Hi Laurie
Quick question - many many years (sad how time flies...) ago you did some great work on Teres major. With all the recent enthusiasm for MSI in sporting dogs, it has not been any of the muscles implicated, and yet, I wonder. I do find it can be quite painful. and while it does not run across the medial border of the glenohumeral joint it will probably be stressed when one tests foe shoulder abduction angle.
I would value your thoughts on this.
Have a lovely day!
A.V.
Teres Major update?
Re: Teres Major update?
This is a great question! Great because I'm delighted to answer it in light of the things I've found over the years!
So, my thinking has evolved. 1) I think we can and do still see primary Teres Major strains. Dogs that run and turn quickly, or loose footing, or land a jump with the intention to turn immediately upon impact (and again, loose footing). - ... and over stretch the Teres Major muscle.
But over the years, I have seen a second group. 2) Teres Major muscle is overused because it's compensating for something else. In this category, I have seen dogs that over use Teres Major because they have painful arthritic elbows, OR a weak hind end. In both scenarios, I think of it much like a person walking with those walking poles - using their arms to help pull themselves forwards. So, the elbow dog, pulls him or her-self forwards to avoid an up/down propulsion through the elbow joint. The weak rear end dogs, pull themselves forwards because they lack any drive from the rear. As such, they overuse the muscle and it develops trigger points / areas of tension - much like an iliopsoas that is protecting a knee with a cruciate tear or surgical intervention.
A third group has now emerged! 3) Teres Major secondary to an MSI. This group I only just tapped into around the time of the landmark Cook et al study in 2006. I had found some dogs that had recurrent soft tissue problems of their shoulders (i.e. Teres Major, supraspinatus, biceps tendons...). Which I could resolve, but give it a few months or a year and they'd be back with a different shoulder issue! BUT, in some of these cases, (after knowing what to look for), when I looked for a medial shoulder hypermobility, it was there, and quite likely the problem all along!
So, I am now in the camp of thinking that MSI is actually way more common and way more of an issue, and perhaps a cause or the root of other soft tissue problems at the shoulder - Teres Major strains being one of those things.
Thanks for asking and allowing me to update my thoughts on the subject.
All the best!
Laurie
So, my thinking has evolved. 1) I think we can and do still see primary Teres Major strains. Dogs that run and turn quickly, or loose footing, or land a jump with the intention to turn immediately upon impact (and again, loose footing). - ... and over stretch the Teres Major muscle.
But over the years, I have seen a second group. 2) Teres Major muscle is overused because it's compensating for something else. In this category, I have seen dogs that over use Teres Major because they have painful arthritic elbows, OR a weak hind end. In both scenarios, I think of it much like a person walking with those walking poles - using their arms to help pull themselves forwards. So, the elbow dog, pulls him or her-self forwards to avoid an up/down propulsion through the elbow joint. The weak rear end dogs, pull themselves forwards because they lack any drive from the rear. As such, they overuse the muscle and it develops trigger points / areas of tension - much like an iliopsoas that is protecting a knee with a cruciate tear or surgical intervention.
A third group has now emerged! 3) Teres Major secondary to an MSI. This group I only just tapped into around the time of the landmark Cook et al study in 2006. I had found some dogs that had recurrent soft tissue problems of their shoulders (i.e. Teres Major, supraspinatus, biceps tendons...). Which I could resolve, but give it a few months or a year and they'd be back with a different shoulder issue! BUT, in some of these cases, (after knowing what to look for), when I looked for a medial shoulder hypermobility, it was there, and quite likely the problem all along!
So, I am now in the camp of thinking that MSI is actually way more common and way more of an issue, and perhaps a cause or the root of other soft tissue problems at the shoulder - Teres Major strains being one of those things.
Thanks for asking and allowing me to update my thoughts on the subject.
All the best!
Laurie
LAURIE EDGE-HUGHES