Acupuncture for Teres Minor Pain
A person with back of shoulder pain
Effective Treatment for Back of Shoulder Pain
Do you experience pain in the back of your arm or shoulder? Are you finding it difficult to perform activities that require external rotation of the arm, like throwing a ball or reaching overhead? You might be dealing with Teres Minor pain. This blog post will delve into the Teres Minor muscle, its trigger points, and why acupuncture and dry needling could be your go-to treatments.
What is the Teres Minor Muscle?
The Teres Minor muscle is a small muscle located in the shoulder area. It's one of the four rotator cuff muscles, along with the supraspinatus, infraspinatus, and subscapularis. The Teres Minor is responsible for external rotation and adduction of the shoulder joint. It originates from the lateral border of the scapula and inserts on the greater tubercle of the humerus. Working in conjunction with other rotator cuff muscles, it stabilizes the shoulder joint, allowing for smooth and coordinated arm movements.
Common Indications for Teres Minor Trigger Points
Back of Arm Pain
Back of Shoulder Pain
Trigger points in the teres minor cause posterior shoulder pain as well as numbness and tingling in the 4th and 5th fingers. They don’t often occur alone since the teres minor works closely with the infraspinatus muscle - so those two muscles often have trigger points together.
Teres Minor Muscle Actions
Lateral rotation of the shoulder
Adduction of the shoulder
Stabilization of the head of the humerus in the glenoid cavity
Since the teres minor connects the outside of the shoulder blade (scapula) to the upper arm (humerus), it acts to externally rotate and adduct the shoulder. It also helps to stabilize the shoulder along with other muscles in the area.
Signs and Symptoms of Teres Minor Trigger Points
Posterior shoulder pain
Ring and pinky finger numbness and tingling
Perpetuating Factors
Car accidents
Reaching overhead, like playing volleyball or painting
Reaching behind the shoulder while in extension
The main causes of teres minor muscle pain are acute trauma and repetitive strain or overuse.
Teres Minor Trigger Points
Where are Teres Minor Trigger Points?
Trigger points are often found in the belly of the muscle which lies lateral to the shoulder blade in between the infraspinatus (above) and the teres major (below).
Teres Minor Trigger Point Referral Pattern
Pain the size of a silver dollar deep in the posterior shoulder/deltoid muscle
Numbness and tingling of the 4th and 5th fingers
Differential Diagnosis
Axillary nerve compression
Shoulder bursitis
Cervical and Ulnar neuropathy
A/C joint separation
Associated Trigger Points
Infraspinatus
Teres Minor Synergists and Antagonists
Synergists:
Infraspinatus
Supraspinatus
Posterior fibers of the Deltoid
Antagonists:
Subscapularis
Pectoralis major
Anterior Deltoid
Origin and Insertion
Teres Minor Origin
Upper 2/3rds of the lateral border of the scapula
Teres Minor Insertion
Greater tubercle of the humerus
Treatment for Teres Minor Pain
Acupuncture and dry needling are effective treatments for trigger points in the Teres Minor muscle. These treatments are backed by research and clinical studies. In addition to these methods, a comprehensive treatment plan may include targeted stretching and strengthening exercises, myofascial release techniques, and physical therapy to relieve tension and discomfort in the muscle.
Quadrangular Space Syndrome
Quadrangular Space Syndrome is a condition that results from excessive or chronic pressure on the structures passing through the quadrangular space in the shoulder. This includes the axillary nerve and the posterior humeral circumflex artery. The syndrome can be triggered by overuse of the arm, especially in activities that require overhead movement, or by traumatic injuries such as a shoulder dislocation.
The teres minor muscle is directly affected by this syndrome because it is innervated by the axillary nerve and partially supplied by the posterior humeral circumflex artery. When Quadrangular Space Syndrome occurs, it can lead to selective atrophy of the teres minor muscle. This can activate trigger points in the teres minor, resulting in vague shoulder pain and paresthesia (tingling or numbness). Therefore, it's crucial to consider the possibility of Quadrangular Space Syndrome when diagnosing and treating teres minor trigger points.
Corrective Actions
Elimination of mechanical stress on the muscle
Attention to sleeping position
Self-administration of trigger point compression
Self-stretch exercises
Final Thoughts
To minimize discomfort and strain in the Teres Minor, it's crucial to adopt ergonomic practices, such as proper posture and balanced weight distribution across both shoulders. Periodic rest intervals during activities that involve repetitive motion can also be beneficial. For those dealing with ongoing pain or tension in the Teres Minor, acupuncture and dry needling offer promising avenues for relief and recovery.
Over to you
If you liked this article, please share with friends and family who may be suffering with rotator cuff or shoulder pain.
Sources:
Travell, J. G., Simons, D. G. (1993). Myofascial pain and dysfunction: The trigger point manual. London: Lippincott Williams & Wilkins.
Biel, A., & Dorn, R. (2010). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Boulder, CO: Books of Dicovery.
Janda, Vladimír. “Muscle Function Testing.” (1983).
Juneja P, Hubbard JB. Anatomy, Shoulder and Upper Limb, Arm Teres Minor Muscle. [Updated 2023 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513324/
Dalagiannis, N., Tranovich, M., & Ebraheim, N. (2020). Teres minor and quadrilateral space syndrome: A review. Journal of orthopaedics, 20, 144–146. https://doi.org/10.1016/j.jor.2020.01.021
Passigli, S., Plebani, G., & Poser, A. (2016). ACUTE EFFECTS OF DRY NEEDLING ON POSTERIOR SHOULDER TIGHTNESS. A CASE REPORT. International journal of sports physical therapy, 11(2), 254–263.
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