Teres Major Muscle

What is Teres Major Muscle?

• The teres major is a broad muscle of the shoulder joint. It starts from the inferior aspect of the scapula to the proximal part of the humeral shaft. Unlike the teres minor, the teres major muscle will not attach to the glenohumeral joint capsule. Thus it is not considered as part of the rotator cuff muscles.

• This muscle’s primary function is to generate arm movements to the shoulder joint. By contract, it pulls the humerus posteriorly (extension) & rotates it medial towards the trunk (internal rotation). Additionally, it helps to the stabilization of the shoulder joint.

Relations of Teres Major Muscle

• The posterior aspect of the scapular portion of the teres major is surfaced by the teres minor & infraspinatus muscles. The anterior portion of the teres major is in relation with the subscapularis muscle.

• The inferior margin of the teres major is parallel to the superior border of the latissimus dorsi muscle. The adjoining fibers of these 2 muscles may be fused in some individuals. Combining with the teres minor muscle, teres major forms the posterior axillary fold. Sometimes their muscle bellies or insertion tendons even blend with 1 another.

Origin of Teres major:

• Inferior angle & lower part of the lateral border of the scapula.

Insertion:

• Intertubercular sulcus (medial lip) of the humerus.

Nerve supply:

• Lower subscapular nerve (C5-C7).

Blood supply:

• Thoracodorsal branch of subscapular artery & posterior circumflex humeral artery.

Action:

• Extension & internal rotation of the humerus (arm).

The function of Teres Major Muscle

• The primary function of teres major is to create the movements of the humerus at the glenohumeral joint; it pulls the anterior surface of the humerus medially towards the trunk (internal rotation). Furthermore, it can also extend the arm from the flexed position.

• Along with the pectoralis major & latissimus dorsi muscles, the teres major can pull the trunk superiorly (through adduction) when its humeral attachment is fixed. This is why it is also termed the climbing muscle. Additionally, it provides stabilization to the shoulder joint. 

Clinical Significance of Teres Major Muscle

• Myofascial pain syndrome
• The teres major is relatively more liable to the development of trigger points. These are the local, permanent hypertensive areas with rigidification (myofascial pain syndrome).

• Common causes are poor stretching prior to the physical activities, trauma (e.g. fall on the shoulder) & microtraumas through chronic inappropriate straining. Symptoms consider local pain, which may radiate to the lateral shoulder during palpation & difficulties in abducting & elevating the arm.

Teres Major Stretching Exercise

Doorway Stretch:

• Stand beside a door frame or corner of a wall.
• Keeping the back straight & the inner core engaged, bring the arm up against the wall with the elbow & shoulder bent at 90 degrees.
• With the arm planted on the wall, draw the opposite shoulder back followed by the torso in a straight line. Keep the back straight & core engaged.
• Hold this for 30 secs & repeat 3 times on each side 2 times per day.

Camel Pose Stretch:

• Kneel on the floor with knees hip-width apart & hands on the waist. Tuck the toes or place them flat against the floor.
• Slowly reach back & place one hand on each heel.
• Keep the chest lifted, shoulders back & down, engage the core, & slowly push the hips forward.
• Hold for 15-20 secs & repeat 3 times.

Hand Behind the Back Stretch:

• Stand tall with the feet shoulder-width apart. Interlace the fingers behind the back & straighten the arms.
• Keep the chest lifted & pull the shoulder blades downward.
• Hold for 15-20 secs & repeat 3 times.

Floor Angels Stretch:

• In supine position with feet hip-width apart & flat on the floor.
• Position both arms to the beside at a 90-degree angle with palms facing higher toward the roof.
• Keeping in contact with the floor at all times, slowly bring the arms up over the head until they are fully extended.
• Then slowly bring both arms behind to the 90-degree starting position.
• Repeat 10 times for 3 sets.
• Remember to keep the back flat against the floor & ribs tucked at all times

Above-the-head Chest Stretch:

• The patient is in a sitting or standing position, interlock the fingers, then bend the elbow joint & raise the arms above the head.
• Then Gently squeeze the shoulder joint blades together & move the elbow joint &hands backward.
• Vary the height of the hands to emphasize the shoulder joint & chest means hands are behind the head, hands are on top of the head, and the hand is also a few inches above the head.

Bent-arm Wall Stretch:

• The patient is Assume a split stance, Right leg is in the front & the left leg in the back, in a doorway & at the end of a wall.
• Then Bring the left arm up to shoulder height & position the palm & inside of the arm on the wall surface or doorway.

• The patient arm looks like a goal post.
• Then Gently press the chest through the open space to feel the stretch.
• Moving the arm higher & lower which is allow to you stretch the various sections of the chest.
• Then Repeat this exercise on the other side.

Extended Child’s Pose on Fingertips:

• The patient is Kneeling on the floor.
• Try to Touch the big toes together & the patient is sitting on the heels.
• Next, separate the knee joint about as wide as the hip joint.
• Then Bend the forward from the hip joint & walk the hands out as far in front of them as possible.
• With the arms extended palms are facing down then come up onto the fingertips as if the ball underneath the palms & melts the chest toward the floor.

Side-Lying Parallel Arm Chest Stretch:

• The patient is lying prone on the stomach then bring both arms out to the sides then palms facing down & to create the letter, T.
• Then Start to roll onto the right side by pushing with the left hand.
• Lift the left leg, bend the knee joint & place the left foot behind you on the floor for stability.
• Then Rest the right temple on the floor.
• Must be Keep the left hand on the floor for balance.
• For the feel of the extra stretch, lift the left hand toward the ceiling.
• Then Repeat this stretching on the other side.

Teres Major Strengthening Exercise

Lateral raises exercise:

• First, hold a pair of light dumbbells for this exercise.
• You are standing with the feet slightly wider than the hip joint width apart.
• Try to raise the weights to the sides till are at shoulder level.
• Must be remembered to engage the core muscles & slowly lower the weights down to the sides.
• Repeat this exercise for 2 sets, in every set consisting of 12–15 reps & 3 to 4 times per week.

Wand exercise:

• This exercise is helpful to you for increasing ROM exercise.
• The patient is holding the wand with the help of both hands.
• Then perform the shoulder & elbow joint movement.
• Shoulder flexion, abduction, adduction, external & internal rotation & elbow flexion, and extension movement perform with the wand.
• Every exercise does the 2–3 times per day.

Shoulder joint internal rotation isometric exercise:

• To perform shoulder internal rotation you are standing facing a door frame & and outside the wall corner.
• The affected shoulder joint is near the door corner.
• Then flexed your elbow joint up to 90 degrees & make a fist.
• Try to gently press the towel into the corner wall & door jamb like as you rotate your arm inward towards your belly.
• Hold this pressing for 5 to 10 seconds & slowly release.
• Do the 10 to 15 repetitions.

Shoulder Extension isometric exercise:

• To perform shoulder extension you are standing to 6 inches away from the wall & your back is facing the wall.
• Your elbow joint is straight so your hand stays just near your buttocks & makes a fist.
• Try to gently press the towel into the wall behind you.
• Hold this pressing for 5 to 10 seconds & slowly release.
• Complete the 10 to 20 repetitions.

Bent-Over Horizontal Abduction Exercise:

• You are lying on your stomach means in a prone position on a table & bed with your injured arm hanging over the side.
• Must keep your arm straight & slowly raise it to eye level.
• Then slowly lower it back to the starting position & repeat this exercise.
• Do this exercise 2–3 times per day.

Bent-Over Horizontal Adduction Exercise:

• You are lying on your stomach means in a prone position on a table & bed with your injured arm hanging over the side.
• Must keep your arm straight & slowly raise it to eye level.
• Then slowly lower it back to the starting position & repeat this exercise.
• Do this exercise 2–3 times per day.

Dumbell Pullover Exercise:

• Lie across the bench with only the upper back & neck being supported by the bench.
• Hold the dumbbell with both hands, forming a triangle with the hands or by gripping the inner plate.
• Hold the dumbbell directly above the chest with elbows bent slightly.
• Engage the core & slowly lower the dumbbell past the face & over the head as far as you can.
• Pull the dumbbell back over the face to starting position.
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Cable Straight Arm Pull Down Exercise:

• Attach a wide grip handle or different accessory above the head to the cable machine
• Hold the handle with an overhand grip using both hands at shoulder width
• Bend forward slightly at the hips & with the elbows slightly flexed pull down on the handle by depressing the shoulder blades while extending the shoulders
• Pull downwards until the handle reaches the thighs
• Slowly return initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Inverted Row Exercise:

• Set up bar slightly higher than the arm’s length above the surface
• Sit under the bar with both legs stretched out in front of you
• Reach up holding the bar with both hands using an overhand grip wider than shoulder-width apart
• Straighten the body so the arms are straight & heels are on the floor
• Pull up by retracting the shoulder blades until the chest hits the bar
• Slowly lower to initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Underhand Yates Row Exercise:

• Hold a barbell with both hands using an underhand grip at shoulder width
• Bend & the knees & hinge forward at the hips at 45 degrees
• The arms should be almost fully extended with the bar over the thighs
• Pull the bar up to the waist
• Now stop at the top then slowly return to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Underhand Grip Lat Pull Down Exercise:

• Sit on a bench seeing the cable machine
• Reach up & hold the bar with both hands using an underhand grip, shoulder-width apart
• Pull down on the bar by bringing the shoulder blades down & back until the bar reaches the chest
• Slowly return to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Lat Pull Downs Exercise:

• Sit on a bench seeing the cable machine
• Reach up & hold the bar with both hands using an overhand grip, hands are a little wider than shoulder-width apart
• Pull downwards on the bar by bringing the shoulder blades down & back until the bar reaches the chest
• Slowly return to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Pull-Ups Exercise:

• Grasp the bar, hands shoulder-width apart by using an overhand grip
• Begin with arms completely extended the pull the chest up toward the bar as high as you can
• Hold briefly at the top then back to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

ChinUps Exercise:

• Hold the bar, hands shoulder width apart palms with an underhand grip
• Begin with arms completely straight & pull the chest up to the bar as high as you can
• Hold briefly at the top then return to initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Single-Arm Dumbell Row Exercise:

• Hold a dumbbell with a neutral grip with the right hand then place the right knee & right hand under the shoulder on a bench.
• Hold the dumbbell with the left arm straight directly under the left shoulder
• Pull the dumbbell upwards, bending at the elbow & keeping the arm close to the body until the dumbbell is next to the hip
• Slowly lower to initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Seated Cable Rows Exercise:

• Sit on a bench with the knees bent then reach forward & grab the triangle handle
• Pull the handle back towards the navel keeping the back straight & squeezing the shoulder blades together
• Slowly return to initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

High Cable Reverse Crossover Fly Exercise:

• Begin with both handles at head height on the cable machine
• Stand seeing in the center of the two-pulley machine
• Reach up & across the body with both hands grabbing the handles with an overhand grip (or grab the cables)
• Pull the elbows down, out & back as far as possible until the arms are in line with the back
• Slowly return to initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Cable Supine Reverse Fly Exercise:

• Begin with a bench in the center of 2 pulleys
• Reach up across the body grabbing both handles(cable) with an overhand grip
• Lie down on the bench with the arms crossed above the chest with the elbows slightly bent
• Pull the arms down to the sides until the elbow is level with the shoulders, keeping the arms perpendicular to the torso
• Slowly return to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Dumbell Reverse Fly Exercise:

• Hold the dumbbells with both hands with a neutral grip
• Then hinge at the hips until the body is almost parallel to the floor
• Starting with the arms hanging down from the shoulders pull the dumbbells up & back until the elbows are level with the shoulders
• Slowly lower to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Band Pull-Aparts Exercise:

• Stand up straight, with feet shoulder width apart
• Grasp the band close to the ends with an overhand grip
• Raise arms outwards in front of you at shoulder height
• Stretch the band apart by squeezing the shoulder blades together
• Slowly lower to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.

Face Pulls Exercise:

• Set the cable at head height
• Grab the handles and rope with an overhand grip
• Keeping the elbows below the shoulders pull back until the hands are parallel to the face
• Slowly return to the initial position
• Complete the 5 to 10 repetitions.
• Repeat 3 sets at a time.