Neck Pain can be a LATS Problem

I would like to share a great article written by my friend David Weinstock from California. Interesting stuff, David!

Client came in complaining of neck pain, elbow pain, and low back pain. How are all these related? Inhibited lats. The lats depress the scapula via the humerus to oppose scapular elevation- traps and levators. Facilitated upper traps and levators will cause neck pain. The lats are a part of the posterior sling system. When they are inhibited, the thoracolumbar fascia becomes facilitated, causing low back pain. The lats also contribute to scapular stability. When they are inhibited, following the "Joint by Joint" approach, the elbows lock up to create stability. So inhibited lats can cause elbow pain. One inhibited muscle causing three distinct dysfunctional movement patterns. Rather than treat the symptoms, find the cause, and resolve all three at once by unraveling the puzzle.

The Importance of Functional Lats

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.

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.
  

About Our Guest Writer:

 David Weinstock has been practicing and teaching manual therapy techniques since 1973. He graduated from Johns Hopkins University as a pre-med student. David then traveled extensively in Central and South America learning from native healers and a variety of practitioners. He graduated from the New Mexico School of Natural Therapeutics in 1979. In 1985 David cofounded the Institute of Conscious Bodywork in Marin County California. NeuroKinetic Therapy was developed in 1985 in collaboration with several peers. He taught many different classes at the Institute, including advanced anatomy, carpal tunnel syndrome, TMJ, and NeuroKinetic Therapy until 2005. 

David’s book, “NeuroKinetic Therapy, an Innovative Approach to Manual Muscle Testing,” was published in 2010. Since then it has been translated into Japanese and Korean, and is now in its second edition. David now travels nationally and internationally teaching chiropractors, physical therapists, personal trainers, massage therapists, and Pilates instructors. 

David maintains a busy private practice in Marin County California, using NeuroKinetic Therapy to treat athletes and weekend warriors alike. Acute and chronic injuries and conditions are assessed and rehabilitated, and the client is sent home with an individualized exercise program.

David enjoys living in beautiful Marin County with his wife, daughter, and pets. He is an avid hiker, cross-country skier, and tennis player. He is in contact with people from around the world sharing knowledge and information.

VISIT HIS WEBSITE AT: http://neurokinetictherapy.com/