The pectoralis (pec) minor muscle is the little brother of the bigger muscle on the front of our chest, the pec major muscle.
Pec minor is significantly smaller, despite this it attempts to do everything its bigger brother does and this can lead to trigger points within the muscle.
A pec minor that harbors trigger points may be responsible for pain at the front of your shoulder. It is this chest pain that physiotherapy can help with.
WHAT IS THE PECTORALIS MINOR MUSCLE?
Although it is the little brother of the pec major, it has a different function. Pec minor is a small thick muscle. Located underneath the pec major at the front of the chest.
Pectoralis Minor originates from the front of the shoulder blade (coracoid process of the scapula) and has three segments that attach onto ribs 3, 4 and 5. When contracted it produces a force that brings the shoulder blade (scapular) downward and forward onto the rib cage.
The muscles primary function is to stabilise the shoulder girdle against the rib cage. It can also play a role in respiration it abnormal breathing patterns or periods of respiratory distress.
PAIN AND SYMPTOMS FROM THE PECTORALIS MINOR MUSCLE
The pec minor has many referral points, which means it’s presentation can often be seen in various locations through the chest, shoulder and arm.
Symptoms of the pec minor injury include;
- Chest pain – can be burning and stabbing
- Anterior shoulder pain
- Pain in between shoulder blades in upper back
- Pain and/or numbness through the inner arm, inside of elbow, into wrist, hand and 4th and 5th fingers
- A sore/tight pec minor can contribute to a rounded shoulder posture as the muscle pulls the shoulder forward
- Difficulty reaching forward and upward
- Depressed shoulder girdle and winging of the scapular
THE PECTORALIS MINOR TRIGGER POINT
As mentioned above the pec minor can develop trigger points which can cause significant discomfort.
Firstly, what is a trigger point and how do they develop? A trigger point is a small knot in your muscle which can cause significant dysfunction and pain. This pain can be localised to the area of the knot as well as referred to various parts of the body.
Trigger points develop due to repetitive movements/overuse, an extended period of inactivity (particularly in positions where the muscle is shortened) and/or after an acute strain/injury to the tissue.
With the pec minor, there are a few ways in which the trigger point can be activated
Paradoxical breathing (chest breathing) makes the pec minor work
continuously in a role that it is not designed to do. This is something that can occur during respiratory distress or just as an abnormal breathing pattern. Through repetitive over use, trigger points can become active as the muscle tightens up.
Another common way pec minor muscle pain can develop is through poor posture. Remaining in a sustained rounded shoulder position, which is common with office workers, the muscle is left in a shortened position. The sustained shortened position leads to shortening of the muscle fibres and the development of trigger points.
The primary trigger point for the pec minor is located slightly inferiorly and medially to the front of the shoulder near the middle of the muscle. There can be multiple trigger points in aggravated states, normally arising closer to the shoulder near the attachment point at the front of the shoulder blade.
PHYSIOTHERAPY MANAGEMENT OF PECTORALIS MINOR PAIN
Physiotherapy has various techniques which can help resolve pec minor muscle pain. Chest physiotherapy includes, but not limited to;
- Deep tissue release – through various massage and muscle release techniques. Tension in the muscle can be reduce à leading to decreased symptom presentation.
- Muscle lengthening – stretching of the pec minor will help bring about change in the muscle tissue and shoulder position. Lengthening of the muscle will often be used in conjunction with massage.
- Posture correction – it is important to address likely causes of the presentation. Correcting any postural anomalies will go a large way in decreasing likelihood of re-occurrence of pain and discomfort.
- Strengthening exercises – addressing muscular imbalances between the anterior and posterior components of the shoulder will assist in keeping the shoulder in an ideal position. Not only increasing the strength of muscles, but strengthening them in a good position and good technique is vital in optimising function.
- Self-management strategies – Your Brisbane physiotherapist will not only help you physically but through teaching of several self-management strategies.
- Teaching how to self-release, giving home strengthening and stretching exercise by your Brisbane physiotherapist. You can take control of your own rehabilitation and help ensure you have less issues in the future.