Stretching for Pain Relief - Pectoralis Major and Minor
Two Great Exercises for Loosening the Pecs
Trigger points in the Pectoralis muscles are common and often develop as a result of poor posture or overload
Along with the pectoralis minor, the pectoralis major forms the anterior wall of the axilla.
The pectoralis major can develop multiple trigger points. These typically refer pain across the anterior deltoid and down the lateral aspect of the arm into the thumb and fourth and fifth digits.
These trigger points may, in rare cases, mimic the symptoms of angina. Pain from these trigger points can also be felt as interscapular and subscapular pain.
Pec Major - Common Trigger Points
Origin
Clavicular head: medial half or two-thirds of front of clavicle. Sternocostal portion: front of manubrium and body of sternum. Upper six costal cartilages. Rectus sheath.
Insertion
Crest below greater tubercle
of humerus. Lateral lip of intertubercular sulcus (bicipital groove) of humerus.
Action
Adducts and medially rotates humerus.
Clavicular portion: flexes and medially rotates shoulder joint, and horizontally adducts humerus toward opposite shoulder. Sternocostal portion: obliquely adducts humerus toward opposite hip.
Pectoralis major is one of the main climbing muscles, pulling the body up to the fixed arm.
Nerve
Nerve to upper fibers: lateral pectoral nerve, C5, 6, 7.
Nerve to lower fibers: lateral and medial pectoral nerves, C6, 7, 8, T1.
Basic Functional Movement
Clavicular portion: brings arm forward and across body, e.g. as in applying deodorant to opposite armpit.
Sternocostal portion: pulling something down from above, e.g. a rope in bell ringing.
Referred Pain
Clavicular portion: local pain, radiating to anterior deltoid and long head of biceps brachii area. Sternal portion: “acute” back pain into anterior chest wall in a 10–20 cm patch of diffuse pain around medial border of upper extremity.
Stronger pain below medial epicondyle in a 5 cm patch, diffuse pain into 4th and 5th digits.
Costal portion: 5th and 6th ribs leads to severe cardiac referral (even at night). Intense breast pain (10–15 cm patch). Diffuse radiations into axillary tail, and into axilla.
Indications
Post myocardial infarct rehabilitation, cardiac arrhythmia, mid-scapular back pain, breast pain and hypersensitivity, thoracic outlet syndrome, anterior shoulder pain, golfer’s and tennis elbow, round- shouldered postures, chest pain, chronic fatigue, hyperventilation syndrome.
Causes
Poor posture while sitting, round- shouldered postures, heavy lifting, chilling of muscle in air conditioning, immobilization of shoulder or arm in cast or sling, anxiety and poor breathing, sports overload (e.g. weight training, rowing, boxing, push-ups).
Differential Diagnosis
C5–C6 radiculopathy. Biceps tendonitis. Rotator cuff muscle lesions. Intrathoracic pathology. Esophageal pathology. Tietze’s syndrome. Ischemic heart disease (angina). Thoracic outlet syndrome.
Connections
Latissimus dorsi, subscapularis, teres minor, infraspinatus, trapezius (middle fibers), serratus anterior, scalenes, deltoid, coracobrachialis, sternalis, SCM, paraspinals.
General Advice
Round-shouldered posture leads to shortening. Work sitting posture is key. Sleeping posture, especially hands folded over chest or hands above head. Bra type and support may be relevant.
Stretching and Mobility
See the video above for two great exercises for shoulder mobility - ideal for tight pecs and latent trigger points.
If you have a partner to work with, you can also try the following stretch.
Technique
Sit on the ground and have a partner stand behind you. Reach behind with both arms and have the partner (gently) further extend your arms.
Muscles Being Stretched
Primary muscles: Pectoralis major and minor. Anterior deltoid.
Secondary muscles: Biceps brachii. Brachialis. Brachioradialis. Coracobrachialis.
Injury Where This Stretch Might Be Useful
Dislocation. Subluxation. Acromioclavicular separation. Sternoclavicular separation. Impingement syndrome. Rotator cuff tendonitis. Shoulder bursitis. Frozen shoulder (adhesive capsulitis). Biceps tendon rupture. Bicepital tendonitis. Biceps strain. Chest strain. Pectoral muscle insertion inflammation.
Important Notes for This Stretch
Keep your palms facing outward and your arms slightly above parallel to the ground.
Links
Find a Trigger Point Professional in your area
More Articles About Trigger Points
Dry Needling for Trigger Points
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