Trigger Point Therapy - Serratus Posterior Inferior
Serratus Posterior Inferior is an often overlooked cause of lower back pain
This muscle may be primarily a muscle of proprioception but it's important to remember that it also acts as a supporting structure for the lower back, stabilizing the four lower ribs and assisting in pulling them down and back.
The importance of the serratus posterior inferior is often forgotten and tightness and trigger points tend to be overlooked.
Kinetics
The serratus posterior inferior works in conjunction with the iloicostalis, longissimus thoracis, and quadratus lumborum.
It may also work with the serratus posterior superior as a spinal stretch receptor system or kinesiological monitor (Vilensky et al. 2001).
Trigger points in serratus posterior inferior may cause an uncommon local ache radiating over and around the muscle
Trigger Points
Trigger points in the serratus posterior inferior may cause an uncommon local ache radiating over and around the muscle.
This may extend across the back and over the lower ribs, even continuing through the chest to the front of the body.
This discomfort is typically described by clients as a nagging ache.
In many cases this pain will remains after other trigger points have been inactivated.
This should be a good indicator for the therapist to recheck the serratus posterior inferior for undiscovered trigger points.
Serratus Posterior Inferior - trigger points and tightness in this muscle tend to be overlooked
Indicators and Perpetuating Factors
These Trigger points are usually initiated by acute back strain in conjunction with the strain of other muscles in the region.
Perpetuating factors include paradoxical breathing, sagging and unsupportive mattresses (e.g. sleeping on a sofa or water bed), chairs with insufficient lumbar support, body asymmetry, and herpes zoster infections.
General Advice for Patients
Control perpetuating factors: Have the trigger points addressed by a therapist. The use of pressure tools such as the Backnobber are terrific for myofascial release self-help. Stretching and muscle energy techniques (see below).
Stretching
Cross your forearms just above the wrist, at about chest height.
Inhale deeply as you slowly raise them up until the area where the arms cross is level with your forehead.
Now lower the arms as you exhale.
Do this once or twice, allowing for a brief rest (a few breaths) before repeating. Do this exercise set several times a day.
Understanding Trigger Points in the Serratus Posterior Muscles
Trigger points in the Serratus Posterior Superior (SPS) and Serratus Posterior Inferior (SPI) muscles are often overlooked as sources of pain. However, they can contribute to a range of discomforts, often mimicking other conditions and causing confusion during diagnosis. Recognizing the symptoms associated with these muscles can help in addressing pain effectively, whether you're a healthcare professional or someone dealing with chronic discomfort.
Serratus Posterior Superior (SPS) Trigger Points
The Serratus Posterior Superior is located in the upper back, and its trigger points are a common cause of pain in this region. Pain associated with the SPS is frequently described as a deep, constant ache beneath the upper portion of the scapula (shoulder blade). This pain can extend along the back of the shoulder and arm, down to the ulnar side of the forearm, hand, and little finger. Some individuals may even experience numbness that aligns with the C8-T1 nerve distribution into the hand.
Certain movements can exacerbate this pain, particularly those that press the scapula against the trigger points in the SPS. Common examples include lifting objects with outstretched arms, such as placing dishes on a high shelf, or sleeping on the same side, which applies pressure to the muscle. Understanding these triggers is crucial for both managing symptoms and planning effective treatment strategies.
Serratus Posterior Inferior (SPI) Trigger Points
The Serratus Posterior Inferior is located in the lower thoracic and lumbar regions of the back and is often implicated in low back pain. Pain from SPI trigger points is sometimes mistaken for kidney pain due to its location. Symptoms include a dull ache in the lower back, pain when stretching overhead, discomfort during twisting movements at the waist, and sharp pain when bending forward.
These trigger points can create significant discomfort during everyday activities, such as reaching for items, rotating the torso, or engaging in physical exercise. For individuals experiencing chronic back pain that seems resistant to other treatments, addressing SPI trigger points might provide relief.
Managing and Treating Trigger Points
Trigger points in the SPS and SPI muscles can often be alleviated through targeted manual therapy, stretching, and strengthening exercises. Techniques such as trigger point release, myofascial release, and gentle mobilization of the surrounding muscles can help reduce tension and restore normal function. Correcting postural imbalances and avoiding activities that exacerbate pain are also important steps in managing these trigger points.
For therapists and fitness professionals, understanding these trigger points allows for a more accurate diagnosis and effective treatment. For individuals dealing with these symptoms, consulting with a qualified therapist trained in trigger point therapy can make a significant difference in reducing pain and improving quality of life.
Learn More with Niel Asher Education
At Niel Asher Education, we provide comprehensive online courses designed for healthcare and fitness professionals looking to expand their knowledge of trigger point therapy and other manual techniques. Our courses equip professionals with the skills to diagnose and treat complex musculoskeletal issues, including those related to the serratus posterior muscles.
To learn more about our programs and resources, click here.
Take the next step in your professional development and help your clients find relief from chronic pain today!
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This blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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