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Worrisome Mid Back / Thoracic Discomfort

Worrisome Mid Back / Thoracic Discomfort
Latissimus Dorsi
Worrisome Mid Back / Thoracic Symptoms Solved by Trigger Points in Your "Pull-Up" Muscle
writtenby
Hello, Everyone!

There is an excellent reason our chests are protected by a powerful cage of ribs and fascia ... to protect our life-sustaining organs, such as the heart and lungs. When you have pain in the chest or thoracic cavity, you must certainly not ignore it. If there are accompanying symptoms down your arm, there may be something very unpleasant brewing in this vital area of your body, and you should seek a proper medical evaluation.

However, many times it is hard to track down the cause of pains and aches in the this scary body region. Thankfully, the field of trigger point therapy has offered many solutions to these otherwise enigmatic symptoms. Pain in the thoracic cage and chest are frequently the result of easy to treat trigger points in several muscles, rather than an indication of serious illness.

In this issue we are going to look at one such muscle that causes mysterious thoracic pain without a dangerous underlying cause. It is named the Latissimus Dorsi, commonly called the “Lats” (shaded in green in the image to the left). The Lats are an important back and shoulder muscle you use in performing a “pull-up.”

Here is the referred pain pattern for your Lats shown in red. The distressing pain centers around the lower angle of the shoulder blade (Scapula) and then often projects down the back and inside of the shoulder and arm down to the pinky and ring finger. Significant pain in the front of the shoulder is also common.

The symptom that makes this pain seem dangerous is that it doesn't respond to movement, position or stretching, which causes medical professionals to suspect organ related illness. We usually expect a tight muscle or sore joint to feel different when we change position, whereas organ disease such as a tumor in the lungs would remain unaffected by position.

In the case of the Lats, the referred pain shares more in common with an organ than with most other muscles. The suspected reason that this trigger point doesn’t respond to position is that the Latissimus Dorsi is a long muscle with more than a usual amount of slack in it. The only position that really stretches it is reaching the arms very high overhead, such as when you are hanging from a pull-up bar. As a result, your doctor might run a number of diagnostic tests for organ disease before you realize that this is a simple trigger point issue.

Below are a few simple tests you can perform yourself to see if you have trigger points in your Lats, as well as the solution to eliminating this pain and restoring full function to this pull-up muscle. Please also make sure you are evaluated by a qualified physician if you have chest or thoracic cage symptoms.

*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional. Please consult your physician to determine whether these self-care tips are appropriate for you.


(3) Quick Self-Tests to Tell if You have Trigger Points in Your Latissimus Dorsi:

TEST 1: Mouth Wraparound Test

Passing Not Passing

This test checks for full range of motion of the Lats. Stand and raise your arm and hand back behind your neck and head and wrap your fingers around your cheek to your mouth (as shown). Keep your head level but turn your head away from the side you are testing to 45 degrees. A Passing result occurs when you can touch your fingers to the middle of the mouth. A Not Passing result is not being able to reach far enough to touch the middle of the mouth.

TEST 2: Reach for the Sky Test

Best if performed while looking into the mirror, raise both arms straight up overhead. If one or both arms cannot raise until the elbow is straight and the arm is flush with the ear, this Not Passing result again indicates myofascial dysfunction of the Lats. The patient in the picture fails on the right side and passes on the left side.

TEST 3: Palpation of Lats
Palpation is the gold standard for Trigger Point detection. It is a little tricky to palpate some regions of the Latissimus Dorsi, so you may want to use a Backnobber or a ball against the wall to search for trigger points. Check for tenderness and taut bands, as well as any referred pain.



Simple Self-Care Remedies

Here are simple self-care tips for relieving myofascial pain and dysfunction in your Latissimus Dorsi:


Step 1: Warming Up with Moist Heat

To relax and warm up the fibers of the Lats, soak your shoulder and mid back in a warm bath or place moist heat such as a Fomentek bag for 10-15 minutes over the mid back.


Step 2: Compression

You can use several self-care tools to compress the Lats. A Backnobber works very well. Also a tennis ball in a sock draped over your shoulder or a therapy ball against the wall are excellent. Here in the photo a medium sized ball is being used to cover the full breadth of the muscle. As always when you find a tender spot, press in to tolerance and hold for 10 seconds while completing at least two full breaths in and out. Then continue searching for more tender spots until the entire muscle is covered.


Step 3: Stretching & Range of Motion

There are several stretches for the Lats. An easy one demonstrated here is to raise the arm overhead and use the opposite hand to grab the wrist and gently pull into more of a stretch. Hold for 20 seconds and repeat 3 reps twice per day on each side.


Perpetuating Factors:

You can develop or perpetuate trigger points in the Lats in several ways, as well. Sleeping on one side consistently can put pressure on the muscle and cause trigger points to develop. A tight bra can be a common cause. Also, activities with the arms overhead and pulling activities such as pulling weeds and gardening are frequent causes.

Your Lats will respond very well to these self-care techniques, and your mid back and shoulder will thank you! Remember to have any chest or thoracic pain evaluated by an appropriate medical professional.

Happy self-care!
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