Pectoralis Major Pain

The pectoralis major (pec major) is the large muscle that covers each side of the chest.

Pectoralis major trigger points (TrPs) are a major contributor to pain in the chest. Because TrPs shorten the muscle and pull the shoulders forward you will often experience pain in the upper back between the shoulder blades and a band of pain just under the shoulder blades.

A shortened pec major can also press on blood vessels and nerves which will cause pain, tingling, and numbing in the inside of the arm that often descends down into the hand.

Contents Of Article:

Muscle Location

Trigger Point Symptoms 

Trigger Points Cause

Prevention and Treatment

Interesting Facts 

Other Muscles With Similar Pain Patterns

Pectoralis Major Pain Pattern Pectoralis Major Pain Pattern

Where Is The Pectoralis Major Muscle?

The pectoralis major covers each side of the upper chest. The muscle has two heads that attach to different areas:

  • The clavicular head attaches to the collar bone
  • The sternal head attaches to the sternum, the cartilages of the upper 6 ribs, and to a sheath of connective tissue (aponeurosis) of the external oblique muscle

The two heads then come together to connect the upper arm (bicipital groove of the humerus)

What Movements Does The Muscle Control?

  • Lowers the arm back toward the body when the arm is extended to the side
  • Moves the arm in toward the body
  • Moves arm in and across the front of the body
Pectoralis Major Origin, Insertion, Action, Innervation Pectoralis Major Muscle

The Pectoralis Major Anatomy page lists origin, insertion, innervation, and blood supply information. Muscle actions are listed along with agonists and antagonists for each muscle movement.

What Are The Signs and Symptoms of Pectoralis Major Trigger Points?

Pain in the chest, pain in the front of the shoulder and pain in the upper back are the most common symptoms of trigger points in the pectoralis major.

Trigger points can also contribute to pain, tingling, numbness going down the inside of the arm and into the pinky and ring fingers.

The signs and symptoms are:

  • Chest pain
  • Pain in the front of the shoulder
  • Pain in the inner arm, inner elbow traveling down to the into the middle and ring fingers
  • Breast pain and tenderness
  • Upper back pain between and under the shoulder blades
  • Pain when trying to reach behind the body
  • Rounded shoulder posture
  • Contributor to forward head posture
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Trigger points are small knots found in the muscle that when pressed increase pain in the area or send referred pain to another area of the body. To learn more about trigger points read Muscle Trigger Points and How They Contribute To Muscle and Joint Pain.

What Causes Trigger Points To Develop In The Pectoralis Major Muscle?

  • Slouching posture
  • Lifting heavy objects using your shoulders, arms, and upper back muscles not only stresses the pec major but many other muscles in the neck, shoulder, arm, and back.
  • Working with your arms out in front of you ie. using a computer, driving, horseback riding.
  • Working or doing projects that require keeping your arms up over your head ie. painting.
  • Exercises like push-ups and planks that require your arms and shoulders to lift your body weight. Gymnasts often experience with the pec muscles.
  • Keeping your shoulders rolled forward or pulled up
  • Carrying a heavy purse or backpack on one shoulder
  • Large breasts- the weight of the breast often pull the shoulder and chest muscles forward contributing to the shortening of muscles and TrPs.

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How To Avoid Development of Trigger Points In The Pectoralis Major

  • Standing up straight, sitting upright, keeping the shoulders back and your head lifted will help many muscles including the pecs to fend off TrP development.
  • If you work at a desk an ergonomic chair with adjustable arms is your friend. Take the time to adjust the chair to your specific needs. Make sure your arms are well supported and you are not reaching to use the desktop or keyboard.
  • Take frequent breaks if you are doing activities that require you to have your arms overhead for extended periods of time. Move around and do some upper body stretches to counteract the strain.
  • Use proper form when lifting objects. Squat down, don’t bend over and keep your upper arms close to the body.
  • Consider a  Rolling Backpack or a Crossbody purse to relieve pressure on the shoulder and pectoralis muscles.
  • When you feel muscle fatigue setting in while exercising it is time to take a break or stop. Trying to push through often causes overuse syndrome and injuries which contribute to trigger point development.
TWD Recommends:
If you have rounded shoulder or forward head posture, correcting your posture will reduce your neck, back, and shoulder pain. I  recommend the HailiCare Posture Corrector. The corrector fully supports the back and abdominal area while gently pulling your shoulder back which helps you retrain muscle memory to maintain proper posture. You will notice immediately a reduction of pain and tension. Start slowly, wearing the brace only 20-30 minutes a day slowly increasing the time you wear it. 

Pectoralis Major Trigger Point Treatment

Trigger points in the pec major can be intimidating if you are not sure how to approach treatment. There are many massage therapists, athletic trainers, physical therapist and chiropractors that have training in trigger point therapy and can show you how to find and treat specific trigger points.

You should also know that you can learn self-treatment. It takes a little time and practice but it is not difficult to learn.  The Trigger Point Therapy Workbook is an excellent resource to learn self-treatment. The book explains trigger points and includes diagrams showing where the trigger points are located as well as how to treat each area. It is a book I highly recommend to everyone who wants to learn about muscle pain and its effect on the body.

TWD Recommends:

The best resource to learn how to treat small painful knots is The Trigger Point Therapy Workbook. The authors explain trigger points and their effects in everyday language, not medical speak. I recommend this book to anyone interested in learning to treat their own muscle pain.

Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice to relieve pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)

How Long Before I Feel A Reduction In Pain?

Once you start treating the trigger points you will usually feel some relief quickly though it takes time to fully deactivate the trigger point(s).

TrPs that have developed fairly recently usually deactivate after several days of treatment. If they have been in the muscle for months or years treatment and recovery time will take longer. It is important to be consistent in your treatments and continue treatment until the trigger points are deactivated (gone).

Interesting facts about the pec major:

  • Both the pectoralis major and pectoralis minor muscles can cause pain that mimics heart attack symptoms. If you are concerned about the symptoms, be safe and get medical attention.
  • Poland’s syndrome also known as Poland’s anomaly is a rare congenital anomaly in which the pectoral muscles are underdeveloped or absent on one side of the body. The condition affects the arm and hand on one side of the body. French boxing silver and bronze Olympic medal winner Jerome Thomas is affected on the left side of his body.  His left arm is shorter than the right arm and he has a small left hand. His pectoral muscle is absent on the left side. PGA golfer Bryce Molder also is affected with Poland’s syndrome on his left side. He too is missing the pectoral muscle on his left side and has a small left hand.
  • Pectoralis major and the pectoralis minor pain patterns are very similar.

Pectoralis major muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

  • Bicipital tendonitis
  • Costochondritis
  • Supraspinatus tendonitis
  • Subacromial Bursitis
  • Medial epicondylitis
  • Golfers Elbow
  • Lateral epicondylitis
  • Tennis Elbow
  • Pleurisy
  • Ankylosing spondylosis
  • Esophagitis
  • Gastroenteritis
  • Hiatal hernia
  • Gallbladder dysfunction
  • Angina pectoris
  • Heart disease
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Other muscles that should be considered and examined:

Associated satellite trigger points

A muscle trigger point often produces more trigger points in other muscles within the pain referral area. These are called satellite trigger points.

If you find trigger points in the pectoralis major it is likely you will find trigger points in some of these muscles.

  • Latissimus dorsi
  • Teres major
  • Subscapularis
  • Serratus anterior
  • Coracobrachialis
  • Rhomboid Major
  • Rhomboid Minor
  • Trapezius
  • Infraspinatus
  • Teres minor
  • Deltoid

TWD Recommends:

Relax While Easing Your Pain and Stiffness

Heated Massage Pad to relieve back pain.
You’re tired, your lower back and hips are stiff and hurt. All you want to do is lie down and be able to relax.

The Snailax Vibrating Massage Mat With Heat is made for those times. The mat features a full-body vibrating massage and has multiple settings for massage and heat. The remote allows you to adjust settings with a push of a button. Use this to relax muscles in the back, hips and upper legs. 

Pectoralis Minor

Similar pain pattern in the chest, arm and upper back.

Differences: Pain in the front of the shoulder is often more intense with pec minor TrPs.

Serratus Anterior

Similar pain pattern in the chest and arm.

Differences: Pain going down into the side of the ribs and pain around the inside border of the shoulder blade.

 

Serratus Posterior Superior

Similar pain pattern in the chest, down the inside of the arm, into the hand and fingers. 

Differences: Pain around and under the shoulder blade, pain is more intense around the elbow, wrist, and hand. No pain in the front of the shoulder.

Latissimus Dorsi

Similar pain pattern in the front of the shoulder and pain descending down into the arm.

Differences: Pain going down the side of the ribs and pain in the middle to lower back.

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Donna Martin

Massage Therapist Owner: thewellnessdigest.com Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.

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