Trigger Points – Hard to Resolve Forearm Pain

Pain across the chest and down the arm is similar to the sensations of heart attack. Most of my clients have already checked with their heart specialist and tests show that they are OK. People with these symptoms need to check with a medical doctor before getting bodywork that may mask important indicators.

Client’s Description

referral - pectoralis major - sternal

People usually complain of pain in the upper forearm.  They actually grab or trace the area indicated in the picture. They will search for an activity that stressed the forearm but usually can’t come up with one. Some of my regulars will have already tried massaging and stretching the forearm.

Clients with this pattern of pain in the chest and arm usually find that is inconsistent but intense when it occurs. They have often adopted a slumped posture on that side that leaves slack in the sternal pectoral section.They may not have noticed that the pain pattern occurs when they roll that shoulder and arm back until that section stretches. Turning over in bed or leaving this shortened during sleep may wake them at night with chest or arm pain. If the pain becomes constant it is usually during these times of prolonged immobility.

This can be onset by reaching forward at shoulder level. Recently, I had a client who was mounting a birdhouse on top of a post and held his arm forward at shoulder level for a period. This unusual activity is exactly the sort of thing that causes a latent trigger point to become more active combined with the sort of activity that aggravates this trigger point.

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Self Care

The breathing exercise in this posthigh pec stretch is great for this. Make sure that the magazines are high enough to allow the shoulder blades to drop back on either side of the magazines. Doorway stretches are great for this but need to be done gently at first with the elbows level to the shoulder on the door frame. Two things will really speed this process; using the ice and stretch method or making this a regular habit by doing it several times a day for just a few seconds each time.

Therapy Notes

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Pectoralis Major is a complicated muscle that has 4 distinct bellies, each of which has its own trigger points and referral patterns. They need to be considered together and separately. You can see from these illustrations that the joints that they cross as a whole are different than the joints of the sternal belly.

Once the lower cervical vertebrae and upper thoracic vertebrae have been released, focus on the shoulder joints. Displacements in the sternoclavicular joint, acromioclavicular joint and glenohumeral joint all support activity in these trigger points.

The pectoralis minor is very similar in position, arm pain and impaired activities. It needs to be checked and resolved at the same time. A chronically shortened sternal pectoralis major produces a rounded upper back with a spread between the shoulder blades. This is more upright than  the rounded shoulders of a shortened pectoralis minor.

Similar Patterns

Pain across the chest and down the arm is similar to the sensations of heart attack. Most of my clients have already checked with their heart specialist and tests show that they are OK. People with these symptoms need to check with a medical doctor before getting bodywork that may mask important indicators.

Click on these categories to see if there is a referral pattern that better describes your concerns.

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Tony Preston has a practice in Atlanta, Georgia where he sees clients.

He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

Question? Comment? Typo?
The Body Guild.org
(404) 226-1363
tony@thebodyguild.org


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