There are very few muscles in the body whose functionality is as important as the lats. Because it connects the thoracolumbar fascia to the humerus, inhibition of the latissimus dorsi can cause compensations in the neck, shoulder, elbow, lower back, and gait. This article will detail these compensation patterns and how to resolve them. This information is important for all massage therapists, Pilates instructors, personal trainers, physical therapists, etc. because inhibition of a muscle that is centrally located causes global responses. Understanding how these patterns are formed and relate to each other is essential in resolving long-standing and difficult presentations.
First, let’s start with the neck and shoulder. The lat via its attachment to the humerus is capable of scapular depression. It is opposed by the elevators of the scapula including the upper trapezius and the levator scapula. After palpating tight spots in the neck extensors, upper traps, and levator scapula I will then test the function of the lat by asking the client to hold their palm against their hip. If this is a weak test I then therapy localize tender spots on the aforementioned muscles while testing the lat to see if they strengthen the test. Whichever one makes the tests the strongest is the one I release first. If that does not completely resolve I then proceed to the next tenderest spot and continue on until the test is strong. If the lat tests strong to begin with, I will challenge it by having the client shrug their shoulder or turn their head to the opposite side. One of these will usually inhibit the lat. When the lat tests strong and can withstand the challenges, I consider that a reprogramming of the motor control system. I will then assign a home program of first stretching the neck/shoulder muscles followed by strengthening of the lat. It is crucial that the client follows this protocol exactly in order to successfully reprogram the motor control system. When the reprogramming occurs it is stored in the short-term memory. By constant repetition the reprogramming is then shifted to long-term memory.
Now let’s talk about the elbow. When the body perceives an instability in a joint it will very often either compress that joint or a nearby joint. I find very often with difficult to resolve cases of medial or lateral epicondylitis that the elbow is compressing to stabilize for the shoulder joint. Inhibition of the lat will often result in either of these situations. I will test the lat by having the client either holding their pinky against their hip with the palm up for medial epicondylitis or with the thumb against the hip with the palm down for lateral epicondylitis. If the test is weak I will then therapy localize spots around the epicondyles and then proceed with the NeuroKinetic Therapy protocol. A home program would be releasing the areas around the epicondyle followed by strengthening of the lat.
Finally the lower back. The latissimus dorsi is contiguous with the thoracolumbar fascia. Any inhibition of the lat will cause muscles/functions in that area to compensate. These include the ipsilateral erector spinae group, the quadratus lumborum, the gluteus maximus, and the gluteus medius. This may also cause a contralateral rotational compensation, including the piriformis. Follow the NKT protocol, identify the facilitated muscles/functions using therapy localization, challenge the reprogramming, and assign the appropriate home program.
Gait can also be affected by inhibition of the lat. The lat is also an extensor of the humerus. Start by testing humeral extension with contralateral straight leg hip extension. If the extension of the humerus is inhibited check for tender spots in the opposite glute, hamstring, calf, and plantar foot muscles. Use the NKT protocol. Extension of the humerus may also be tested against flexion of the opposite humerus or flexion of the ipsilateral leg.
Functionality of muscles/functions that are centrally located are essential in maintaining healthy global relationships. The latissimus dorsi with its attachments to both the upper body and lower body is a muscle whose function is crucial in maintaining balance. A strong functional lat = a happy body.