Latissimus Dorsi

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Latissimus Dorsi is a back muscle which connects the upper extremity to the spinal column.

Anatomical Attachments:

• Origin: Attaches to the thoracolumbar aponeurosis from T6 to the iliac crest and the muscular slips from ribs 9, 10, 11, or 12.
• Insertion: Attaches to the floor of the intertubercular groove of the humerus.

Action: Adducts, extends, and medially rotates the arm; pulls the shoulder downward and backward.

Synergist: Pectoralis major and minor, Subclavius, Serratus anterior, Trapezius, Rhomboid major and minor, Levator scapulae.

Antagonist: Deltoid, Supraspinatus, Infraspinatus, Teres major and minor, Subscapularis.

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Nerve Supply: Thoracodorsal nerve (C6, C7, C8).

Vascular supply: Descending scapular, subscapular arteries.

• Primary: The pain refers to the inferior angle of the Scapula which extends to the posterior shoulder, down the arm, the forearm, the hand and the 4th and 5th digits.
• Satellite or associated triggers: Pectoralis major, Teres major, Subscapularis, Triceps brachii, Scalenes, upper Rectus abdominis, Iliocostalis, Serratus anterior, Serratus posterior superior and inferior, and lower Trapezius, Rhomboid.

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Trigger Point Signs and Symptoms: Mid-back and arm pain.

Trigger Point Activating and Perpetuating Factors: Trauma, throwing a football, swinging a baseball bat, pull-ups, shoveling snow or dirt, constantly lifting heavy objects.

Differential Diagnosis: For shoulder blade and arm pain consider: C6 C7 or C8 radiculopathy, Angina pectoris, Myocardial infarction, Thoracic outlet syndrome, Brachial plexus entrapment, Entrapment of suprascapular nerve at the spine of the scapula, Pulmonary carcinoma, Adhesive capsulitis (Frozen shoulder), Ulnar Neuropathy, Bicipital tendinitis, Charcot’s joint, Articular Dysfunction, Eosinophilic fasciitis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication. For side pain consider: Slipped rib syndrome, Bruised ribs, Separated ribs, Rib fracture, Kidney infection, Possible Gallbladder pancreas hepatic (liver) or spleen involvement.

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