Stretching for Pain Relief - Pectoralis Major and Minor | Pectoralis Muscles, Shoulder, Stretching and more | Niel Asher Education Blogs and Articles blog

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.

Pectoralis Major Trigger Points

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

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.