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Integrated functional anatomy of the teres major. Attachments, nerves, palpation, joint actions, arthrokinematics, fascia, triggerpoints, and behavior in postural dysfunction. Common foam rolling, injury prevention, and stretches for the teres major.

Teres Major

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I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

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I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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This course describes the anatomy and integrated function of the teres major muscle (a.k.a. little helper or little brother to the latissimus dorsi muscle). This muscle originates on the inferior angle of the scapula (shoulder blade) and inserts on the lesser tubercle of the humerus (upper arm bone). The teres major muscle lies just inferior to the teres minor muscle; however, the teres major is not a rotator cuff muscle. The teres major is composed primarily of type II muscle fibers, but type I muscle fibers still compose 40%. The teres major muscle crosses the shoulder joint (glenohumeral joint), and contributes to shoulder adduction, shoulder extension, and shoulder internal rotation (medial rotation). This course also describes the role of the teres major muscle in glenohumeral arthrokinematics, fascial integration, postural dysfunction, and subsystem integration. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) must be aware of the integrated function of the teres major for the detailed analysis of human movement, and the development of sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing injury prevention and physical rehabilitation/physical therapy (e.g. loss of extensibility (tight shoulders), teres major strain, rotator cuff muscle injury, tendon rupture, shoulder impingement, upper crossed syndrome), the synergistic function of the teres major (e.g. synergistic function with the latissimus dorsi, but not the rotator cuff muscles or shoulder blade muscles), and teres major exercises and techniques for enhancing sports performance (e.g. ensuring ideal teres major length for optimal shoulder stability, strength, power, upper arm, and back hypertrophy).

Brookbush Institute’s most recommended techniques for the Teres Major (see videos below):

Teres Major and Latissimus Dorsi Static Release

Teres Major and Latissimus Dorsi Static Stretch

Teres Major and Latissimus Dorsi Dynamic Stretch

A cadaver dissection of the teres major, teres minor, infraspinatus, and latissimus dorsi

 Course Description: Teres Major

Introduction

 of Latin origin referring to “round” or “cylindrical” (

 c.1300, from Latin maior (earlier *magjos), irregular comparative of magnus “large, great” (see 

Teres major attachment on the inferior angle of the scapula

By Henry Vandyke Carter - Henry Gray (1918) Anatomy of the Human Body - Bartleby.com: Gray's Anatomy, Plate 203, Public Domain, https://commons.wikimedia.org/w/index.php?curid=307344

Attachment and Innervation

The nerve roots of the brachial plexus innervating with upper body muscles

Attachment & Innervation: Teres Major

Relative Location

The teres major inserting on the lateral lip of the bicipital groove of the humerus

The teres major, teres minor, infraspinatus and deltoid muscles on the scapula

Where is the Teres Major Located?

Palpation

Muscles on the posterior side of the torso, note the location of the teres major relative to the latissimus dorsi

Palpating the Teres Major

Introduction to the Teres Major

Actions

 Adduction, extension and internal rotation (8, 11, 22), although the teres major seems to only be active when adduction or extension is resisted or internal rotation is a component of reaching behind one's back (16).

 Shoulder flexion, abduction, and external rotation

Internal Rotation: The teres major is an internal rotator that acts synergistically with the 

 when placing the arm behind the back or against external resistance (11).

 is the prime mover, the teres major acts as a synergist, along with the posterior head of the deltoid, long head of the triceps, and the coracobrachialis.

By Anatomist90 - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17900184

Arthrokinematics

The teres major muscle on the posterior side of the shoulder joint

Teres Major Muscle Actions

Fascial Integration

My Fascial Hypothesis: Large fascial sheaths not only play a role in the transmission of mechanical force but may also play a role in dictating the function of muscular synergies. This is likely caused by reducing or increasing tone of invested musculature via reflex arcs formed between mechanoreceptors embedded in the connective tissue and the attached musculature. In this way, my view of fascia differs slightly from noted expert on the subject Tom Myers. I think of these large fascial sheaths (specifically the thoracolumbar fascia, iliotibial band, and abdominal fascial sheath) as nature's “motherboard.” A place for mechanical information to be communicated to the nervous system for more efficient recruitment of the muscular system. Despite having a slightly different philosophy it does not change the fact that fascia plays an important communicative role in the human body and we have Tom Myers to thank for his work.

Image of the fascial system of the body connecting muscles

 The teres major shares a similar fiber direction, performs all of the same joint actions, and invests in the anterior humerus adjacent to the 

 - some texts, report a blending of the teres major and latissimus dorsi tendons, part of the way in route to the humerus (8, 11, 15). Further, the teres major and 

 share a nearly continuous fascial connection with the pectoralis major via the medial intermuscular septum (6). All 3 of these muscles may assist in adduction and internal rotation and may restrict end range flexion. These muscles do have a propensity to become short/overactive during postural dysfunction, and all 3 muscles play a role in throwing motions. Further study on the fascial relationship and synergy between the "muscle of the intertubercular groove" or "muscles investing in the medial intermuscular septum" may provide further insight into shoulder function.

The fascial integration between the lats, pecs and teres major muscles at the shoulder joint

Fascial Integration of Latissimus Dorsi, Teres Major and Pectoralis Major at the Shoulder – https://ittcs.files.wordpress.com/2010/11/img_0350.jpg?w=500&h=675

 The origin of the teres major abuts attachments of the 

. Although the fascial relationship and synergistic actions between the 

 and teres major suggest fairly obvious relationships, the fascial connection between the teres major, 

 alludes to more complex and vague relationships. The 

 are external rotators, comprising half of the rotator cuff and are essential to dynamic stabilization of the shoulder. Throughout the range of most shoulder motions, these muscles are fairly active with activity increasing linearly when the arm is elevated to roughly 120° (19). Not only does the teres major perform the opposite joint action (internal rotation), the activity of the teres major does not follow a similar pattern - it seems to only contribute to motion when the arm is forced to move against external resistance, and when reaching behind one's back (16). It may be that the septum created by the infraspinatus fascia, between the 

 and teres major, is not a sign of a fascial relationship, but the end of a fascial relationship encapsulated within the infraspinatus fascia. Although further relationships may be hypothesized between the 

 via the infraspinatus fascia, it seems far more likely that the teres major is nothing more than support for the 

 and this may or may not be mediated by fascial integration.

The adaptive hyperkyphosis of individuals sitting at a desk

Behavior in Postural Dysfunction

Several clinicians and texts have alluded to the propensity of the teres major to become short and over-active (7, 8, 11,12), resulting in a decrease in abduction and lateral rotation and early upward rotation of the scapula during arm elevation (8,11).

 present with limitations in shoulder flexion and abduction and a resting posture that includes excessive humeral internal rotation (1, 2), as well as, excessive anterior and inferior glide (17). A short/over-active teres major may contribute to all of these dysfunctions. Many noteworthy clinicians have documented the effectiveness of release and lengthening techniques intended to affect the 

 for reducing symptoms of shoulder pathology and enhancing posture (1, 2, 5, 7, 8, 11,12), and these techniques most often affect the teres major. The 

 and teres major should likely be thought of as a functional unit.

Lumbopelvic Hip Complex Dysfunction (LPHCD):

 The teres major plays no significant role.

: The teres major plays no significant role.

, the teres major has a propensity to become 

, implying that this muscle should be included in 

 techniques. Mobilization of the glenohumeral joint may be beneficial for improving activity and function. Licensed professionals (PT, ATC, DC, OT, DO) may find manual mobilization techniques beneficial.

Signs of Altered Length/Tension and Tone:

Palpation results in tenderness (trigger points or tender points) and may result in radiating symptoms that penetrate deeply into the posterior deltoid, with potential spillover down the posterior lateral portion of the arm and the dorsal surface of the forearm (8).

Common trigger points and referral pain patterns of the teres major

Teres Major Trigger Points - http://www.necksolutions.com/wp-content/uploads/2014/01/teres-major.gif

Postural Dysfunction and the Teres Major

Techniques and Ending Info

Latissimus Dorsi and Teres Major SA Static Release

Latissimus Dorsi, Erector Spinae Static Stretch (Child's Pose)

Latissimus Dorsi Active Stretch (Child’s Pose)

Latissimus Dorsi Dynamic Stretch

Exercises and Techniques for the Teres Major (and Latissimus Dorsi)

Phillip Page, Clare Frank, Robert Lardner, 

Assessment and Treatment of Muscle Imbalance: The Janda Approach

NASM Essentials of Corrective Exercise Training

NASM Essentials of Personal Training: 4th Edition

Diagnoses and Treatment of Movement Impairment Syndromes,

David G. Simons, Janet Travell, Lois S. Simons, 

Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition

Joint Structure and Function: A Comprehensive Analysis: Fifth Edition

Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani

Manipulative Therapy: Musuloskeletal Medicine

Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004

John V. Basmajian, Carlo J. De Luca. Muscles Alive: Their Function Revealed by ElectroMyography. 1985

Lawrence, R.L., Braman, J.P., Staker, J.L., Laprade, R.F., Ludewig, P.M. (2014) Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, Part 2: Glenohumeral joint. 

Journal of Orthopaedic & Sports Physical Therapy

Konrad G, Jolly J, Labriola J, McMahon P, Debski R. Thoracohumeral Muscle Activity Alters Glenohumeral Joint Biomechanics During Abduction. J Ortho. Res 24:748, 2006

Inman VT, Saunders JB, Abbot JC, Observatinos on the function of the shoulder joint. J Bone Joint Surg 26:1 – 30, 1944

Harryman DT II, Sidles JA, Clark JM, McQuade KJ, Gibb TD, Matsen FA 3rd: Translation of the humeral head on the glenoid with passive glenohumeral motion. 

Dancker M, Lambert S, Brenner E. (2015). The neurovascular anatomy of the teres major muscle. 

Boccia G, Pizzigalli L, Formicola D, et al. (2015). Higher neuromuscular manifestations of fatigue in dynamic than isometric pull-up tasks in rock climbers. 

Rajaratnam BS, Goh JCH, Kumar PV. (2013). Control strategies to re-establish glenohumeral stability after shoulder injury. 

BMC Sports Science, Medicine, and Rehabilitation.

Sciascia A, Kuschinsky N, Nitz AJ, et al. (2012). Electromyographical comparison of four common shoulder exercises in unstable and stable shoulders. 

Lovering, R. M., & Russ, D. W. (2008). Fiber type composition of cadaveric human rotator cuff muscles. 

journal of orthopaedic & sports physical therapy

Bibliography

Questions, comments, and criticisms are welcome and encouraged.

Teres Major

Related Courses:

Course Description: Teres Major

Introduction to the Teres Major
3 Sub Sections

Teres Major Muscle Actions
1 Sub Section

Fascial Integration

Postural Dysfunction and the Teres Major

Exercises and Techniques for the Teres Major (and Latissimus Dorsi)
4 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Teres Major

Related Courses:

Course Description: Teres Major

Introduction to the Teres Major3 Sub Sections

Teres Major Muscle Actions1 Sub Section

Fascial Integration

Postural Dysfunction and the Teres Major

Exercises and Techniques for the Teres Major (and Latissimus Dorsi)4 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Introduction to the Teres Major
3 Sub Sections

Teres Major Muscle Actions
1 Sub Section

Exercises and Techniques for the Teres Major (and Latissimus Dorsi)
4 Sub Sections