Muscle News Vol I.32:  Pectoralis Minor
 
Heart Attack?  Thoracic Outlet Syndrome? Or Trigger Points in Your Chest Muscle!
As we have seen in previous issues, trigger points can sometimes mimic more severe health problems.  One of the most serious and concerning health problems is the myocardial infarction (heart attack), which is often accompanied by pain in the left chest, shoulder and down the inside of the left arm, forearm and hand.  

These symptoms just happen to be very similar to the symptoms of trigger points in the star of this month's Muscle News ... a chest muscle known as the Pectoralis Minor (Pec Minor).

The referred pain diagram of the Pec Minor to the left shows the uncanny similarity to heart attack pain.  For this reason, it is important to always have this pain examined by a physician.  

However, don't be surprised if you find that your heart is in perfect health.  It might just be that you have been sitting hunched over your computer or steering wheel too long and developed trigger points in your Pec Minor.

Additionally, trigger points in the Pec Minor can cause or contribute to another condition called Thoracic Outlet Syndrome (TOS).  

TOS is caused by compression of nerves and/or blood vessels in the upper chest or base of the neck near your collar bone.  This area is known as the "Thoracic Outlet" because all the nerves and blood vessels going down your arm exit here.  A tight shortened Pec Minor (among other things) can cause compression of these nerves and blood vessels, leading to symptoms of aching, numbness, burning, or tingling pain in the hand, inner forearm, chest and sometimes neck.

Here is a case study you can read in the Journal of the Canadian Chiropractic Association of a patient who suffered from TOS and possible Heart Attack symptoms.  Treatment of the Pec Minor resulted in complete resolution of symptoms.  Many trigger point therapists find similar results time and again. 

So, let's take a look at some tests and self-care tips to detect and resolve trigger points in the Pectoralis Minor!

*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional.  Please consult your physician to determine whether these self-care tips are appropriate for you.
(3) Quick Self-Tests to Tell if You have Trigger Points in Your Pec Minor:

We've included one more test than usual this time.  The first 2 tests are the typical range of motion and palpation of the Pec Minor, while the 3rd specifically tests for its involvement in Thoracic Outlet Syndrome.  

TEST 1:  Stopwatch to Ear Test
 
The test in this video to the left demonstrates how to check for full range of motion of the Pec Minor.  Stand with your arms at your side.  Raise your arm and without turning your head, try to place the back of your wrist (where the face of your watch would be located) up to your ear.  Then try to extend the arm directly back behind you, as shown in the video.  A Passing result occurs when you can touch your wrist to your ear and extend it directly back behind you.  If the wrist can't touch the ear without turning the head and the arm cannot extend directly behind you, that is a Not Passing result.   


TEST 2:  Palpation
 
Palpation is the gold standard for Trigger Point detection.  Start just beneath the Clavicle a little more than halfway from your sternum to your shoulder.  Press into the fibers of the Pec Minor with firm but comfortable pressure.  Check for tenderness and taut bands, as well as any referred pain, numbness and/or tingling down the arm and into the hand.  Cover the entire length of the muscle, being careful to avoid breast tissue for females.


TEST 3:  Pulse Overhead Test (Wright's Maneuver for TOS)
 
    

The test in this video above demonstrates how to check for compression of nerves and blood vessels by the Pec Minor, thereby causing Thoracic Outlet Syndrome.  Start with the arm down at waist level and check for your Radial Pulse on the thumb side of your wrist.  When you find your Radial Pulse, maintain contact while raising your arm above your head, as shown in the video.  If you still feel your pulse just as strong and there is no numbness or tingling in your hand with your arm above your head, that is a Passing result.  If the Radial Pulse weakens or disappears or numbness or tingling starts in your hand, that is a Not Passing result, indicating the likelihood of trigger points in the Pec Minor.
 

Simple Self-Care Remedies

Here are simple self-care tips for relieving myofascial pain and dysfunction in your Pec Minor:


Step 1:  Warming Up with Moist Heat

To relax and warm up the fibers of the Pec Minor, soak your shoulder and chest in a warm bath or place moist heat such as a Fomentek bag for 10-15 minutes over the chest and shoulder.   


Step 2:  Compression

This video to the left demonstrates how to use your self-care tool to resolve trigger points in the Pec Minor.  As always when you find a tender spot, press in to tolerance and hold for 10 seconds while completing at least two full breaths in and out.  Then continue searching for more tender spots until the entire muscle is covered.  

 


Step 3:  Stretching & Range of Motion

Perform the following exercise in the video to the left 2-3 times per day to keep the Pec Minor functioning well and avoid compression of nerves and blood vessels. 

 

   


Happy self-care!
  
  
Sincerely,
  
Your Friends at The Pressure Positive Co.
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Link Highlights:

NAMTPT LOGO National Association  of Myofascial Trigger Point Therapists

________________
 
Trigger Point Therapy for Low Back Pain: A Self-Treatment Workbook 

by Mary Biancalana MS CMTPT LMT (Author), Sharon Sauer CMTPT LMT (Author), Bernard Filner MD (Foreword)

Learn the secrets to lasting pain relief: finding and deactivating trigger points, the underlying cause of most low back pain. Trigger points are sensitive tight spots in taut bands of muscle tissue. Treating trigger points that refer pain to the low back and buttock areas, rather than addressing only the specific sites of your pain, is the best way to comprehensively treat occasional or chronic discomfort and prevent it from coming back.

Packed with illustrated treatment techniques, Trigger Point Therapy for Low Back Pain offers effective strategies beginners can practice at home and detailed hands-on protocols health care practitioners can use while working with patients. Find out which of eleven muscles could be causing back pain, then learn specific trigger point treatments and correct underlying perpetuating factors to immediately relieve soreness and tension in these muscles. If you're ready to try a targeted approach to eliminating back pain, this manual will provide you with all the information you need to get started and end low back discomfort once and for all.


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