Ep 319 -The Teres Major and Minor: Tell Me How You Really Feel: “The Rebel MT” with Allison Denney

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0:00:48.9 Speaker 2: Vents and tirades are necessary sometimes. It can be relieving, cathartic even, to get things off your chest. We so often in life stifle what we want to say or bite our tongues when we see someone doing something we don't agree with or disapprove of, because keeping the peace is often the better choice. Deep down, it is what we really want, not to create friction, but it can feel so good to vent and succumb to the frustration. We can sit on our high horse and dismantle all the things we think are just wrong. But for most of us, I would imagine the aftermath of spewing judgment is not as exhilarating. A sense of morality seeps in and pokes at our deepest selves and asks, "Is that really okay what you just did? Is that really who you want to be in this world? A judgy, unempathetic know-it-all." No, of course you don't. So then the shame sinks in and the pointed questions arise. Why you haven't learned how to control yourself or to not be so reactive can feel frustrating. It can be entirely mind boggling. The time it takes us to figure out ourselves is distressing.

0:01:56.8 S2: Granted, life is the journey and we never stop learning, but wouldn't it be great if we learn some of these things a little more efficiently, like we eat too much at dinner, feel awful that night, and then actually stop overeating, yet we fall back into the same patterns that are embedded in our neural pathways and that are very difficult to undo according to pretty much all of psychology. Even then, there are so many lessons we only know from theory and maybe never have had to actually apply them. For instance, I know that in moments of threat and danger, remaining calm can be life-saving. Buffy seems to have this down pat. Having never been face-to-face with a vampire though, I can't say that calm would be my first instinct. How we approach pain can straddle the same conundrums, not only in ourselves, but also how we approach our clients. As a therapist, the mere understanding that it can take a person a lifetime to learn a lesson can be the difference between good work and powerful work. The insight that the person in your office not only falls into the same or similar traps that you do, but also that their soft tissues face many relatable moral crossroads is a helpful tool.

0:03:09.7 S2: I mean, if someone has to choose between having dessert at night and trying to stay on a diet, doesn't it also make sense that a muscle has to choose between being in control or letting go. Okay, maybe not intentionally, but recognizing that hard choices are not always reserved for the conscious minds might help us choose the right approach. Let us take, for example, the teres major and the teres minor. These two muscles tucked way up in the axilla, underneath the posterior deltoids are the perfect representation of this. Literally buried in the armpit of human anatomy, they have been taught from day one that they are at odds, constantly fighting for control over the humerus, and not a lot of people are paying attention to these two so they don't have a lot of opportunities to learn self reflection or moral awareness. Deeper life lessons and personal growth it seems have gotten lost in the shuffle. Before we explore some techniques that will help infuse them with a stronger sense of virtue, let's first get an understanding of where they are and why they have become stuck in their ways.

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0:04:17.2 S2: The teres major and minor don't only share a name, they also share an attachment site, both originating at the lateral border of the scapula, they aren't layered onto each other, but instead split the scapula in half. The teres minor being the smaller of the two occupies the upper half or two-thirds depending on your source of this ledge, and the teres major being the larger one hangs onto the lower half or one-third and the posterior aspect of the inferior angle of the scapula. So in other words, if you lift your left hand up and rest it on your right shoulder, and you take your right hand, reach around your chest and then grab your left wing, pushing your thumb into your armpit and then back towards your wing bone or your scapula, you've got these two muscles in your grasp. Slide up into your armpit and you've got the teres minor, slide down and you've got the teres major. You've also got the latissimus dorsi in there, but that one would be more in your palm. Focus on what your fingers and your thumb are feeling. They're the ones with more nerve endings anyway.

0:05:21.0 S2: Ironically, the word teres has Latin roots meaning rounded or polished. In my experience, though, this is not quite what they feel like. I'm betting they start off that way, but as time does its thing, and for my clients who are experiencing any kind of pain in the neck, shoulder or arm, they feel a little more like frayed ropes, the kind of frayed ropes that you might see hanging onto a boat and its respective peer, weathering storm after storm with one job on its mind, hold on tight. As you follow these tattered cables from the scapula out, this is where they divide and attempt to conquer. The teres minor, the smaller, more obscure one, reaches to the outside of the humerus and teams up with the infraspinatus and the supraspinatus to latch on to the greater tubercle, that rough bump at the top of the arm bone because the teres minor is so, well, minor, it lands inferior to the other two, which means it's going to play a role in laterally rotating the shoulder.

0:06:22.4 S2: The teres major on the other hand dives under the path of the teres minor through the trenches of the armpit and teams up with latissimus dorsi to grab hold of the crest of the lesser tubercle of the humerus, or the slight ridge just below the small bump at the front of the top of your arm bone. You may have heard the teres major referred to as lats' little helper which is appropriate considering it helps the lats do what they do, internal rotation, but maybe the lats, the broadest muscle of the back is helping the teres major which would explain why we as a general rule are stronger with internal rotation than we are with external rotation. It makes me want to root for the teres minor. I'm a sucker for the underdog. Think about their insertions like this.

0:07:08.0 S2: If your shoulder was hurting, you might reach around and grab the outside of your shoulder to instinctively rub it. Where your thumb lands is where the teres major insertion lives and where your fingers land would be where the teres minor insertion lives. You might even be able to feel them fire with a little experiment. With your right hand doing the palpating of your left shoulder, bend your left elbow and push the back of your hand against a wall or some sort of resistance. Your fingers will feel a group of muscles contract, among which one of them deeper and a little inferior is the teres minor. Now, push your palm against a similar form of resistance and feel the teres major and its strong helper, the lats, fire into your thumb. If you alternate and repeat this a handful of times, you can start to imagine how these little axillary ropes might become frayed over time, pushing and pulling against and on top of one another. It's exhilarating just thinking about it.

0:08:02.3 S2: Now that you have a better understanding of your own teres major and minor, it's time to get to know your client's. You have started the session by checking in with your client but it's time to ask the teres muscles how they feel. With your client prone, bring their arm into 90 degrees of abduction and allow their elbow to bend so that their forearm is dangling to the floor. Like you did with your own wing, grab the lats into your palm and use your fingers and your thumbs to slide up and down the lateral border of their scapula. My guess is that those muscles will start telling you all sorts of stories that they believe to be true. Very much like when you interrupt two kids fighting over a toy, the teres major and minor will instinctively start yelling at you and demanding that they have the humerus first. Time for you to intervene. Squat or sit down so that you are at their level and so that your body mechanics are on point, and similar to how you might parent those two kids, listen to what they are telling your fingers and thumbs. Yelling at them is not going to heed any productive outcomes.

0:09:04.0 S2: Get a sense of which one is more frayed, more tired, and most likely more irritated. Tell the other one to be patient for a moment while you focus on the one who needs a little more attention. It's never a bad idea to also engage the inner workings of your client. Have them take a deep breath and access those letting go signals that travel from the brain to the muscles with a few focused inhales and exhales. Start by making nice here. I know that making nice is always a good wrapping up approach, but these two have forgotten how to make nice with each other. So start with the basics before moving on to the more advanced work. Once you feel the tension begin to lessen, it's time to start introducing the idea that these two muscles might not be in touch with how they really feel. Maybe they don't feel seen. Maybe they don't feel important. A life of competition has thrust them into a pattern of always needing to be something that they're not. Remind them that they don't actually need to compete and that they have permission to be vulnerable, because you are there to hold them for that moment.

0:10:09.1 S2: Remember that there are a lot of other vessels and glands and sensitive anatomical elements that have fallen prey to this lifetime of tension. This is not going to be resolved in one session. As these two muscles learn how to work together, begin to incorporate stretches that allow each of them to breathe, then start to engage them separately with resistance, and then sinking in deeper to find the old wounds or trigger points that are no doubt lurking. This kind of work takes time. Remind yourself and your client that old patterns can be stubborn. The reactivity of a muscle is there for a reason, it may be masking a deeper truth, but that doesn't make the pain less real. We can study pain syndromes and dysfunctions for decades and we can understand them through books and practice to some degree, but until we experience it ourselves, debilitating back pain, nagging migraines or the angry tension between two neglected muscles, we don't really know what it's like. The best we can do is understand the human condition. Knowing your anatomy and knowing your physiology is advantageous indeed. What it means to be human though, to understand how we really feel underneath the layers of chaos offers unending insights into what it feels like to experience pain.

0:11:29.2 S2: And here we are, the end of the episode. Thank you to the extraordinary crew over at ABMP for helping me get my words into your ears. And if you wanna get any of your words into my ears or more accurately into my brain via my eye balls from a computer screen, drop me a line at rebelmt@abmp.com, that's R-E-B-E-L-M-T@abmp.com. I always wanna hear your questions, comments, suggestions, or salutations. Also, if you're interested in checking out anything else I'm doing, head over to rebelmassage.com where you will find all sorts of fun things to click on, like homemade organic products for your practice, cool links to continuing education classes, thoughts I have typed up and posted here and there and other rebel massage dabblings.

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