Therapy Notes – Pectoralis Major

The pectoralis major is a broad, fan-shaped muscle made of flat overlapping strips that covers the anterior ribs.

Pecs are often the victim of cervical problems. They are innervated by the brachial plexus and are intertwined with THORACIC OUTLET SYNDROME. They also perpetuate THORACIC OUTLET SYNDROME by holding pectoralis minor short, which entraps the brachial plexus. A thorough treatment of the neck and thorax is often needed to produce longer-lasting results.

Pectoralis major produces symptoms when short and strong as well as when they are overstretched. They are seldom seen as overstretched as extension postures are often not recognized for their impaired functions. The trigger points produce issues with anxiety, breathing, and heart-related symptoms. These symptoms are not often conveyed to the bodyworker as part of a musculoskeletal problem.

Many things make this muscle difficult to treat. It presents issues with
modesty. It is usually very sensitive physically. Breast tissue is often in the way of treatment. Its relationship to THORACIC OUTLET SYNDROME is often
misunderstood. Anatomy books are seldom accurate in describing the twisting costal layer and therefore make for confusing palpation. Clients and therapists often don’t connect many of the indications with this muscle.


Review the Anatomy

Pectoralis major has an odd, overlapping twist near the insertion tendon on the bicipital groove and varies a great deal from person to person.

This protocol allows better access to the serratus anterior b placing the client in a recumbent position so that breast tissue falls out of the way where it is easily draped. This opens the lateral wall of the rib cage for access under the shoulder blade.

Self-Care can be an important correcting posture that has tight, shortened pecs. These doorway stretches are a classic stretch but vary depending on the section of the pectoralis major needs to be lengthened. Make sure to review the self-care section for the trigger point you are addressing.


This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


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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.

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