0:00 This is Brent, coming at you with another one of our manual stretching videos. In 0:03 this video we're doing the pectoralis major. We're going to talk about body 0:06 position, technique, we're going to talk about handling, we're going to talk about 0:10 your body position, and then we're going to talk about some of the modifications 0:13 or preliminary exercises we're going to have to do to ensure that other 0:16 structures don't compromise the effectiveness of this stretch. I'm going 0:21 to have my friend, Leanne, come out and help me demonstrate this technique. Now, 0:25 let's talk about body position first, specifically, patient or client body 0:28 position. I want Leanne as close to me as she possibly can be, so I'm going to use 0:32 my hip to block her out, make sure she's right at the edge of the table, and then 0:36 I'm going to make sure that her scapula is stabilized by the table, but her 0:40 shoulder is hanging off. If I'm going to pull Leanne back into this position, you 0:44 have seen a chest stretch before, the last thing I want is the table to be in 0:48 the way of the humerus. From here, talking about how we're actually 0:54 going to stabilize the shoulder and get Leanne into this position for the stretch. 0:58 I'm going to use a grip like so. This is your traditional PNF lumbrical grip, 1:02 bending at the first MCPs, and keeping my forefingers together. I'm 1:07 going to brace her acromion down. The tendency for people as they go into a 1:12 chest stretch is to get into this position which is our anterior tipping 1:16 and a little bit of elevation of this acromion shelf. We don't really want that. 1:21 That could lead to some impingement pain while we're doing this stretch. The nice 1:24 thing about this hand position as well, is I can use my palm to stabilize her 1:29 humeral head. Now, the tendency is, as I pull this way, her humeral head 1:34 actually tries to pop this way. It's not a good thing. A lot of people have, or I 1:38 should say most people have a little bit of anterior capsule laxity, and a little 1:42 bit of posterior capsule tightness, so if I allow her humeral head to keep popping 1:47 forward that's going to contribute to that movement impairment pattern, rather 1:53 than helping to fix it and it's definitely not going to be beneficial 1:56 long-term to getting her a good chest stretch and fixing any upper body 1:59 dysfunction that we may have. So, once again, acromion shelf down, and then right 2:05 over her humeral head with my my palm. I'm then going to go right below her wrist 2:10 with a lumbrical grip here, and then all I'm going to do is pull Leanne 2:14 back into horizontal abduction, external rotation just above shoulder height 2:23 until I feel that first resistance barrier. Feel a good stretch? Now, you 2:29 should notice that my body position is pretty much straight up and down. My arms 2:32 are pretty much nice and long, so I don't have any unnecessary stretch. I could 2:37 hold this position all day. Leanne feels comfortable. Remember, if we're doing our 2:42 static stretching techniques you may have to hold this position for up to 2 2:45 minutes to get that desired release. Now, let's talk about some of the things that 2:50 could happen during the stretch and tend to happen depending on which patient 2:53 clientele population we're working with that could impact the effectiveness of 2:58 this stretch. First things first, every once in a while I'll see somebody get to 3:02 here and they start feeling a little tingly in their hand. Well, a little 3:07 tingly may not be damaging, it's definitely not going to help us with our 3:11 stretch, as soon as they feel tingly they're probably going to start guarding 3:14 on us and we're not going to get that release. So, to back off on a nerve 3:19 stretch, which is not a good idea anyway, all I'm going to do is I'm going to take 3:22 Leanne's elbow, I'm going to bend it like so, I'm going to move this hand over her 3:27 humeral condyles, but kind of cupping her elbow, and now I'm just going to control 3:31 from the elbow, go through the same motions, horizontal abduction and 3:35 external rotation, acromion shelf depressed, humeral head depressed, pull 3:43 her back into that stretch. So this is still a pec stretch, our pec doesn't 3:47 cross our elbow. Leanne feels good in this position, and if she had any nerve-ness 3:52 in her hand it would probably subside after doing something like this. 3:57 Now, let's talk about some of the other things that could affect this stretch. 4:01 Generally, if I were to ask Leanne, 'where did you feel that stretch', her chest area, 4:08 right, we want her to feel it in her pecs. So, if I don't have pec feeling, 4:14 instead they're feeling it somewhere else, like, let's say, they're feeling it 4:16 in their armpit, or they're feeling it in their posterior shoulder, we can go 4:21 back to some of those commonly over active structures that we know are 4:23 involved in this upper body dysfunction, and start trying to figure out how are 4:28 we going to get those out. Now, when it comes to the back of the shoulder the 4:32 pinching is usually posterior deltoid involvement, we need to 4:35 go ahead and do our release techniques before we start this stretch. If it's 4:39 armpit, chances are it's subscapularis or teres major and once again, we're 4:43 probably going to want to go ahead and release first. For my personal trainers 4:47 out there you can use your foam rolls, and we have videos on those 4:50 self-administered techniques. For all of my licensed professionals out there, you 4:54 can go ahead and do that manually and then go ahead and retry the stretch. 4:58 Chances are, if you release those structures, stretch if necessary, that 5:03 when you come back to this chest stretch her humeral head will be able to glide in 5:07 the glenoid fossa the way it needs to to ensure that those structures don't 5:11 become overactive while we're doing this. The last one, and this one tends to be 5:16 a little tricky, there tends to be a little bit of a feel to this, is some 5:21 individuals, when you're bracing with this hand, acromion shelf down, humeral 5:26 head down, you'll get them to here and they just get kind of stuck on you. 5:30 They just won't go down, they tend to have a very intense feeling in the 5:34 lateral aspect of their chest but not across their whole chest, this is 5:38 probably pec minor involvement. So, if my pec minor is really, really short, really, 5:44 really overactive, it's not going to allow my scapula to posteriorly tilt, 5:49 and I'm not going to be able to pull her far enough into horizontal abduction and 5:53 external rotation to get a stretch in her pectoralis major. So, once again, I can go 5:58 back and release that muscle, and I'll show you in a separate video a 6:02 specific stretch for the pectoralis minor. So a really quick review of 6:07 what we just went through because I know that was a lot of information and we 6:11 need to get back to the primary technique, which is a pectoralis major 6:13 stretch. I have Leanne right up against my hip here, so she's all the way to the 6:17 edge of the table, that's going to save my body mechanics. Her humeral head is 6:22 off the table, scapula is stabilized on the table. I'm going to use this hand to 6:27 wrap my fingers over the top of the acromion shelf and press it down, 6:31 stabilize a little bit. I'm then using my palm to stabilize the humeral head 6:36 that way. So acromion shelf this way, humeral head that way, and then 6:43 I can go ahead and if you really want to get fancy, you can give a little 6:46 distraction to this stretch, and then pull down into horizontal abduction and 6:51 external rotation. How does that feel? -Good. We're going to hold that until 6:56 we get that release, once again 30 seconds to 2 minutes. I hope you enjoy 7:00 this technique, get good practice in it, the better you get at your technique, the 7:04 better results you're going to get. I'll talk with you soon.
