Do you experience pain in your shoulder blade area? It might be due to teres minor muscle trigger points.
In this blog post, we will discuss what teres minor is, the symptoms of pain, and how to alleviate the discomfort using self-massage techniques and other methods. We hope that this information helps you find relief from your pain!
What causes teres minor muscle pain?
A few things can contribute to the development of minor pain and muscle trigger points. These include:
Repetitive motions
If you make the same motions repeatedly, it can lead to strain on the muscle and the formation of trigger points.
Poor posture
Poor posture can put unnecessary strain on the muscle and lead to trigger points.
Direct injury
An injury to the muscle can cause trigger points to form.
Anatomy of teres minor
The teres minor muscle is a small, triangular muscle located in the back of the shoulder. It originates on the lower half of the scapula (shoulder blade) and inserts onto the upper part of the humerus (upper arm bone).
Teres minor is one of the four rotator cuff muscles. Common injuries to the rotator cuff muscles include:
- rotator cuff tears
- damage to the teres minor tendon
- rotator cuff tendon tears
- teres minor tear
Teres minor tears are usually associated with massive rotator cuff tears as their attachment point on the humerus is less susceptible to individual injury. Teres minor tendon tears will occur mostly with tears of other rotator cuff tendons.
Mechanism of action of teres minor
The muscle helps to stabilize the shoulder joint and also aids in the external rotation of the arm. However, when the power is tight or has trigger points, it can cause pain in the shoulder blade area.
Additionally, the teres minor is part of the quadrangular space. The quadrangular space is a triangular-shaped area at the back of the shoulder.
It is bordered by the teres minor muscle, long head of the triceps muscle, and humerus. The quadrangular space houses the axillary nerve and posterior circumflex humeral artery.
(Source: Häggström, Mikael (2014). “Medical gallery of Mikael Häggström 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 2002-4436. Public Domain.)
Restriction in this area, including tightness in the teres minor, can compress these structures and cause pain. The pain may radiate down the arm or into the neck.
Symptoms such as numbness, tingling, and weakness in the arm and hand can often mimic symptoms of cervical disc herniation.
Symptoms of teres minor trigger points
There are a few symptoms that are associated with teres minor trigger points.
Pain in the shoulder blade area
This is the most common symptom of teres minor pain. The pain may be a dull ache, or it can be sharp and stabbing.
Pain with movement
The pain may worsen with certain motions, such as reaching overhead or behind the back.
Weakness in the arm
Muscle weakness can cause the arm to feel heavy or hard to lift.
Numbness or tingling in the arm
This is caused by the compression of nerves in the area, precisely the quadrangular space.
How to alleviate teres minor pain
Self-massage and trigger point release
Massaging the muscle can help to release trigger points and tension. For example, a tennis ball or foam roller can be used to massage the muscle. In reality, almost anything that provides compression can be used to create tension in the force for self-massage and self-trigger point therapy.
The effect of foam rolling has been mainly studied in the context of athletic performance. In a recent systematic review with meta-analysis, it was found that the impact of foam rolling on performance was negligible; however, there did seem to be an effect on perceived pain(1).
We won’t debate the performance-enhancing effects of foam rolling and whether it is time worth spending. Instead, give it a try and if you find it helps, consider it a low-cost, low-invasive mechanism to help alleviate teres minor pain.
To use a foam roller:
Place the foam roller on the ground. Position yourself so that the teres minor muscle rests on the roller. Slowly roll back and forth over the muscle, applying pressure to your tolerance. When you find a tender spot, stop and hold for 30 seconds.
Repeat this process until the muscle feels less tight.
Stretching
Stretching the muscle can help to alleviate pain and improve the range of motion.
To stretch the teres minor:
Stand with your arm at your side and your palm facing behind you.
Bend your elbow to 90 degrees, keeping your palm facing behind you.
Using your other hand, grab hold of your bent elbow and pull it across your body towards the opposite shoulder.
You should feel a stretch in the back of your shoulder. Hold for 30 seconds and repeat on the other side.
If you have any pain or discomfort, stop the stretch and consult with a doctor or physical therapist.
Strengthening exercises
While stretching can help to improve range of motion, strengthening exercises are essential for the stability and function of the shoulder. For people with teres minor pain, it is necessary to focus on activities that don’t require moving the arm overhead.
Here are a few examples of exercises that can help to strengthen the shoulder without moving the arm overhead:
Prone Y’s
Lie face down on a bench with your arms hanging off the edge. Slowly raise your arms to the side, keeping them straight until they align with your body. Return to the starting position and repeat.
Prone T’s
Lie face down on a bench with your arms hanging off the edge. Slowly raise your arms to the side, keeping them straight until they align with your body. Return to the starting position and repeat.
Side-lying Lateral Raise
Lie on your side with your bottom arm resting on your side and your top arm hanging down. Raise your top arm until it is in line with your body. Return to the starting position and repeat.
Stop and consult a doctor or physical therapist before continuing if you have pain with any of these exercises.
Dry needling
Dry needling is a treatment that involves inserting thin needles into the skin to target trigger points and myofascial pain.
The needles stimulate the nerves that supply the muscle, which can help relieve pain and improve function. Dry needling is often used to treat trigger points, myofascial pain, and tension headaches.
The needles are typically inserted into the skin with a quick, jerking motion, which can sometimes cause a brief cramping sensation. However, this sensation is generally not painful and should subside quickly.
Relief from dry needling can last several hours or days, although some people may require multiple treatments before seeing significant improvements.
Dry needling is typically administered by physical therapists or other healthcare professionals trained in its use. Dry needling is best used with other therapy such as strengthening and mobility work.
Dry needling coupled with more natural pain remedies can also be used.
Trigger point injections
A trigger point injection is a shot of medicine put into a muscle to relieve pain. The treatment usually contains a local anesthetic and a steroid and is injected into the muscle. The goal is to release or relax the muscle.
Relief usually lasts for several weeks. Then, the injections are given by a pain management doctor, an anesthesiologist, or a physiatrist.
The teres minor muscle is often injected to relieve shoulder pain. When the teres minor muscle is tight or contracting, it can cause pain in the shoulder. The trigger point injection relaxes the muscle and relieves pain.
Surgery for rotator cuff tear
Surgery may be the best option to repair the damage if you have a rotator cuff tear. A rotator cuff tear can occur due to a sudden injury, such as a fall, or from repetitive stress, such as overhead activities. An orthopedic surgeon typically does surgery to repair a rotator cuff tear.
During surgery, the orthopedic surgeon will make an incision in your shoulder and reattach the torn tendon to the bone. Sometimes, a small piece of bone may need to be removed to provide access to the tendon.
In other cases, part of the surrounding muscle may need to be removed. Once the tendon is reattached, the incision is closed wi h stitches or staples.
After surgery, you will likely need physical therapy to help regain range of motion and strength in your shoulder. A physical therapist or occupational therapist will help design a custom rehabilitation program for you.
This may include exercises, stretches, and massages. Dry needling may also help release muscle knots and trigger points that can cause pain.
Frequently Asked Questions
What causes teres minor pain?
The teres minor does the external rotation of the humeral head and can be injured by sudden trauma, such as a fall, or by repetitive stress, such as overuse. Injuries to the teres minor include:
- contribution to a massive rotator cuff tear
- teres minor fatty degeneration
- irreparable rotator cuff dysfunction
- teres minor tears
- teres minor rupture
- rotator cuff disorders
Where do you feel teres minor pain?
You may feel minor pain in the shoulder, specifically in the back and outside of the shoulder joint. The pain may also radiate down the arm.
How long does it take for teres minor to heal?
The extent of the injury determines how long it takes for the teres minor to heal. Therefore, the teres minor should be part of a complete posterior rotator cuff evaluation for anything from irreparable rotator cuff tears, common rotator cuff tear patterns, assessing teres minor tear, and artery damage such as injury to the circumflex scapular artery.
Teres minor integrity affects the external rotation of the shoulder (with the elbow flexed or extended) and is an integral part of the rotator cuff.
Surgery is necessary if massive rotator cuff tears occur, and recovery will take several months. Minor injuries such as muscle strain can take a few da s to a few weeks.
What is the difference between teres minor and rotator cuff?
The rotator cuff comprises four muscles: the teres minor muscle, the supraspinatus, subscapularis, and infraspinatus. All four muscles stabilize the shoulder joint and allow for a wide range of motion.
Additionally, the rotator cuff muscles work synergistically with other muscles of the back such as the rhomboids, latissimus dorsi, and deltoids.
How can you tell the difference between infraspinatus and teres minor?
The infraspinatus is located on the back of the shoulder blade and attaches to the humerus (upper arm bone). The teres minor muscle is located below the infraspinatus and connects to the humerus.
Both muscles work together to rotate the arm outward (external rotation). You can tell the difference between the two muscles by their location and attachment points.
(1)Wiewelhove T, Döweling A, Schneider C, et al. A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Front Physiol. 2019;10:376. Published 2019 Apr 9. doi:10 3389/fphys.201 .00376