Pectoralis Minor Manual Static Release

Differentiation

1. The pectoralis minor lies deep to the pectoralis major .
2. The pectoralis minor has a near vertical fiber direction, while the pectoralis major has a near horizontal fiber direction.
3. The position of the pectoralis minor is cranial and lateral relative to the pectoral region as a whole, with an insertion on the coracoid process and origin on ribs 3 - 5.
4. The muscle may be palpated through the axilla, by coursing the fingers under the pectoralis major , along the ribs, in the direction of the coracoid process.
5. Before reaching half the width of the pectoralis major your fingers should abut a set of ropy, near vertical fibers, that lie flat against the rib cage.
   • Note: Generally, the pectoralis minor and surrounding tissues are fairly tender. Be gentle.

Potentially Sensitive Tissues

• The brachial plexus and axillary artery course underneath the pectoralis minor . The axillary lymph nodes may also be compressed when palpating through the axilla if care is not taken.

Trigger Points

• The most common pectoralis minor trigger points are in the center of the muscle belly.

Release Technique

1. This technique can be done in side-lying; however, it may be most comfortable with the patient lying supine.
2. Asking the patient to place their hands behind their head is often a comfortable position for the patient, moves the arm out of the way of the axilla, moves the pectoralis major so that it is easier to palpate under, and this arm position also lengthens the pectoralis minor making it easier to compress sensitive nodules.
3. Use one or both hands to palpate around (above and below) the mass of the anterior deltoid as it joins the mass of the pectoralis major .
4. Follow the underside of the mass into the axilla using one, or both thumbs.
5. It is easiest to locate the pectoralis minor if you press the thumbs into the ribs, under the pectoralis major , and gently move the fingers medially in the direction of the coracoid process.
6. Before reaching half the width of the pectoralis major your fingers should abut a set of ropy, vertically oriented fibers.
7. Once a taut band is located, the length of the band may be explored for a dense nodule.
8. The direction of force may be adjusted to aid in pinning and compressing a dense/sensitive nodule.
9. Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).