Massage & Bodywork

SEPTEMBER | OCTOBER 2016

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Imagine three long fingers extending on an inferior and medial diagonal path from the coracoid process to ribs 3–5 (attachments have been found on ribs 2 and 6 on some people). This multitasking stabilizer connects the shoulder girdle (scapula and clavicle) to the thorax. The pectoralis minor seems to glory in pulling the coracoid process toward the ribs (whether it needs it or not), causing a profusion of myofascial and biomechanical distortions. The pectoralis minor drags the glenohumeral joint with it as it pulls the coracoid process toward the ribs. Restrictions in blood flow can occur, as a portion of the axillary artery lies beneath the pectoralis minor. Tingling and numbness (the distal portion of the brachial plexus passes deep to the coracoid process) can also result from the pectoralis minor's predilection for locking short. When the arm is abducted and externally rotated, the artery and nerves are stretched around the pectoralis minor close to its coracoid attachment—hence the tingling and numbness. A tight pectoralis minor restricts scapular mobility and interferes with the scapulo-humeral rhythm, causing limited humeral mobility and scapular winging. Humeral mobility depends on both scapular mobility and fixation of the scapula at the right time and place. The glenohumeral joint follows the scapula. Wherever the scapula goes, the glenohumeral joint is sure to tag along. If the scapula is superglued to the ribs, glenohumeral joint movement is compromised. My mantra is, "Restore scapula mobility and stability, and you'll go a long way to restoring glenohumeral joint function." The obstinate pectoralis minor can produce a hailstorm of problems throughout the body, especially in the shoulders, arms, and neck, and with respiration. Working with it effectively goes a long way in helping your clients with neck and shoulder issues, breathing restrictions, and even wrist and elbow pain. If the iliopsoas is the hidden prankster of low-back pain, 1 the pectoralis minor is the hidden prankster of the shoulder girdle. This feature reviews the anatomy of the pectoralis minor, common pathology, and suggestions for working with it. C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 81 Cut pectoralis major Cut pectoralis major X = Common locations of trigger points

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