The latissimus dorsi or lats are the large flat muscles on each side covering the width of the middle and lower back. They connect the bone of the upper arm to the spine and the hip. When pain presents in these muscles, it is typically caused by:

• Repetitive overuse in a job or doing a task/chore that requires constant
• Bending
• Pulling
• Pushing
• Reaching
• Twisting
• Kneeling
• A result of poor technique in sports or similar physical activities.

Chiropractic treatment, along with exercises, can help prevent and relieve this pain.

Symptoms of lat pain

The objective is to diagnose whether the pain is located in the latissimus dorsi or other muscles in the shoulders or back. If the latissimus dorsi is injured, an individual might feel pain in several areas, these include:

• Lower, middle, and upper back
• Back of the shoulders
• The base of the shoulder blade
• Lower arms
• Inside of the arms, extending down to the fingers

In certain cases, the pain will present without warning and can be felt in the surrounding muscles. This type of pain often gets worse when the individual:

• Extends their hands forward and out in front
• Raises their hands above their head
• Tosses or throws an object

Damage or injury to the latissimus dorsi

Tissue damage or injury can cause other symptoms to present. These include:

• Tingling in the lower arms
• Breathing causes aching and/or pain
• Tendonitis in the middle and/or lower back

If the source of the back pain cannot be identified, or if it is accompanied by:

• Fever
• Breathing problems
• Abdominal pain
• Consult a doctor as these could be symptoms of a more serious condition.

Uses and Causes

The lat muscles are used in everyday activities. These include:

• Picking up objects like grocery bags
• Opening heavy doors
• Chest expansion for breathing
• Pushing against the armrests of a chair to stand up
• Using handrails to climb stairs

For sports or working out, the lats are used in:

• Weightlifting exercises using the upper body
• Bench-presses
• Rowing
• Swimming
• Throwing

Common causes of pain include:

• Overusing the muscles
• Using poor techniques
• Exercising without warming up

Risk of injury

Individuals that are at risk of developing this injury include those that:

• Are continually reaching overhead
• Regularly chop wood
• Perform regular shoveling
• Move furniture or other heavy objects
• Regularly practice poor posture

Tearing the latissimus dorsi is possible, especially for athletes. Some athletes with increased risk include:

• Golfers
• Baseball pitchers
• Gymnasts
• Swimmers
• Tennis players

Exercises that can help bring relief

Certain exercises can alleviate the aches, pain, and strengthen the lat muscles to prevent and/or worsen the injury. It is recommended to consult a doctor, sports chiropractor, or personal trainer before beginning a therapeutic exercise regimen. This is to ensure that the exercises are right for the individual and their condition and that they use the correct form. Here are two exercises that can help reduce the pain. The doctor, chiropractor, or trainer will recommend the frequency the individual should perform the exercises.

Back bow

This pose is known as the superman pose. To perform:

• Lay facedown on the floor
• Extend the legs so they are straight
• Stretch arms away from the body, so they are in front of the head
• Use the back to raise the shoulders
• Extend the arms and legs upward
• Hold the position for 10 seconds

Pelvic raise/lift

To perform this exercise:

• Lay flat on your back with the arms at the sides
• Bend the knees like for a sit-up with the heels close to the buttocks
• Keeping the hands and feet in place
• Lift the pelvis upward
• Slowly lower back to the floor

Prevention

Individuals can prevent lat pain with lifestyle adjustments. These include:

• Using proper technique and posture during work, sports, and exercise
• Staying aware to not overuse the muscles
• Staying hydrated
• Warming up and cooling down thoroughly before and after a workout, sports, physical activities
• Regular stretching
• Applying ice and heat before and after work, sports, and physical activities
• Chiropractic care
• Physical therapy massage

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Body Composition

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Nutrition and Recovery Advantage

Two important steps to achieve optimal health include:

Nutrition

Having a proper protein intake is important for muscle adaptability or the way muscles adapt to stress during exercise and/or strength training. This is also important to stimulate muscle protein synthesis after exercising and/or strength training. To ensure the body is getting the strength and hypertrophy improvement from exercise and strength training, it is recommended to eat around 25g of high-quality protein after workout sessions.

Recovery

For those doing aerobic and strength training, maximize recovery time between workout sessions. This is because strength and aerobic fitness health gains are low when the two only have a separation of 6 hours or less. Twenty-four hours between sessions is recommended especially if the priority is endurance performance.

References

Anderson, S. E., Hertel, R., Johnston, J. O., Stauffer, E., Leinweber, E., & Steinbach, L. S. (2005, November). Latissimus dorsi tendinosis and tear: imaging features of a pseudotumor of the upper limb in five patients. American Journal of Roentgenology, 185(5), 1145–1151
www.ajronline.org/doi/abs/10.2214/AJR.04.1247

Donohue, Benjamin F et al. “Sports Injuries to the Latissimus Dorsi and Teres Major.” The American journal of sports medicine vol. 45,10 (2017): 2428-2435. doi:10.1177/0363546516676062http://journals.sagepub.com/doi/abs/10.1177/0363546516676062?journalCode=ajsb

Henseler, J. F., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2014, April). Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation? Journal of Shoulder and Elbow Surgery, 23(4), 553–560
www.jshoulderelbow.org/article/S1058-2746(13)00399-6/fulltext%20

George, Michael S, and Michael Khazzam. “Latissimus Dorsi Tendon Rupture.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,4 (2019): 113-118. doi:10.5435/JAAOS-D-17-00581

Lehman, Gregory J et al. “Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study.” Dynamic medicine: DM vol. 3,1 4. 30 Jun. 2004, doi:10.1186/1476-5918-3-4