Latissimus Muscle Strain/Injury

A latissimus dorsi strain, often called a “lat strain” or “lat tear,” is an injury to the latissimus dorsi, the large, flat muscle that spans from the lower spine to the upper arm. If you’re feeling sudden pain through your back, armpit or shoulder after lifting, throwing or pulling, our Sports Physiotherapy team can assess it and put together a rehab plan.

What does the latissimus dorsi do?

The latissimus dorsi is involved in most pulling and lifting movements, which is exactly why it’s prone to strain in the gym and in throwing sports (Kenhub anatomy reference):

• Shoulder joint movement. It drives adduction, extension and internal rotation of the shoulder, letting you bring your arm back towards your body, extend it behind you, and rotate it inward.
• Arm extension. It helps extend the arm at the shoulder, letting you reach out and away from your body.
• Shoulder stabilisation. It helps stabilise the shoulder joint, which matters for posture and injury prevention.
• Pulling and lifting. It’s heavily involved in movements like chin-ups and rows.
• Athletic performance. It plays a role in throwing and swinging motions, so strengthening it can support performance in sports like baseball, tennis and swimming.

What causes a latissimus dorsi strain?

A tear in the latissimus dorsi can happen from sudden trauma, overuse, or repetitive stress. In general, a strain occurs when a sudden twist, jolt or overload applies more force than the muscle or tendon fibres can tolerate, which is what causes the tear (Better Health Channel: sprains and strains). Common causes include:

Sudden trauma

This can happen during activities such as weightlifting, particularly during pull-ups or heavy lifting. Sports involving throwing or swinging motions, such as baseball or tennis, can also predispose people to lat strains. Latissimus dorsi and teres major tears are a recognised, if uncommon, injury among throwing athletes, most extensively studied in professional baseball pitchers (systematic review, PubMed).

Overuse

Repetitive motions that strain the latissimus dorsi without adequate rest and recovery can lead to overuse injuries, including tears.

Poor technique

Using improper form during exercises or activities that engage the latissimus dorsi increases the risk of injury.

Symptoms of a latissimus dorsi strain

Symptoms of a latissimus dorsi tear may include:

• Sudden, sharp pain in the back or armpit area
• Swelling and bruising
• Weakness or reduced ability to use the arm effectively
• Limited range of motion in the shoulder or upper arm
• A popping or tearing sensation at the time of injury

If you’ve just had a sudden, severe injury with significant swelling, an inability to move the arm, or you’re unsure what’s happened, get it assessed by a doctor first to rule out anything more serious, such as a fracture. Physiotherapists don’t diagnose or replace that initial medical assessment; a physiotherapy assessment is the right next step once anything more serious has been ruled out.

How to rehab a latissimus dorsi strain

Rehab for a latissimus dorsi strain typically involves a combination of protection, gentle movement, strengthening, and a gradual return to activity. The current first-aid approach for muscle strains is Protection, Optimal Loading, Ice, Compression and Elevation (POLICE), and healthdirect recommends physiotherapy as part of ongoing management (healthdirect: sprains and strains). Here’s a structured approach:

Rest and protection

Initially, it’s important to protect the injured muscle and avoid activities that aggravate the strain, including heavy lifting, overhead movements, and other activities that place significant load on the latissimus dorsi.

Pain management

Ice or cold therapy can help manage pain and swelling in the first few days. If you’re considering an over-the-counter pain reliever, check with your pharmacist or GP about what’s appropriate for you.

Gentle stretching

Begin with gentle stretching to maintain flexibility and prevent stiffness. Perform each stretch slowly and hold it for 20 to 30 seconds without bouncing. Useful stretches for the latissimus dorsi include a stretch against a wall or doorway, overhead arm reach stretches, and side bends.

Strengthening exercises

As pain and swelling settle, gradually introduce strengthening exercises for the latissimus dorsi and surrounding muscles. Start with low resistance and progress as tolerated. Common options include:

• Lat pulldowns. Using a cable machine or resistance band, start with light resistance and gradually increase the weight as strength improves.
• Dumbbell rows. Hold a dumbbell in one hand and, with the opposite knee and hand on a bench for support, pull the dumbbell up towards your hip, squeezing your shoulder blade towards your spine.
• Resistance band rows. Secure a resistance band to a stationary object at chest height, hold one end in each hand, and pull the band towards your body, bending your elbows and squeezing your shoulder blades together.

Functional training

Incorporate functional exercises that mimic daily activities or sports-specific movements to improve overall strength and coordination, focusing on pulling, rowing and lifting patterns.

Core stability

Strengthening the core muscles is important for supporting the spine and pelvis, which can help reduce the risk of future injury. Useful exercises include planks, bridges and bird-dog exercises, targeting the abdominals, obliques and lower back.

Gradual return to activity

Once you’ve regained strength, flexibility and pain-free range of motion, gradually reintroduce activities that involve the latissimus dorsi. Start with low-impact activities and build up intensity and duration as tolerated, listening to your body rather than pushing through pain.

Preventive measures

To reduce the risk of re-injury, focus on good posture, proper lifting technique, and regular stretching and strengthening. Warm up adequately before activity, and pay attention to your body’s signals to avoid overexertion.

Research following professional baseball pitchers with latissimus dorsi or teres major tears has found a high rate of return to play, whether treated operatively or nonoperatively (PubMed Central). That’s general research in a specific athletic population, not a prediction for how any individual’s recovery will go.

When to see us

Get in touch with one of our physiotherapists for a full assessment and an individualised treatment plan to help you get back to full function. Book online or call us at Level 2, 127 Bathurst Street, Sydney CBD. You can read more about our approach on the Sports Physiotherapy page.

Sources

• Kenhub: Latissimus dorsi muscle anatomy and function
• Better Health Channel: Sprains and strains
• healthdirect: Sprains and strains
• Latissimus Dorsi and Teres Major Injuries in Major League Baseball Pitchers: A Systematic Review, PubMed
• Baseball Pitchers who Suffer Latissimus Dorsi and Teres Major Tendon Injuries Have a High Return to Play Rate After Either Operative or Nonoperative Treatment, PubMed Central

This article is general information, not a diagnosis. If you’ve had a sudden or severe injury, get it assessed by a doctor or physiotherapist before starting any rehab program.