Serratus posterior inferior & low back pain

[Stereo]

Hi there , I am George from Greece ,I have recently started to work as massage therapist , I have trained to the trigger point therapy which I use it very often..
Today I worked with a client for the first time for his low back pain..
It seems that the source of the problem is in the QL muscles , something that I have seen before, but in the Serratus posterior inferior also...
When I pressed with my hand his right SPI , he felt a big pain in the spot, and also in the left side low back area, ( under his left QL)
After massaging a little the area , I tried it again. Pressing the right serratus posterior inferior, gives a big pain in the area under the left QL .
Is it normal to refer pain in that way ?
Also it seems to have a piriformis syndrome and maybe a small problem to his illiopsoas muscle..


With piriformis, QL, and illiopsoas OK, but what about the Serratus, ? Any advise?
Thanks

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[sarahkelly]

Hi Stereo,
Any chance you were pressing on the Latissimus Dorsi instead?

[Stereo]

Hi Sarahkelly, thank you very much for your replay, but i don't believe that was Latissimus Dorsi....
The spot was about 4-5 cm away from his spinal at the upper edge of his right QL
I hop you understand .....
sorry for my bad English , thanks again

For the record , I treat him 3 times , and hopefully he is fine for the time ..
I learned him several stretches for
Latissimus Dorsi, QL, Hamstrings, lumbar spine, Iliopsoas etc....and he is trying to practice them every day.
In the next 2-3 days I will learn him how to make those muscle stronger to avoide a future problem

[finchr]

I have found that muscle pain is usually the result of movement dysfunction involving joints as well. What movemets are limited and either provide lasting reilef or discomfort? Ilet the pt lead me to the answer. You can chase pain all day at times or it continues to reappear . We have to treat the symptoms obviously but the true magic occurs when we find the cause so the problem remains abolished.. If you find a referral pattern then it is supposed to occur. It just is otherwise it wouldn't occur. Don't get hung up on that. Can you change the Sx. Treat what you think is he problem and if it goes away and stays away you are on mark.
A lot of muscle Sx are the result of an not the primary cause. Why does a select muscle overwork or not?? There are reasons. Again we have to treat the Sx as well as why it did ths in the 1st place? Fascinating stuff

[Stereo]

Hi finches,
yes I agree with you and I am trying to fix the cause and not only treat the spot that pain is more active..
In this case , with the Serratus patient , I checked his whole muscle system and I figured that he has very strong legs ( all the basic muscles) but he has weak low back muscles ,erector spinae, multifidi,QL,...
also he used to exercise his rectus abdominis usually..
I believe he has a muscle unbalance and the problem very often as he says is located in low back , QL and Serratus..

[finchr]

In this case try ruling out the lumbar spine(discs, ligaments,etc) by using the McKenzie assessment (McKenziemdt.org) or ruling in as the case may be. This helps to narrow the possibilities. By using a thorough methodical subclassification such as Sx response to movement and position (force) often the orgination of Sx can identified. Muscle imbalances routinely accommodate these.

[Stereo]

I will try this method also...thank you very much for your help and your advise..

[toddchaney]

You should discuss it with your client if he has been ever engaged with lifting heavy objects. Like prevously mentioned, you need to find the cause and not just treat the symptoms.