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 Treating Trigger Points in Teres Major

 

 

Trigger points in the Teres Major muscle are associated with many common shoulder injuries

The teres major, along with the tendon of the latissimus dorsi, which passes around it, and the subscapularis, forms the posterior fold of the axilla.

 

 

Teres Major and Trigger Points

Trigger points in the teres major are typically associated with frozen shoulder syndrome; pain on reaching above head; pain when driving; and common impingement syndromes.

Common Causes

Trigger points form in teres major for a number of reasons which often include sports related injuries, forceful overhead lifting, post shoulder fracture/ dislocation, frozen shoulder syndrome, sudden unexpected loading of shoulder (trauma), and prolonged immobility (sling).

Indications

Frozen shoulder syndrome, pain on reaching above head, slight pain on rest, pain when driving, impingement syndromes (sometimes misdiagnosed as thoracic outlet syndrome).

Differential Diagnosis

Impingement syndromes. Rotator cuff tendinopathy. Cervical neuropatterns (C6-C7). Thoracic outlet syndrome. Supraspinatus calcification.

Referred Pain Patterns

Deep pain into posterior glenohumeral joint and an oval zone (5–10 cm) of pain in the posterior deltoid area (can radiate strongly to long head of biceps brachii). Diffuse pain into the dorsum of forearm.

 

    

Referred Pain - Anterior View

 

 

Referred Pain - Posterior View 

 

 

Self Help Tips

Stretching and self-massage can help with pain relief, and sometimes also help dissipate the trigger points. Below are the details of two simple exercises that we often recommend.

 

 

Technique

Stand with your arm out and your forearm pointing upwards at 90 degrees. Place a broomstick in your hand and behind your elbow. With your other hand pull the bottom of the broomstick forward.

Note

Many people are very tight in the rotator cuff muscles of the shoulder. Perform this stretch very slowly to start with and use extreme caution at all times.

 

 

 

Technique

1. Take a tennis ball or hard rubber ball. There are also some pressure tools that are specifically designed for this task. They are better, but not essential.

2. Place the host muscle in a comfortable position, where it is relaxed and can undergo full stretch.

3. Apply gentle and gradually increasing pressure to the tender point until you feel resistance. This should be experienced as discomfort and not as severe pain.

4. Apply sustained pressure until you feel the tender point yield and soften. This can take from a few seconds to several minutes.

5. Steps 3-4 can be repeated, gradually increasing the pressure on the tender/trigger point until it has fully yielded.

6. To achieve a better result, you can try to change the direction of pressure during these repetitions.

 

Links

Find a Trigger Point Professional in your area

More Articles About Frozen Shoulder

More Articles About the Rotator Cuff

Dry Needling for Trigger Points

NAT Professional Courses

Certify as a Trigger Point Therapist

Trigger Point Workbooks 

 

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We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

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Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT 2014.

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Niel Asher Technique

Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.

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This trigger point therapy 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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