How to Treat Latissimus Dorsi Pain, According to Physical Therapists

Got pain in your lats? Chances are, you’re a fitness buff. The latissimus dorsi (“lat”), one of a pair of large, flat muscles in your back, isn’t often hurt. But when it is, it’s usually the result of a sports or exercise injury. 

Even though your lat muscles span the width of your middle and lower back, due to how well they’re anchored to the spine and pelvis, you’re most likely to feel pain in your shoulders, the back of your chest wall, and the back of your arms when they’re strained. 

If you do experience latissimus dorsi pain, don’t worry that the discomfort will keep you out of the gym or away from a favorite activity. Conservative treatment — including targeted exercises to stretch and strengthen the injured muscle — can help relieve pain and restore strength and range of motion. 

Read on to learn more about what causes latissimus dorsi pain, along with how to prevent and treat it — especially with exercises recommended by our Hinge Health physical therapists.

What Is Latissimus Dorsi Pain? 

“The latissimus dorsi is one of the coolest-looking muscles because it resembles a cape,” says Kristin Vinci, PT, DPT, a physical therapist at Hinge Health. “If you look at someone’s back, the lats are like a big, upside down triangle on each side of the spine,” she explains. The upper two points are at the back of your arm, connecting to the upper arm bone. Then it stretches to your side along the spine, before narrowing like a V toward the pelvis. “The lats are what give weightlifters and bodybuilders that classic V-shape definition in their back,” says Dr. Vinci. 

Whether you work out a lot or not, your latissimus dorsi muscles provide support and stability to your shoulders for overhead motions. Their primary function involves upper arm movement at your shoulders. “You might not be aware of or really focus on these muscles, but the lats play an important behind-the-scenes role in your overall function,” says Dr. Vinci. 

For instance, the muscle is engaged when you reach to get something heavy off a high shelf. “As you lower your arm, the latissimus dorsi muscle helps control that movement against gravity,” says Dr. Vinci. For athletes, the lats are a key player in upper body movements like pull-ups and chin-ups: As you pull your body upward, the lats move inward to help pull your arms downward and behind your body. Then, when you lower back down, the latissimus dorsi helps your arms extend. 

Latissimus dorsi pain is often felt in the upper extremities, such as when you extend your arms by reaching forward or overhead. “You could also really feel it when the muscle is most active — when you’re pulling down, squeezing in, or pulling toward you,” says Dr. Vinci.

Symptoms of Latissimus Dorsi Pain

A latissimus dorsi strain can range from mild to severe. Symptoms may include:

• Pain when using your arms, especially when reaching overhead. The pain can extend to your forearm and into your fingers.

• Shoulder tightness or stiffness.

• Nerve sensitivity that can cause a burning, tingly sensation or warmth in your mid-back, side ribs, or the back of your arm.

Causes of Latissimus Dorsi Pain 

A serious injury, such as a car accident or a severe fall, may cause latissimus dorsi pain, but it’s typically related to working out. Pain or soreness may be due to overuse, which can be compounded by forgetting to warm up first. “If you’re a little weak in your lats and start swimming, rock climbing, or doing a robust pull-up workout, it could lead to a strain if you do too much too fast,” says Dr. Vinci. 

Other activities that heavily rely on the latissimus dorsi muscles include exercises that involve pulling and throwing, like:

• Rowing

• Swimming

• Chopping

• Chin-ups and pull-ups

• Baseball, especially pitching

• Tennis

• Gymnastics

The above exercises recommended by Hinge Health physical therapists can help ease latissimus dorsi pain. When performing the stretching exercises, hold the stretches for as long as it feels comfortable to maximize the relief you’ll feel. If you’ve been doing some active strengthening prior to experiencing latissimus dorsi pain, you will likely be able to start the strengthening exercises within a few days to a week after pain sets in, says Dr. Vinci. They will make your muscles stronger, more resilient, and better able to cope with the demands placed on them, making you less prone to injury. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatment Options for Latissimus Dorsi Pain

Regardless of the reason for your lat pain, there’s a lot you can do to feel better and get back to the activities you enjoy. The following tips from our Hinge Health physical therapists can provide relief for latissimus dorsi pain. 

• Physical therapy. Targeted stretching and strengthening exercises, like the ones above, are often key to healing latissimus dorsi pain — and decreasing the risk of re-injury. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for latissimus dorsi pain. Check with your doctor to make sure you are able to safely take these medications, based on your medical history.

• Cold or heat therapy. Put ice or heat on your lats for 15-20 minutes up to four times per day. Ice is often more helpful in the first few days after a lat strain to reduce pain and swelling. After a few days, you can keep using ice or switch to heat. Test each out to see if one helps reduce symptoms like pain and stiffness more than the other.

• Protect the injured area — but keep moving. Instead of avoiding movement entirely, scale back on activities that cause an unacceptable increase in lat pain. “You don’t want to rest until the pain goes away completely, especially if you’re usually very active,” says Dr. Vinci. “You can rest the lat muscle for a few days by avoiding upper body exercise. Then, gradually increase your activity and exercise with movements that cause only minimal levels of pain. How quickly you progress will depend on the severity of your injury.” Let your symptoms be your guide or work with a physical therapist if you want support as you ease back into exercise.

• Elevate. If you have a lot of swelling in your upper arm, lie on your back with your arm draped over a pillow. Alternatively, you can lie on your uninjured side with your sore arm on a pillow in front of you and take deep breaths. This will help gently stretch the latissimus dorsi muscle.

How to Prevent Latissimus Dorsi Pain

You can help reduce the risk of developing latissimus dorsi pain by employing these tips:

• Build up gradually. “When you’re starting a new activity or building your training, especially with high-intensity overhead exercises, make sure you gradually progress and don’t do too much too soon,” says Dr. Vinci. 

• Stay hydrated. Muscle injury often occurs when the tissues are overstretched too quickly, explains Dr. Vinci. “If your body is well hydrated, your tissues will be more pliable, more resilient, and better able to stretch to their full length in order to sustain that force,” says Dr. Vinci. 

• Warm up prior to physical activity. Warming up increases blood flow to muscles, allowing them to contract and relax more easily, reducing the risk of injury. Dr. Vinci says you don’t have to do a “lat-specific” warm-up. You can walk, run, or ride a stationary bike.  

PT Tip: Keep Up the Cardio

Latissimus dorsi pain shouldn’t stop you from engaging in lower-body exercises, so light-to-moderate aerobic exercise like walking and using a stationary bike are excellent options to aid in a gradual return to exercise, says Dr. Vinci. “They will increase blood flow without putting any demand on the shoulder.” 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Holschen, M., Körting, M., Steinbeck, J., & Witt, K.-A. (2019). Traumatic Tear of the Latissimus Dorsi Tendon in a CrossFit Athlete: Surgical Management. Journal of Orthopaedic Case Reports, 9(5), 82–86. doi:10.13107/jocr.2250-0685.1546

2. Nassef, A. (2010). Latissimus Dorsi Muscle. Physiopedia. https://www.physio-pedia.com/Latissimus_Dorsi_Muscle