Latissimus strain

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Written By Dr. João Arthur Ferreira

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Do you often feel a nagging pain in your middle back when you intend to pick up something from the ground or while playing fetch with your dog? It could be due to strain in your latissimus muscle.

Latissimus strain is quite common, as you may think. It could be due to bad posture, often slouching while working or studying, poor biomechanics while lifting heavy objects or improper form of training in the gym.

Latissimus dorsi, known as lats, is a wide “V” shaped muscle that spans the middle and lowers the back. It aids with core stabilizer muscles. 

Lats move our arm in a pulling motion bringing the arm closer to the torso. If the lats are shortened, every time we want to raise our hand, it pulls in our lower back, leading to shoulder and lower back pain

Habitual reasons that exacerbate pain

Maggie Knott would say, “Where the eyes go, the head goes. In other words, the head is protruding forward to focus more on a particular task, say working on your laptop or while using a phone. 

Unintentionally, you clench your jaw, round up back, and shrug your shoulders. Holding this position for long hours overstretches your back muscles. At the same time, there is progressive shortening of neck muscles. 

Our bodies are physiologically designed to take over the job of incompetent muscles by activating compensatory mechanisms. This leads to a vicious cycle of muscle imbalance. 

Here, I will discuss 2 of the most modifiable reasons that concisely explain why muscle imbalance occurs. 

Bad posture 

We have often heard “straighten up your back” or “sit up straight” by parents, teachers, office colleagues, or random passersby. But we paid no heed to their advice.

The habitual slump causes significant pain when the muscles can no longer bear the uneven load. 

The forward head posture adds 30 to 60 pounds; to create more stability, the body tightens and overstretches compensatory muscles. 

Posture is not limited to the way how you sit or stand. It impacts how you carry the load, how you perform your daily activities, the position in which you watch television or read a book, and how you bend down while washing dishes. All of these activities impact posture and muscle imbalance.

Poor ergonomics

Most days are spent sitting at work, driving, or watching Netflix. A good quality chair can prevent most musculoskeletal disorders in the working community. 

You can correct it by being aware of your body posture and mindfully changing positions alternately. 

● Make a conscious effort not to slouch or hunch over when prepping a meal, eating, driving, using your phone, and working at the desk. 

● You can use a wedge cushion to prevent back pain

● Stand after every 20 minutes, stretch, and walk a few steps.

● Wear good quality comfortable shoes. 

Have you started going to the gym recently?

Latissimus strain occurs in novice gym goers. Most people describe latissimus pain as constant pain that aggravates in a certain position and while performing specific exercises. 

Mild discomfort is felt in the back when performing deadlifts, squats, military presses, and bench presses. 

You see, most of the time, the problem doesn’t lie in the type or intensity of the exercise. Instead, it provokes due to the poor form of exercise. 

The subconscious habitual slouch gives rise to the problem, and weight lifting concomitantly provokes the pain. 

Muscle imbalance

If you notice precisely, our bodies are asymmetrical. You can visualize minor differences in your hands and feet. However, this asymmetrical pattern is present in your body’s muscles.

Latissimus muscle imbalance commonly occurs in gymgoers, and it’s nothing to worry. 

Casual ImbalanceSpecific imbalance
This term defines anatomical imbalance that is present in normal inactive people. It happens due to the active use of the dominant limb in daily activities. You might notice you can pick up more grocery bags with your right arm than your left arm.This type of imbalance occurs in a specific muscle group of a particular limb. It presents when the weak limb forces the muscles above or below to compensate for the movement.

Where does the problem arise from?

You are stronger on your dominant side. A vigorous-intensity exercise amplifies the pain. When you increase the load, the dominant limb sustains more force than the non-dominant limb.

Another common mistake that people make is they perform deadlifts and pullups with a mixed grip by holding the barbell in an underhand and overhand position. This position definitely causes asymmetrical strength discrepancy from side to side.

How to treat pain?

It is fundamentally unsound to think that your body has to be balanced and symmetrical.

Concentrate on muscle symmetry

Unilateral exercise

Introducing Unilateral exercises in your training sessions is perfect to counter uneven lats. Incrementally put more weight on your non-dominant limb to engage it.

Wide grip exercises, Cable exercises, Foam rolling and Dumbbells are more promising to increase strength and elicit muscular imbalance on the weaker side.

Mind muscle connection

While performing the barbell bench press, lat pulls down or deadlift, think as if you are picking more load from your non-dominant side.

Focus on joint mobility

After performing unilateral exercises, you need to reset the latissimus muscle by going through a partial or full range of motion to regain joint mobility.

Do’s Don’ts
Relax and take a short break from vigorous exercises until you regain full ROM
In the first 48 hours of injury, apply an ice pack to reduce spasms and inflammation.
After 48-72 hours, apply a hot pack to enhance blood flow and remove tissue exudates.
Visit a Physical Therapist for proper injury evaluation and treatment    
Do not go above the point from where the pain starts.
Do not lift the weight when the lats are in the spastic phase.
Do not stop training the dominant side altogether when performing unilateral exercises.
To fix uneven lats, do not focus on a full body workout; focus on specific muscle groups where the problem lies.    


Should I stop exercising for a while?

If you can twist the trunk to look behind and reach down to your toes with little pain or tightness, then there is nothing to worry about.

You can take a small break for a day or two; however, stopping the exercise altogether will bring more harm than good.

Uneven lats do not impact exercise regime but affect the quality of life and day-to-day activities.

Is it due to a poor form of deadlift?

Most of the time, the poor form of the deadlift is the hidden culprit and aggravates constant low-level pain. It could be due to mixed grip or uneven load distribution.

Should I keep exercising at a lower weight?

Give your uneven lats some time to heal from injury; meanwhile, you can do as follows;

  • Perform low-intensity exercises when you switch to heat therapy
  • Gradually achieve full ROM over a few weeks.
  • Perform light chest stretches without triggering pain
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Physiatrist, M.D. Pain Center of University of São Paulo

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