Trigger Point Therapy - Teres Minor

 

Posted by Team NAT on Mar 31, 2017

 

 Teres Minor Trigger Points - often associated with Rotator Cuff Injuries

The teres minor decelerates internal rotation of the shoulder joint.

Inhibition in this muscle due to short/ spastic subscapularis, latissimus dorsi, teres major, and pectoralis major muscles sets up the ideal conditions for repetitive stress in sports, such as swimming and rugby, and in any activity involving acceleration through internal/external rotation and flexion/extension of the shoulder complex.

Numbness or tingling will be felt in the fourth and fifth digits of the same arm, as well as pain in the posterior shoulder at the greater tuberosity. Teres minor myofascial trigger points are often sponsored by the subscapularis.

Teres Minor - Common Trigger Point Site

Anatomy

A member of the rotator cuff, which comprises the supraspinatus, infraspinatus, teres minor, and subscapularis.

The rotator cuff helps hold the head of the humerus in contact with the glenoid cavity (fossa, socket) of the scapula during movements of the shoulder, thus helping to prevent dislocation of the joint.

Origin

Upper two-thirds of lateral border of dorsal surface of scapula. 

Insertion

Lower facet on greater tubercle of humerus. Capsule of shoulder joint.

Action

As a rotator cuff muscle, helps prevent upward dislocation of shoulder joint. Laterally rotates humerus. Weakly adducts humerus. Antagonists: subscapularis, pectoralis major, latissimus dorsi.

Nerve

Axillary nerve, C5, 6, from posterior cord of brachial plexus. 

Basic Functional Movement

Example: brushing hair back.

Indications

Shoulder pain (especially posterior), frozen shoulder syndrome, rotator cuffrehabilitation, subacromial bursitis, biceps tendonitis, shoulder pain at top outer section of shoulder blade near posterior deltoid, often associated with other shoulder problems (especially rotator cuff issues), numbness/tingling in 4th and 5th fingers.

Note: Trigger points in the teres minor muscle mainly cause a deep pain in the shoulder which can sometimes be misinterpreted as bursitis. 

Causes

Reaching above 90 degrees and/or reaching behind back, gripping steering wheel in RTA, holding heavy object for long time, computer/mouse, overuse syndromes. 

Differential Diagnosis

C8–T1 radiculopathy. Rotator cuff tendinopathy. Shoulder–wrist–hand syndrome. Subacromial/deltoid bursitis. Shoulder impingement syndromes (painful arc). Acromioclavicular joint dysfunction.

Connections

Infraspinatus.

Trigger Point Treatment

Spray and Stretch	YES
Compression	YES
Muscle Energy Techniques	YES
Positional Release	YES
Dry Needling	YES