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Integrated functional anatomy of the pectoralis major. Attachments, nerves, palpation, joint actions, arthrokinematics, fascia, triggerpoints, and behavior in postural dysfunction. Common strength exercises, foam rolling, release techniques, and stretches for the chest muscles.

Pectoralis Major

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Brookbush Institute

I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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Courses

This course describes the anatomy and integrated function of the pectoralis major muscle (a.k.a. the pec major, and is included in the terms pecs, pectoralis muscle, chest muscles, and pectoral muscles). This muscle has a large, superficial muscle belly on the anterior surface of the chest wall, spanning from the sternum to the anterior deltoid, superficial to the pectoralis minor. This muscle is one of the few muscles that have a significantly larger percentage of type II muscle fibers, when compared to type I muscle fibers. The pectoralis major muscle can be divided into two distinct muscle bellies; the clavicular head originates on the clavicle, and the sternal head originates on the sternum and cartilage of the first six or seven ribs. Both heads invest in a common tendon that inserts into the intertubercle groove of the humerus (upper arm), deep to the anterior deltoid muscle.

The pectoralis major muscle crosses the shoulder joint (glenohumeral joint), is the primary shoulder horizontal adductor, contributes to adduction and internal rotation, the clavicular head contributes to shoulder flexion, and the sternal head contributes to shoulder extension. This course also describes the role of the pectoralis major muscle in glenohumeral arthrokinematics, fascial integration, postural dysfunction, subsystem integration, and synergistic function. For example, the pectoralis major and anterior deltoid contribute to upper limb horizontal adduction and internal rotation, in synergy with the 

 which aids in rotating the kinetic chain inward, during a 

Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) must be aware of the integrated function of the pectoralis major for the detailed analysis of human movement, and the development of sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing human movement analysis, human performance, injury prevention, and physical rehabilitation. For example, the pectoralis major contributes to internal rotation of the upper arm bone in synergy with the anterior deltoid and subscapularis muscles, and the sternal head of the pectoralis muscle contributes to shoulder extension in synergy with the posterior deltoid and latissimus dorsi. Understanding the function of this muscle will aid in the selection of pectoralis major exercises and techniques for enhancing sports performance, especially pushing movements (e.g. hypertrophy and bodybuilding training, pushing a defender out of position, throwing a punch, etc.). And, the pectoralis muscle's role in rehabilitation protocols, including addressing a “tight pec major”, pectoralis muscle tears including complete tears and partial tears, muscle bell tears, pectoralis tendon tears, tendon ruptures, post pectoralis tendon repair, rupture repair surgery, contribution to shoulder joint pain, and shoulder impingement syndrome, etc.

Chest Exercises and Pushing Exercise Progressions

Pectoralis Major and Minor Static Stretch (Crucifixion Stretch)

Pectoralis Major and Minor Vibration Release

Static Manual Release of the Pectoralis Major

A cadaver dissection of the pectoralis major muscle on the anterior side of the body

 Course Description: Pectoralis Major

Introduction

 early 15c., “ornament worn on the breast,” from Middle French pectoral and directly from Latin pectorale “breastplate,” noun use of neuter of adjective pectoralis (see 

 (adj.)). – As a shortened form of the pectoral muscle, attested from 1758. Slang shortening pec for this is first recorded in 1966. Related: Pectorals; pecs. (

 c.1300, from Latin maior (earlier *magjos), irregular comparative of magnus “large, great” (see 

The scaplua with attachments for the pectoralis major, trapezius, deltoids, and sternocleidomastoid highlighted

Henry Gray (1918) Anatomy of the Human Body (See "Book" section below)
Bartleby.com: Gray's Anatomy, Plate 200

Attachment and Innervation

The pectoralis major origin on the ribcage and sternum

The insertion of the pectoralis major on the lateral lip of the bicipital groove of the humerus

Attachment & Innervation: Pectoralis Major

Relative Location

Where is the Pectoralis Major Located?

Palpation

Palpating the Pectoralis Major

Introduction to the Pectoralis Major

Actions

Clavicular Head (Upper Fibers): Shoulder horizontal adduction, adduction, internal rotation and may contribute to flexion (8).

Sternal Head: (Lower Fibers): Shoulder horizontal adduction, adduction, and internal rotation. Note: These fibers likely play a larger role in adduction than the clavicular head, and may assist in extension (but not hyper-extension) of the arm from an elevated position (8).

Integrated Function

An anterior view of the pectoralis major muscle 

Arthrokinematics

A lateral view of the location of the lats, pecs, and teres major on the torso 

The clavicular and sternal heads of pec major on a bodybuilder

Fascial Integration

Image of the fascial system of the body connecting muscles

The muscles of the superficial front line, including the pectoralis major, rectus abdominis, and adductors

Subsystems

Anterior oblique subsystem including the external obliques, pectoralis major, and contralateral adductors

Pectoralis Major Actions

Behavior in Postural Dysfunction

Several clinicians and texts have alluded to the propensity of the pectoralis to become short and overactive (1, 2, 5, 7, 8, 11,12); however, dysfunction likely results in inhibition and a reduction in power/max strength production during high-intensity activity (19, 20).

 present with limitations in shoulder flexion and abduction and a resting posture that includes excessive humeral internal rotation (1, 2), as well as, excessive anterior and inferior glide (17). A short/over-active pectoralis major may contribute to all of these dysfunctions; however, in a study by Glousman et al., elite pitchers with shoulder pathology showed a decrease in pectoralis major activity during throwing (20). This seems contradictory, but it is not uncommon to see a reduction in prime mover activity, despite posture that would imply adaptive shortening and an increase in activity (the psoas, 

 are common examples of a similar phenomenon). Hypothetically, dysfunction of a joint would reduce the ability to stabilize force, and reflexive inhibition of prime mover activity would serve to protect the joint. Adding to this rationale, it has been my clinical experience that smaller proximal muscles tend to be more susceptible to changes in activity and length, which may increase the chance that synergistic dominance will result. Many noteworthy clinicians have documented the effectiveness of release and lengthening techniques intended to affect the pectoralis major for reducing symptoms of shoulder pathology and enhancing posture (1, 2, 5, 7, 8, 11,12); however, it is also common for those techniques to have an effect on the 

. Suggestions for treatment of pectoralis major should likely include release and lengthening techniques to affect static standing posture, but also include pushing movements in re-conditioning, resistance training, and performance enhancement routines.

Lumbo Pelvic Hip Complex Dysfunction (LPHCD)

: The pectoralis major plays no significant role.

Sacroiliac Joint Dysfunction (SIJD): The pectoralis major plays no significant role.

 The pectoralis major plays no significant role.

, the pectoralis major has a propensity to become 

, implying that this muscle should be included in 

 techniques. However, the pectoralis major may be victim to prime mover inhibition in the presence of shoulder pathology, and "pushing" motions should be included in re-conditioning, resistance training, and performance enhancement programs. Mobilization of the glenohumeral, sternocostal, and sternoclavicular joints may be beneficial for improving activity and function. Licensed professionals (PT, ATC, DC, OT, DO) may find manual mobilization techniques beneficial. A comprehensive warm-up including activation, integration, and reactive techniques is recommended if max strength or power training will immediately follow mobility techniques. Videos on techniques specific to the pectoralis major below.

Upper Body Dysfunction leading to Scapular or Thoracic Spine Pain

Palpation results in tenderness (trigger points or tender points) and may result in radiating symptoms across the chest, anterior shoulder and axilla, and down the medial side of the arm to the medial epicondyle (8).

The common trigger points and referred pain patterns for the pectoralis major muscle

http://www.kingofthegym.com/wp-content/uploads/2014/11/pectoralis-major-combined.jpg

Postural Dysfunction and the Pectoralis Major

Pectoralis Major (Self-Administered) Static Release

Pectoralis Major and Minor Static Wall Stretch

Pectoralis Major and Minor Static Stretch Crucifixion/Cross Stretch

Active Pectoralis Major, Pectoralis Minor, and Subscapularis Stretch

Manual Pectoralis Major Stretch

Exercises and Techniques for Pectoralis Major

Neural Spine (drawing-in maneuver or bracing if necessary)

Neutral cervical spine (Chin-tucked & head back)

Scapula protracts during the concentric phase and retract during the eccentric phase.

Forearms should remain parallel to the direction of resistance (force vector).

All variations can be done in the sagittal plane for those exhibiting signs of 

, and progressed to a horizontal plane and incline variations.

Hands may be placed on an elevated surface to reduce load, a lower surface to increase load, or feet may be elevated above the height of the hands to increase load. Push-ups on "hands and knees" may also be used as a regression to decrease load.

Push-ups to single-arm balance with rotation

Push-Ups with hands on one medicine ball on one foot

Push-Ups with hands on two medicine ball on one foot

Push-ups with hands on a stability ball against wall

Push-up with hands on a stability ball on one foot

Chest/Pushing Strength & Power Progressions

Push-Ups

Bench Press

Dumbell Press

Band Chest Press

Dumbell Press on Stability Ball

Suspension Press

Medicine Ball Chest Pass

Sled Push

Power Push-Up

Exercise Progressions

Phillip Page, Clare Frank, Robert Lardner, 

Assessment and Treatment of Muscle Imbalance: The Janda Approach

NASM Essentials of Corrective Exercise Training

NASM Essentials of Personal Training: 4th Edition

Diagnoses and Treatment of Movement Impairment Syndromes,

David G. Simons, Janet Travell, Lois S. Simons, 

Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition

Joint Structure and Function: A Comprehensive Analysis: Fifth Edition

Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani

Manipulative Therapy: Musuloskeletal Medicine

Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004

Langevin, H., Fox, R., Koptiuch, C., Badger, G., Greenan-Nauman, A., Bouffard, N., Konofagou, E., Lee, W., Triano, J., Henry, S. (2011) Reduced thoracolumbar fascia shear strain in human low back pain. BMC Musculoskeletal Disorders. 12: 203.

Lawrence, R.L., Braman, J.P., Staker, J.L., Laprade, R.F., Ludewig, P.M. (2014) Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, Part 2: Glenohumeral joint. 

Journal of Orthopaedic & Sports Physical Therapy

Tubbs RS, Shoja MM, Shokouhi G, Loukas M, Oakes WJ. Insertion of the pectoralis major into the shoulder joint capsule. Anat Sci Int. 2008 Dec;83(4):291-3

Wang HK, Cochorane T. 2001. Mobility impairment, muscle imbalance, muscle weakness, scapular asymmetry and shoulder injury in elite volleyball athletes. J Sport Med Phys Fitness 41(3): 403-10

Glousman R, Jobe F, Tibone J, Moynes D, Antonelli D, Perry J. Dynamic Electromyographic analysis of the throwing shoulder with glenohumeral instability. 

Harryman DT II, Sidles JA, Clark JM, McQuade KJ, Gibb TD, Matsen FA 3rd: Translation of the humeral head on the glenoid with passive glenohumeral motion. 

Sanchez ER, Sanchez R, Moliver C. (2014). Anatomic relationship of pectoralis major and minor muscles: a cadaveric study. 

Prakash KG, Saniya K. (2014). Anatomical study of the pectoral nerves and its implications in surgery. 

Tsou JY, Su FC, Tsao PC, et al. (2014). Electromyography activity of selected trunk muscles during cardiopulmonary resuscitation. 

Campbell ST, Ecklund KJ, Chu EH, et al. (2014). The role of pectoralis major and latissimus dorsi muscles in a biomechanical model of massive rotator cuff tear. 

Bibliography

Questions, comments, and criticisms are welcome and encouraged.

Pectoralis Major

Related Courses:

Course Description: Pectoralis Major

Introduction to the Pectoralis Major
3 Sub Sections

Pectoralis Major Actions
4 Sub Sections

Postural Dysfunction and the Pectoralis Major

Exercises and Techniques for Pectoralis Major
5 Sub Sections

Exercise Progressions
9 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Pectoralis Major

Related Courses:

Course Description: Pectoralis Major

Introduction to the Pectoralis Major3 Sub Sections

Pectoralis Major Actions4 Sub Sections

Postural Dysfunction and the Pectoralis Major

Exercises and Techniques for Pectoralis Major5 Sub Sections

Exercise Progressions9 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Introduction to the Pectoralis Major
3 Sub Sections

Pectoralis Major Actions
4 Sub Sections

Exercises and Techniques for Pectoralis Major
5 Sub Sections

Exercise Progressions
9 Sub Sections