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