Understanding the Teres Minor Muscle: Anatomy, Trigger Points, and Trigger Point Therapy

The human shoulder is a complex and highly mobile joint that relies on the coordinated function of various muscles. Among the key players in this system is the teres minor, a small but significant muscle that is part of the rotator cuff group.

Despite its size, the teres minor plays an essential role in shoulder stability and movement, making it a crucial muscle for both everyday activities and athletic performance.

In this extensive blog, we will explore the anatomy of the teres minor, delve into the common issues related to trigger points in this muscle, and discuss effective trigger point therapy techniques to alleviate pain and restore function.

Anatomy of the Teres Minor

The teres minor is one of the four muscles that make up the rotator cuff, a group of muscles and tendons that provide stability and movement to the shoulder joint. The teres minor muscle originates from the lateral border of the scapula, a bony ridge on the shoulder blade, and inserts into the greater tubercle of the humerus, the upper arm bone. This muscle is positioned posteriorly, meaning it lies towards the back of the shoulder.

Functionally, the teres minor is primarily responsible for the external (lateral) rotation of the humerus. It also assists in the adduction of the arm (bringing the arm closer to the body) and stabilizes the shoulder joint by holding the head of the humerus firmly within the shallow socket of the scapula. Given its role in these movements, the teres minor is especially active during activities that involve lifting, throwing, or reaching, particularly those that require precise shoulder control.

Trigger Points in the Teres Minor

Trigger points are hyperirritable spots in muscle tissue that are characterized by the presence of tight bands of muscle fibers. These points can become tender and produce referred pain, which is pain perceived at a location other than the site of the trigger point. In the case of the teres minor, trigger points often develop as a result of overuse, repetitive strain, poor posture, or trauma to the shoulder area.

The pain associated with teres minor trigger points can be particularly troublesome. It is typically felt deep in the posterior shoulder and can radiate down the arm, sometimes as far as the wrist. Individuals with active trigger points in this muscle may experience discomfort during specific movements, such as reaching overhead, throwing, or performing any activity that requires external rotation of the shoulder. The pain is often described as a dull ache, but it can become sharp during certain activities or when pressure is applied to the trigger point itself.

Causes of Teres Minor Trigger Points

Several factors can contribute to the development of trigger points in the teres minor muscle:

1. Repetitive Motion: Activities that involve repeated external rotation of the shoulder, such as throwing sports (e.g., baseball, tennis) or certain occupational tasks, can strain the teres minor and lead to trigger point formation.

2. Postural Imbalances: Poor posture, especially rounded shoulders and forward head posture, places undue stress on the rotator cuff muscles, including the teres minor. Over time, this can contribute to the development of trigger points.

3. Shoulder Injuries: Trauma or injury to the shoulder, such as dislocations, rotator cuff tears, or even minor strains, can trigger the formation of trigger points as the muscle attempts to protect the joint.

4. Muscle Imbalances: Imbalances in the shoulder muscles, where some muscles are overdeveloped while others are weak, can lead to compensatory patterns that stress the teres minor and create trigger points.

Identifying Teres Minor Trigger Points

Identifying trigger points in the teres minor muscle typically involves palpation, where a clinician or therapist applies pressure to specific areas of the muscle to locate tender spots. When a trigger point is found, the individual may feel a sharp, localized pain that often radiates to the back of the shoulder, along the upper arm, or even down to the hand. Additionally, the range of motion may be limited, and the muscle may feel tight or stiff.

Self-assessment can also be useful. If you suspect you have trigger points in your teres minor, you can gently press along the lateral border of your scapula, particularly towards the upper part of the bone, where the teres minor is located. If you experience tenderness or a referred pain pattern, it could indicate the presence of a trigger point.

Trigger Point Therapy for the Teres Minor

Treating trigger points in the teres minor involves several approaches aimed at relieving pain, restoring normal muscle function, and preventing future occurrences. Here are some effective trigger point therapy techniques:

1. Manual Trigger Point Release: One of the most common and effective methods is manual trigger point release, where a therapist applies sustained pressure to the trigger point. The pressure is held until the muscle begins to relax, which can take anywhere from 30 seconds to several minutes. This technique helps to deactivate the trigger point and restore normal blood flow and muscle function.

2. Stretching and Mobility Exercises: After releasing the trigger point, it's important to perform stretching exercises to elongate the muscle fibers and prevent them from tightening up again. For the teres minor, gentle stretches that involve shoulder external rotation and scapular retraction can be particularly beneficial.

3. Dry Needling: Dry needling is a technique where a thin needle is inserted directly into the trigger point. This can help to release the tight muscle fibers and reduce pain. While it should be performed by a trained professional, dry needling is an effective option for stubborn trigger points.

4. Self-Massage Techniques: Individuals can perform self-massage using a massage ball or a foam roller. By positioning the ball or roller against a wall and pressing it into the area where the teres minor is located, you can apply pressure to the trigger point and achieve a similar effect as manual therapy.

5. Corrective Exercises: Strengthening the rotator cuff muscles, particularly the external rotators like the teres minor, can help prevent trigger points from returning. Exercises such as resisted external rotation using a resistance band can be beneficial in balancing the muscles around the shoulder.

6. Posture Correction: Since poor posture is a common contributor to trigger point formation, working on improving your posture is crucial. This includes exercises to strengthen the back muscles and stretches to open up the chest, helping to bring the shoulders back into proper alignment.

Conclusion

The teres minor may be a small muscle, but its role in shoulder stability and movement is significant. When trigger points develop in this muscle, they can cause considerable discomfort and impact your ability to perform everyday tasks. Fortunately, with the right knowledge and techniques, trigger points in the teres minor can be effectively treated, allowing you to regain full function and reduce pain.

If you suspect you have trigger points in your teres minor, consider consulting with a healthcare professional or a trained therapist who can assess and treat these issues. Additionally, incorporating preventive measures such as regular stretching, strengthening, and posture correction can help maintain the health of your teres minor and prevent future problems.

References

1. Simons, D.G., Travell, J.G., & Simons, L.S. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual, Vol. 1. Williams & Wilkins.

2. Davies, C. (2013). The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. New Harbinger Publications.

3. Reichert, A.L., Kant, P., & Falla, D. (2016). Chronic Shoulder Pain: A Myofascial Trigger Point Approach. Journal of Bodywork and Movement Therapies, 20(3), 513-519.

4. Stecco, C., & Schleip, R. (2016). Fascial Manipulation: Practical Part. Piccin Nuova Libraria.

5. Fernandez-de-las-Penas, C., Dommerholt, J., & Palacios-Ceña, M. (2015). Manual Therapy for Musculoskeletal Pain Syndromes: An Evidence- and Clinical-Informed Approach. Elsevier.

These references provide further reading on the anatomy of the teres minor, the nature of trigger points, and the most effective treatments for addressing muscle-related pain.