Shoulder pain has become common in our modern society. It is alarming that shoulder tendinitis is even being diagnosed in our young adult populations.
As a matter of fact, I am seeing patients as young as 13 years old with shoulder tendinitis issues.
Why are so many people now suffering with Shoulder Pain? How about a muscle called the pectoralis minor! We call it “pec minor” for short.
Before I break down how a tight pectoralis minor could be the cause of our patients’ shoulder pain we need to discuss proper anatomical positioning, as well as the origins and insertions of three muscles.
This is so important because it will help us grasp why we might be massaging the entirely wrong place, which frustrates both the practitioner and the patient.
It is my opinion that our modern way of life has changed our superficial anatomical positioning (true posture) and that has caused undue stress on the origins of shoulder muscles. In particular the biceps brachii.
The biceps brachii is an underrated and sometimes overlooked muscle that causes modern day shoulder pain. How so?
The bicipital tendon of the long head must be slotted properly through the intertubercular sulcus of the humerus or undue friction will occur on the tendon sheath, causing lots of pain.
How could the long head of the biceps tendon become offset?
The most common way I have found is not a tight subscapularis but rather a hypertonic pec minor.
The pectoralis minor’s ‘insertion tendon’ shares the origin points with two other muscles:
1) The short head of the biceps brachii originates on the coracoid process of the scapula.
2) The coricobrachialis originates on the coracoid process of the scapula.
So if the pectoralis minor becomes short and fixed, which protracts the shoulder blade into internal rotation, then the humerus must follow. It has to.
When the humerus stays ‘in’ and is swung ‘in’ a plane it normally would not reside, you have greater friction of the biceps tendon and its sheath.
The humerus should swing or be fixed in the sagittal plane as much as possible. However, because of modern life we see the humerus moving or fixed in the oblique plane.
Modern reasons for this might be:
1) sitting at a computer shoulders forward
2) holding a cell phone slumped forward
3) playing video games shoulders forward
4) poor walking posture shoulders forward
5) truck driving over long periods
These are just a few examples of what might be causing the shortening of the pec minor.
So what can we do to help those with a tight pec minor which causes them shoulder pain?
Imagine this – you keep massaging the biceps brachii origin site with crossfiber friction trying to bring relief to the shoulder pain. Which we find works temporarily.
Wouldn’t it be wiser to go after the true root cause of shoulder destabilization? In this case, the pec minor?
Of course it would.
In the video above I demonstrate how to do just that through deep tissue massage.
Doug Holland, LMT.