Teres Major Trigger Points and Referred Pain

Before you read about trigger points in the teres major muscle and its referred pain, you may want to find out more about the teres major muscles themselves.

Since the teres major muscles act in conjunction with the latissiumus dorsi, any activity that overloads and irritates the lats can also lead to problems with the teres major.

Teres Major Trigger Points Causes and Symptoms

Trigger Points in the teres major cause a deep ache in the posterior deltoid and over the long head of the triceps brachii muscle. Sometimes, pain is also referred to the posterior shoulder joint itself and to the dorsal forearm, but rarely the elbow. Trigger points in this muscle can cause sharp deltoid pain when resting your elbows on a table or desk or when reaching up and forward. Along with TrP’s in the latissimus, reaching up and forward may be restricted with pain but the shoulder is not frozen.

muscle model showing teres major muscle labelled
image by robswatski via flickr

Any activities that cause strain or overuse of the latissimus dorsi may also aggravate the teres major, such as pulling the arm downward (pullups, lat pulldowns), and tennis, rowing, swimming, wood chopping, and pitching. Travell and Simons mention that one major known cause of trigger points in the teres major is the strain from driving a vehicle with faulty steering or no power steering, particularly large, heavy vehicles such as trucks that are difficult to steer. 1Simons, David G., Janet G. Travell, Lois S. Simons, and Janet G. Travell. “Chp. 25: Teres Major Muscle.” Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore: Williams & Wilkins, 1999. 587-595.,2Davies, Clair. The Trigger Point Therapy Workbook: Your Self-treatment Guide for Pain Relief. Oakland, CA: New Harbinger Publications, 2004.

The symptoms of teres major trigger points may be confused with subacromial or subdeltoid bursitis, supraspinatus tendinitis, c6 to 67 radiculopathy or a thoracic outlet syndrome. The teres major is one of four muscles (pectoralis major, latissimus dorsi, and subscapularis) that are responsible for a pseudothoracic outlet syndrome that is actually of myofascial origin. However, it should be noted that trigger points in the scalenes, pectoralis minor, and subclavius muscles can produce a true thoracic outlet syndrome, which is caused by entrapment and compression of the brachial plexus and subclavian artery. 3Simons, David G., Janet G. Travell, Lois S. Simons, and Janet G. Travell. “Chp. 25: Teres Major Muscle.” Travell & Simons’ Myofascial Pain and Dysfunction: the Trigger Point Manual. Baltimore: Williams & Wilkins, 1999. 587-595.

The image below shows the location of the teres major trigger point and its referred pain patterns.

teres major trigger points
Teres Major Trigger Points and Referred Pain Patterns

Teres Major Trigger Point Release

There are two main areas of trigger points in the teres major muscle. One of the trigger points is more medial and overlaps the surface of the scapula. The other is more to the side. Both TrP’s refer pain to the same locations as described above. There is a common trigger point area of the latissimus dorsi near the lateral teres major TrP, evidenced by pain of the mid-back along the lower inner edge of the scapula. Any self-treatment of the area may encounter both of these trigger points and it can be difficult, in self-treatment, to differentiate the teres major from the latissimus.

teres major muscle illustration with trigger points marked

You can attempt to massage the muscle with your hand. Reach underneath your arm to grasp and pinch the wad of muscle under the armpit. Feel for any hyper-sensitive areas and massage, taking care to check the area just over the lower lateral border of the scapula, where the teres major attaches. The hand may be tired very quickly by this effort, however.

The TheraCane Self-Massager or Body Back Buddy Self-Massager may also be used to massage the teres major (and the upper latissimus dorsi). A tennis ball, lacrosse ball, or massage ball against the wall may also be effective.

Body Back Buddy Self Massage Tool - Back, Neck, Shoulder, Leg & Feet Trigger Point Therapy & Deep Tissue Massager by Body Back Company (Full-sized Blue)

Sources   [ + ]

1. Simons, David G., Janet G. Travell, Lois S. Simons, and Janet G. Travell. “Chp. 25: Teres Major Muscle.” Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore: Williams & Wilkins, 1999. 587-595.
2. Davies, Clair. The Trigger Point Therapy Workbook: Your Self-treatment Guide for Pain Relief. Oakland, CA: New Harbinger Publications, 2004.
3. Simons, David G., Janet G. Travell, Lois S. Simons, and Janet G. Travell. “Chp. 25: Teres Major Muscle.” Travell & Simons’ Myofascial Pain and Dysfunction: the Trigger Point Manual. Baltimore: Williams & Wilkins, 1999. 587-595.