onto a metal pole and following the jumper a few seconds after. The patient presented with lumbo-pelvic pain and anterior shoulder pain. He had seen many therapists before ourselves to no avail. Three sessions of needling and manual release (plus home stretching) and the problem went away completely.
How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.