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Shoulder

Shoulder

When we talk about the shoulder we usually mean the deltoid. There are more important muscles around your shoulder joint than deltoid, like the rotator cuff muscles, and you should take care of them to avoid injuries.

The Deltoid muscle is the muscle forming the rounded contour of the shoulder. It is divided into three portions, anterior, lateral and posterior, with the fibers having different roles due to their orientation.

Deltoid

  1. The anterior fibers are involved in shoulder abduction when the shoulder is externally rotated. It also works with the subscapularis, pecs and lats to internally (medially) rotate the humerus.
  2. The posterior fibers are strongly involved in transverse extension particularly as the latissimus dorsi is very weak in strict transverse extension. The infraspinatus and teres minor, also work with the posterior deltoid as external rotators, antagonists to strong internal rotators like the pecs and lats. The posterior deltoid is also the primary shoulder hyperextensor, more so than the long head of the triceps which also assists in this function.
  3. The lateral fibers perform the shoulder abduction when it is internally rotated, and perform shoulder transverse abduction when the shoulder is externally rotated.

Origin:

  1. Lateral, anterior 1/3 of the distal clavicle.
  2. Lateral boarder of the acromion.
  3. Scapular spine.

Insertion:

Deltoid tuberosity of the humerus.

Pain and symptoms associated with the Deltoid muscle

– Pain over the tip of the shoulder going down the upper arm
– Shoulder weakness
– Pain in the shoulder area when lifting
– Pain in the shoulder area when holding objects up and in front of the body
– Pain decreases when arm and shoulder are at rest

Pain around the shoulder area caused by the deltoids muscles will subside when resting. If the pain in the deltoid area is continuous even at rest, chances are the source of the pain is being caused by other muscles in the neck, shoulder, upper back, and/or chest.

Activities that cause deltoid pain and symptoms

– Swimming
– Skiing
– Weight-lifting
– Throwing a ball; baseball, softball, football
– Holding heavy tools up
– Picking up and carrying children
– Typing when the keyboard is set up too high

The Teres major is a medial rotator and adductor of the humerus and assists the latissimus dorsi in drawing the previously raised humerus downward and backward (extension, but not hyperextension). It also helps stabilize the humeral head in the glenoid cavity. It is only functional when the Rhomboids fix the scapula. This muscle mainly helps latissimus dorsi.

Origin:

Inferior, lateral margin of the scapula.

Insertion:

Crest of lesser tubercle (just medial to the insertion of latissimus dorsi)

Pain and symptoms associated with the Teres Major muscle

– Pain in the back of the upper arm when reaching forward and up
– Sharp pain in the back of the shoulder with aching sensation in the upper arm when resting elbows on a table.
– Pain in the back of the arm that skips the elbow and continues down to the back of the forearm.

Activities that cause teres major muscle pain and symptoms

– Rowing
– Throwing or pitching a ball
– Swimming
– Chopping wood
– Driving
– Exercise that requires pulling up (chin-up) or pushing down (push-ups) with the arms, or reaching forward or overhead repetitiously

The Supraspinatus muscle is one of the four muscles which make up the rotator cuff. Its main function is to stabilize the upper arm by holding the head of the humerus in position. It is important in throwing motions to control any forward motion of the head of the humerus. Contraction of the supraspinatus muscle leads to the abduction of the arm at the shoulder joint. It is the main agonist muscle for this movement during the first 10-15 degrees of its arc. Beyond 30 degrees, the deltoid muscle becomes increasingly more effective at abducting the arm and becomes the main propagator of this action.

Origin:

  1. Supraspinous fossa.
  2. Muscle fascia.

Insertion:

Uppermost of three facets of the greater tubercle of the humerus.

Pain and symptoms associated with the Supraspinatus muscle

– Deep ache over the outside of the shoulder area which continues during rest
– Pain down the outside of the arm, occasionally extending down into the wrist
– Can cause clicking or popping in the shoulder joint
– Concentrated pain toward the outside of the elbow
– Pain when lifting the arm overhead
– Difficulty and shoulder pain while shaving the face or combing hair

Activities that cause supraspinatus muscle pain and symptoms

– Carrying heavy objects with the arm hanging down ie. suitcase, a bucket of paint, etc.
– Working with arms outstretched in front of the body and /or overhead (painting, working at the computer, driving for long periods)
– Tennis
– Golf

The Infraspinatus muscle is another of the four rotator cuff muscles crossing the shoulder joint and is commonly injured. It is the main external rotator of the shoulder joint. When the arm is fixed, it abducts the inferior angle of the scapula. Its synergists are teres minor and the deltoid. The infraspinatus and teres minor rotate the head of the humerus outward (external, or lateral, rotation); they also assist in carrying the arm backward. Also, reinforces the capsule of the shoulder joint.

Origin:

  1. Infraspinous fossa.
  2. Muscle fascia.

Insertion:

The middle facet of greater tubercle of the humerus.

Pain and symptoms associated with the Infraspinatus muscle

– Pain deep in the front of the shoulder
– Pain going down the front and outside of the arm, sometimes going down into the hand
– Pain going up the back of the neck to the base of the skull
– Pain in the upper back at the inside edge of the shoulder blade
– Weakness and stiffness in the shoulder and arm
– Difficulty reaching the arm behind the body and reaching into a back hip pocket

Activities that cause infraspinatus pain and symptoms

– Keeping the arms overhead for extended periods of time
– Painting overhead
– Keeping the arms extended in front of the body for extended periods of time
– Driving with hands on top of the steering wheel
– Keyboarding and using the mouse on the computer
– Swimmers
– Sports throwing a ball or swinging at a ball
– Tennis
– Baseball
– Football

The subscapularis rotates the head of the humerus medially (internal rotation); when the arm is raised, it draws the humerus forward and downward. It is a powerful defense to the front of the shoulder-joint, preventing displacement of the head of the humerus.

Origin:

Subscapular fossa.

Insertion:

Lesser tubercle of the humerus.

Pain and symptoms associated with the Subscapularis muscle

– Severe pain deep in the back of the shoulder
– Pain in the back of the upper arm
– Pain over the shoulder blade area
– Pain can extend down the back of the arm
– Persistent aching in the wrist with extreme tenderness in the back of the wrist
– Occasionally an extremely tender spot on the front of the shoulder

Activities that cause subscapularis pain and symptoms

– Pitching a baseball
– Tennis
– Swimming
– Tossing heavy objects
– Playing the violin, guitar, banjo
– Falling and landing on your side
– Sleeping on one side
– Immobilization of the arm for long periods (casted arm)

The Teres minor is a narrow, elongated muscle of the rotator cuff.

The Teres minor and the infraspinatus attach to the head of the humerus; they help hold the humeral head in the glenoid cavity of the scapula. They work in tandem with the posterior deltoid to externally (laterally) rotate the humerus, as well as perform transverse abduction, extension, and transverse extension.

Origin:

The middle half of the scapula’s lateral margin.

Insertion:

Lowest of three facets of the greater tubercle of the humerus.

Pain and symptoms associated with the Teres Minor muscle

– Pain toward the back of the upper arm
– Numbness or tingling without pain or aches in the fourth and fifth fingers

Activities that cause teres minor pain and symptoms

– Bringing the arm back with force
– Pitching a baseball
– Rowing, Kayaking
– Holding arms above head for extended periods
– Holding arms out in front of the body for extended periods of time
– Bracing your arms either in front of the body to avoid a fall or overhead impact (something falling from above)

There are two types of rotator cuff injuries:

  1. Acute tears occur as a result of a sudden movement. This might include throwing a powerful pitch, holding a fast moving rope during water sports, falling over onto an outstretched hand at speed, or making a sudden thrust with the paddle in kayaking.
  2. A chronic tear develops over a period of time. They usually occur at or near the tendon, as a result of the tendon rubbing against the underlying bone.

Rotator cuff tear

Please, be careful :)

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“Lats” & friends

Lats and friends

We usually forget that lats belong to another muscle group, the superficial back muscles. They originate from the vertebral column and attach to the bones of the shoulder – the clavicle, scapula, and humerus. All these muscles are therefore associated with movements of the upper limb. The muscles in this group are the latissimus dorsi, trapezius, levator scapulae and the rhomboids.

The latissimus dorsi is the larger, flat, dorsolateral muscle on the trunk, posterior to the arm, and partly covered by the trapezius on its median dorsal region.

Origin:

  1. Spinous process of T7-L5.
  2. Upper 2-3 sacral segments.
  3. Iliac crest.
  4. Lower 3 or 4 ribs.

Insertion:

Lateral lip of the intertubercular groove.

It is responsible for extension, adduction, horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.
Pain and symptoms associated with the Latissimus Dorsi muscle
– Pain is felt in the mid-back especially below the bottom of the shoulder blade.
– Pain is felt in the front of the shoulder.
– Pain in the side and or mid-back similar to a side stitch.
– Numbness, tingling and/or aching that extends down the arm to the little finger and often the ring finger.
– Pain while reaching forward with the arms
– Pain when lifting arms overhead
– Can contribute to breathing difficulty.
– Pain does not worsen with activity nor does it ease at rest, it is steady and constant.
Activities that can cause latissimus dorsi pain
– Activities that require continuously or repeatedly raising the shoulders
– Gymnastics
– Rowing
– Throwing or pitching a ball
– Swimming
– Swinging a baseball bat
– Swinging a tennis racket
– Shoveling dirt or snow
– Chopping wood
– Exercise that requires pulling up (chin up) or pushing down (push-ups) with the arms
– Reaching forward or overhead repetitiously

The trapezius is a broad, flat and triangular muscle. The muscles on each side form a trapezoid shape. It is the most superficial of all the back muscles.

 

Origin:

  1. External occipital protuberance.
  2. Along the medial sides of the superior nuchal line.
  3. Ligamentum nuchae (surrounding the cervical spinous processes).
  4. Spinous processes of C1-T12.

Insertion:

  1. Posterior, lateral 1/3 of clavicle.
  2. Acromion.
  3. The superior spine of the scapula.
It has three functional regions:
  1. Superior (descending part), which supports the weight of the arm.
  2. Intermediate (transverse part), which retracts the scapulae.
  3. Inferior (ascending part), which medially rotates and depresses the scapulae.
Contraction of the trapezius muscle can have two effects:
  1. Movement of the scapulae when the spinal origins are stable.
  2. Movement of the spine when the scapulae are stable. Its main function is to stabilize and move the scapula.
Pain and symptoms associated with the Trapezius muscle
– Headache in the temple area
– Pain in the jaw that travels down into the neck and over behind the ear
– Pain behind one eye
– Tension headache
– Contributes to dizziness
– Pain at the base of the skull
– Stiff neck
– Ache or burning sensation in the middle of the back
– Pain or tingling during raising or lowering the arms
Activities that cause pain and symptoms in the trapezius
– Whiplash
– Lifting heavy objects
– Working with your arms out in front of you (computer, playing the piano, driving)
– Keeping your shoulders rolled forward or pulled up
– Carrying a heavy purse or backpack on one shoulder
– Large breasts

The levator scapulae is a small strap-like muscle. It elevates the scapula.

Origin:

Transverse processes of C1-C3 or C4.

Insertion:

The superior angle of scapula toward the scapular spine.

Pain and symptoms associated with the Levator Scapulae muscle
– Pain at the slope of the neck and shoulder
– Stiff neck, difficulty turning head to look over the shoulder
– Headaches at the base of the skull
– Occasionally pain from the top of the shoulder blade extending to the middle of the shoulder blade
Activities that cause pain or symptoms of the levator scapulae muscle
– Keeping head turned to one side ie. Sleeping on stomach, holding phone to ear with shoulder
– Sleeping without proper head support
– Acute upper respiratory infection will cause the levator scapulae to shorten and become stiff and painful
– Painting overhead for extended periods
– Carrying heavy backpacks or purses
– Whiplash
– Forward head posture

There are two rhomboid muscles, major and minor. The rhomboid major helps to hold the scapula (and thus the upper limb) onto the ribcage. Together with the rhomboid major, the rhomboid minor retracts the scapula when trapezius is contracted. Acting as an antagonist to the trapezius, the rhomboid major and minor elevate the scapula medially and upward, working in tandem with the levator scapulae muscle to rotate the scapulae downward. While other shoulder muscles are active, the rhomboid major and minor stabilize the scapula.

Rhomboid major:

Origin:

  1. Spinous processes of T2-T5.
  2. Supraspinous ligament.

Insertion:

Medial scapula from the scapular spine to the inferior angle

Rhomboid minor:

Origin:

  1. Spinous process of C7 & T1.
  2. Ligamentum nuchae.
  3. Supraspinous ligament.

Insertion:

Medial margin of the scapula at the medial angle

Pain and symptoms associated with the Rhomboid Major and Minor muscles
– Pain along the inside of the shoulder blade especially noticeable at rest.
– Popping and/or grinding noise when moving the shoulder blade
– Inability to straighten the upper body out of a slumped position
Activities that can cause rhomboid muscle pain
– Activities that require continuously or repeatedly raising the shoulders
– Hanging wallpaper
– Rowing
– Throwing a ball
– Pull Ups
– Extended work at the computer
– Military posture: standing with extremely straight posture with shoulders pulled back, chest thrust forward.
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Pecs

Pecs

We usually call our pectoral muscles “pecs”.  The first thing we need to know is that pectoral muscles are a group of muscles.

The pectoralis major makes up the bulk of the chest muscles in the male and lies under the breast in the female.

Origin:

  1. Medial 1/3 of the clavicle.
  2. Anterior aspect of manubrium & length of the body of the sternum.
  3. Cartilaginous attachments of upper 6 ribs.
  4. External oblique’s aponeurosis.

Insertion:

  1. Lateral lip of bicipital groove to the crest of the greater tubercle.
  2. Clavicular fibers insert more distally; sternal fibers more proximally.

It performs four actions:

  1. Flexion of the humerus, as in throwing a ball side-arm, and in lifting a child.
  2. Adducts the humerus, as when flapping the arms.
  3. Rotates the humerus medially, as occurs when arm-wrestling.
  4. Keeps the arm attached to the trunk of the body.
Pain and symptoms associated with the Pectoralis Major muscle
 
– Chest pain
– Pain in the front of the shoulder
– Pain in the inner arm, inner elbow traveling down to the into the middle and ring fingers
– Breast pain
– Upper back pain between and around the shoulder blades
– Pain when trying to reach behind the body
– Rounded shoulder posture
– Contributor to forward head posture
 
Activities that cause pain and symptoms of the pectoralis major muscle
 
– Lifting heavy objects
– Working with your arms out in front of you (computer)
– Driving and horseback riding: both require you to hold your arms up and in front of your body
– Keeping your shoulders rolled forward or pulled up
– Slouching
– Carrying a heavy purse or backpack on one shoulder
– Large breasts
 

The pectoralis minor is a thin, triangular muscle, situated at the upper part of the chest, beneath the pectoralis major. The pectoralis minor depresses the point of the shoulder, drawing the scapula inferior, towards the thorax, and throwing its inferior angle posteriorly.

Origin:

The outer surface of ribs 2-5 or 3-5 or 6.

Insertion:

Medial aspect of the coracoid process of the scapula.

Pain and symptoms associated with the Pectoralis Minor muscle
 
– Chest pain
– Burning and stabbing like pain in the pectoral (chest) area
– Pain in the front of the shoulder
– Pain in the inner arm, inner elbow traveling down to the into the fourth and fifth fingers
– Numbness in the inside of the forearm, wrist, hand and fingers
– Difficulty reaching forward and up
– Pain in the upper back between the shoulder blades
– Pain when reaching behind the body
– Rounded shoulder posture
 
Activities that cause pectoralis minor pain and symptoms
 
– Lifting heavy objects
– Pushing things away from the body
– Push ups
– Lifting objects with arms straight in front of the body
– Working with your arms out in front of you (computer)
– Keeping your shoulders rolled forward or pulled up
– Carrying a heavy purse or backpack on one shoulder
– Hyperventilation, difficulty breathing
– Chronic cough
– Under-wire bras
– Large breasts
– Whiplash
 

The subclavius is a small triangular muscle, placed between the clavicle and the first rib. Along with the pectoralis major and pectoralis minor muscles, the subclavius muscle makes up the anterior wall of the axilla.

Subclavius

Origin:

First rib about the junction of bone and cartilage.

Insertion:

The lower surface of the clavicle.

The subclavius depresses the shoulder, carrying it downward and forward. It draws the clavicle inferiorly as well as anteriorly. Also, protects the underlying brachial plexus and subclavian vessels from a broken clavicle (the most frequently broken long bone).

Pain and symptoms associated with the subclavius muscle

– Pain below the collarbone
– Pain in the upper arm
– Sends pain down the forearm into the thumb, forefinger, and middle finger
– A reliable indicator of subclavius muscle dysfunction is a pain on the outside of the upper arm that skips over the elbow then extends into the forearm. Pain can also extend to the thumb, index, and middle finger while skipping over the wrist.
– The muscle can tighten restricting circulation to the arm and hand causing tingling and numbness

Activities that cause subclavius pain and symptoms

– Lifting heavy objects
– Working with your arms out in front of you (computer, driving)
– Keeping your shoulders rolled forward
– Sleeping on your side with your arm above your head
– Broken clavicle

The serratus anterior is found more laterally in the chest and, forms the medial wall of the axilla.

Serratus anterior

Origin:

Fleshy slips from the outer surface of upper 8 or 9 ribs.

Insertion:

The costal aspect of medial margin of the scapula.

The main action of the serratus anterior is to rotate the scapula, allowing the arm to be raised over 90 degrees. It also holds the scapula against the rib cage – this is particularly useful when upper limb reaches anteriorly (e.g punching).

Pain and symptoms associated with the Serratus anterior

– Pain on the side of the chest toward the middle of the ribcage
– Pain down the arm to the fourth and fifth fingers
– Pain below the shoulder blade
– Difficulty breathing
– Inability to take a deep breath
– Sharp pain in the side (side stitch)
– Pain and difficulty reaching behind the body
– Pain and difficulty when pulling shoulders back
– Sensitivity in and around the area of the breast

Activities that cause serratus anterior pain and symptoms

– Swimming
– Tennis
– Chin ups, Push ups
– Weightlifting
– Gymnastics
– Hyperventilation
– Severe coughing

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Six-pack

Six-Pack

Six pack has 54M results on Google. Not everybody but a lot of people desires a “six-pack”, others simply need to strength their middle section to relief or avoid pain or bad postures.

AbdomenThe transverse abdominal muscle (TVA) is a very important core muscle which is vital in maintaining good posture. It helps to compress the ribs and viscera, providing thoracic and pelvic stability.

The transverse abdominal and the segmental stabilizers of the spine work in tandem.

Without a stable spine, the nervous system fails to recruit the muscles in the extremities, and functional movements cannot be performed.

The TVA is vital to back and core health. Also has the effect of pulling in the abdomen. Training only the rectus abdominis muscle will not and can not give one a “flat” belly. This goal is achieved only through training the TVA.

Recently, the transverse abdominal muscle has become the subject of debate between kinesiologists, strength trainers, and physical therapists. The two positions on the muscle are:

  1. The muscle is effective and capable of bracing the human core during heavy lifts.
  2. It is not.

Anyway, how to do a stomach vacuum:

Origin:

  1. Front of the iliac crest.
  2. Inguinal ligament.
  3. Costal cartilages of the lower 6 ribs.
  4. Thoracolumbar fascia.

Insertion:

Linea alba.

Rectus Abdominis is the most superficial of the abdominal muscles. It is this muscle which forms the six-pack shape! It is a paired muscle running vertically on each side of the anterior wall of the abdomen. There are two parallel muscles, separated by a midline band of connective tissue called the linea alba.

Origin:

  1. Crest of the pubis.
  2. Pubic symphesis.

Insertion:

  1. Xiphoid process (base of the sternum).
  2. 5th,6th and 7th costal cartilages.
The six-pack flexes the lumbar spine, as when doing a so-called “crunch” sit up. The rib cage is brought up to where the pelvis is when the pelvis is fixed: or the pelvis can be brought towards the rib cage (posterior pelvic tilt) when the rib cage is fixed, such as: The Rectus Abdominis assists with breathing and plays an important role in respiration when forcefully exhaling. It also helps in creating intra-abdominal pressure, such as when exercising or lifting heavy weights.
Pain and symptoms associated with the Rectus Abdominis muscle
– Pain that runs horizontal across the mid back under the shoulder blade
– Pain that runs horizontal across the low back
– Pain around the sternum between the breasts (not shown)
– Pain in the low abdomen
– Feeling bloated
– Heartburn and indigestion
– Testicle pain
– Pain in the pelvic area
Activities that cause rectus abdominis pain and symptoms
– Over exercising muscles (sit-ups and leg-ups)
– Shallow breathing
– Chronic coughing
– Sitting for long periods of time
– Sitting in a twisted position
– Childbirth
– Abdominal surgery
– Scars from abdominal surgery
– Chronic Constipation
– Carrying a heavy backpack

The external oblique is situated on the lateral and anterior parts of the abdomen. It is broad, thin, and irregularly quadrilateral. It is the largest and the most superficial (outermost) of the three flat muscles of the lateral anterior abdomen. The obliques wrap around the trunk on each side to form our waists and join to the linea alba, a band of connective tissue running down the front of the abdomen.

Origin:

Lowest 8 ribs.

Insertion:

  1. Front 1/2 of the iliac crest.
  2. Linea alba.
The external oblique pulls the chest downwards and compresses the abdominal cavity, which increases the intra-abdominal pressure. It also has limited actions in flexion and rotation of the vertebral column.

The internal oblique muscle is the intermediate muscle of the abdomen, lying deep to the external oblique and just superficial to the transverse abdominal muscle. The internal obliques wrap around the waist and insert into the linea alba, a cord-like strip of connective tissue running down the center of the abdomen.

The internal oblique performs two major functions. First, as an accessory muscle of respiration, it acts as an antagonist to the diaphragm, helping to reduce the volume of the chest cavity during exhalation. When the diaphragm contracts, it pulls the lower wall of the chest cavity down, increasing the volume of the lungs. When the internal obliques contract they compress the organs of the abdomen, pushing them up into the diaphragm which intrudes back into the chest cavity reducing the volume of the air filled lungs, producing an exhalation.

Also, its contraction rotates and side-bends the trunk by pulling the rib cage and midline towards the hip and lower back, of the same side.

Origin:

  1. Iliac crest.
  2. Inguinal ligament.
  3. Thoracolumbar fascia.

Insertion:

  1. Lower 3-4 ribs.
  2. Linea alba.
Pain and symptoms associated with the External and Internal Oblique muscles – Pain in the side, in the waist area – Pain in the groin area – Pain in the low abdomen – Heartburn and indigestion – Testicle pain – Bladder pain and incontinence – Pain in the pelvis area Activities that cause obliques muscle pain and symptoms – Abdominal scars from surgery – Over exercising muscles (twisting and side bending exercises) – Rowing – Raking leaves – Lifting using tools like shovels or pitchforks – Chronic coughing – Sitting for long periods of time – Slouching posture

The Quadratus Lumborum, or QL, can perform different actions:

  1. Lateral flexion of the vertebral column, with ipsilateral contraction.
  2. Extension of the vertebral column, with bilateral contraction.
  3. Elevates the Ilium (bone), with ipsilateral contraction.
 

Origin:

  1. Posterior iliac crest.
  2. Iliolumbar ligament.

Insertion:

  1. Twelfth rib.
  2. Transerve processes of L1-L4.
This muscle is a common source of lower back pain. The QL connects the pelvis to the spine and is capable of extending the lower back when contracting bilaterally. When the lower fibers of the erector spinae are weak or inhibited, the QLs pick up the slack. Given their mechanical disadvantage, constant contraction while you are seated can overuse the QLs, resulting in muscle fatigue. A constantly contracted QL, like any other muscle, will experience decreased blood flow. In time, adhesions in the muscle and fascia may develop, the end point of which is the muscle spasm. Pain and symptoms associated with the Quadratus Lumborum muscle – Pain in the low back, constant deep aching even at rest – Pain in the hips and buttocks – Groin pain – Pelvic pain – Pain down the front of the thigh – Low abdominal pain – Stabbing back and or abdominal pain when coughing or sneezing
Activities that cause quadratus lumborum pain and symptoms
– Lifting heavy objects
– Twisting while lifting
– Sleeping on a mattress that is too soft
– Horseback riding
– Golfing
– Kayaking
– Leg length discrepancy – one leg shorter than other. This can be the way you were born or due to injury. It is often seen after a leg has been in a cast or splint.
– The QL muscles are often affected when you slip and or fall

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The erector spinae

The Erector Spinae

The erector spinae is not just one muscle, but a bundle of muscles and tendons: Iliocostalis lumborum, Iliocostalis thoracis, Iliocostalis cervicis, Longissimus thoracis, Longissimus cervicis, Longissimus capitis, Spinalis thoracis, Spinalis cervicis, and Spinalis capitis. Paired, they run more or less vertically. It extends throughout the lumbar, thoracic and cervical regions, and lies in the groove to the side of the vertebral column.Erectores espinales

Erector spinae is covered in the lumbar and thoracic regions by the thoracolumbar fascia, and in the cervical region by the nuchal ligament.

This large muscular and tendinous mass varies in size and structure at different regions. In the sacral region, it is narrow and pointed, and at its origin chiefly tendinous in structure. In the lumbar region, it is larger and forms a thick fleshy mass. Further up, it is subdivided into three columns. These diminish in size as they ascend to be inserted into the vertebrae and ribs.

Some of its fibers are continuous with the fibers of origin of the gluteus maximus.

The erector spinae functions to straighten the back and provides for side-to-side rotation. Also maintains the correct curvature of the spine.

Symptoms and pain associated with the iliocostalis lumborum

– Pain in the low back
– Pain concentrated in the buttock
– Occasionally pain in the low abdomen

 

 

Activities that cause iliocostalis lumborum pain and symptoms

– Bending and twisting when lifting
– Straining when trying to lift something too heavy
– Whiplash of the lower back
– Extended periods of sitting in a car or plane

Pain and symptoms associated with the longissimus thoracis

– Pain in the back starting at the bottom of the ribcage extending down into the buttocks, pain is often more significant at the bottom of the buttock.

– Pain in the back starting at the bottom of the ribcage extending down to the top of the hip, pain is often more significant at the top of the back of the hip and buttock

– Difficulty standing when rising from a sitting position

Activities that cause pain and symptoms of the longissimus thoracis

– Bending and twisting when lifting
– Straining when trying to lift something too heavy
– Whiplash of the lower back
– Extended periods of sitting in a car or plane

Symptoms and pain associated with the iliocostalis thoracis

– Pain in the upper back around the shoulder blade concentrated toward the bottom of the shoulder blade
– Pain in the back running from the top of the shoulder blade down to the upper hip bone. Pain tends to be more concentrated toward the bottom of the ribs.
– Chest pain
– Pain in the abdomen area below the ribcage and toward the side

Activities that cause iliocostalis thoracis pain and symptoms

– Bending and twisting when lifting
– Straining when trying to lift something too heavy
– Whiplash of the lower back
– Extended periods of sitting in a car or plane

Pain and symptoms associated with semispinalis cervicis muscle 

– Pain in the back of the upper neck extending up into the back of the head
– Headaches
– Tenderness in the back of the head and/or neck
– Tingling and burning in the scalp

Activities that cause semispinalis cervicis pain and symptoms

– Blow to the back of the head
– Whiplash
– Cervical collar
– Holding shoulders up due to stress
– Stress

Pain and symptoms associtated with the longissimus capitis muscle

– Pain behind and/or just beneath the ear
– Pain sometimes is felt slightly down the neck and behind the eyes
– Headaches
– Tenderness in the back of the head and neck
– Numbness and/or tingling in the scalp

Activities that cause longissimus capitis pain and symptoms

– Tension headaches
– Cluster headaches
– Whiplash
– Degenerative disc disease
– Herniated disc
– Bulging disc
– Prolapsed disc
– Intervertebral or Vertebral stenosis
– Vertebral vascular disorder
– Cervical spine hyperlordosis
– Military neck
– Thoracic spine hyperkyphosis
– Scoliosis
– Spasmodic Torticollis (Wryneck Syndrome)
– Eye Strain
– Ocular disease
– Mastoiditis

Ppain and symptoms associated with the semispinalis capitis

– Pain in the back of the upper neck extending up into the back of the head
– Band of pain going around the top head
– Pain in the temple region going down to the eye
– Headaches
– Tenderness in the back of the head and neck
– Numbness in the scalp

Activities that cause semispinalis capitis pain and symptoms

– Blow to the back of the head
– Whiplash
– Cervical collar
– Holding shoulders up due to stress
– Stress