Your pain pattern,
What aggravates it,
How to get relief,
How People Describe This Pain Pattern
People seldom have any part of this pattern as their primary complaint, but when they do, it is usually biceps pain. When this is a problem, the entire pattern can usually be elicited by pressing up under the collar-bone near the sternum. It is surprisingly intense for a pattern that is seldom a part of their primary complaint. I usually find this trigger point by working the area based on other complaints related to pecs or thoracic outlet syndrome.
A small percentage of people complain about pain along the collar-bone. They trace the pattern along the collar-bone just as shown in the illustration. If subclavius has pulled the collar-bone down onto the subclavian vein, there may be swelling and bluish color in the arm.
Other trigger points more frequently cause the parts of this pattern, so this muscle is easy to overlook until those patterns have been eliminated.
How You Activate and Intensify This Pain Pattern
When I elicit the pattern, which is usually surprisingly intense, the client almost always recalls a forceful movement down and forward with the arm. These have included, tennis forehand with backspin, chopping with an ax or maddock, boot camp exercises and trying to unstick a door. One woman aggravated it by pushing veggies into her juicer. People have also complained about this pattern when the mouse or keyboard are too far away and they have to reach while working on the computer.
The Musculoskeletal Anatomy Behind Your Pain
Subclavius is a small muscle on the bottom of the collarbone. You can read more about the anatomy in this post about subclavius.
Paget-Schroetter syndrome is a specific form of thoracic outlet syndrome where the subclavian artery moves medially until it is restricted and the arm becomes chronically swollen and bluish. It is more common among athletes that weight lift or play tennis.
In one case, I noticed that the arm was swollen a bluish. The arm turned bright red, and the swelling went down when I released the subclavius and pecs, and lifted the collar-bone. Her arm was swollen and bluish again the next morning. I referred her out immediately, and she was able to verify the structural anomaly and restricted vein with ultrasound. She resolved the problem by having a section of her rib surgically cut out to provide room for the vein.
This post on Thoracic Outlet Syndrome has a video and document detailing the structures including the layout of the subclavian vein.
Getting Relief on Your Own
This post has strategies for getting relief on your own. Explore how to change your activities, stretch and other strategies that relieve the pain associated with this trigger point.
Treatment Notes for Therapists
Through Shared Expertise.
This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.
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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