Do you have pain in your upper back?

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If you’re reading this at your computer, or sitting on your couch, take a moment to look and think about your posture. Are your shoulders rounded? is your stomach slouched forward and is your head jutting out like a bird? If you are more a mobile phone reader, you’re most probably sitting in a similar position. Do not worry, you are certainly not alone, and the majority of the population have some kind of postural issue related to the way they sit and move. Most sit with shoulders rolling forward in a kind of hunched position when they get tired, bored or start to concentrate more.

When clients come to see me at my Cardiff clinic, they come with an expectation of me showing them stretches for the muscles that ache or are tight, but thats only half of the problem or issue. All muscles of the body like to work together (agonist and antagonist), when one set of muscles fall behind, another set of muscles will have to pick up the slack.

In my experience the pectoral muscles (Pectoralis major and minor), the large muscles of the chest, are two of the most overlooked and neglected muscles in the body. If they get tight or overworked they can cause all kinds of problems – not just locally around the chest but also causing imbalances

If they get tight, they can cause all sorts of issues – not only locally in the chest, but over time this can cause imbalances and over-stretching of the upper back and neck muscles. This can cause headaches and even pain and numbness in the hands and arms. This leaves you with “knots” and that dull achy feeling you may have at the end of the day.

The pectoralis minor muscle is situated towards the outside if the upper chest. It attaches the 3rd, 4th and 5th ribs to the front of the shoulder blade (coracoid process of the scapula). Its action is to pull the shoulder and shoulder blade down and aids with inspiration by lifting the upper ribs so you can breathe in. If you are getting pain in the front of the shoulder and upper chest, then the first place to look at is the pectorals, especially the minor, and is the most common symptom of pectoralis minor dysfunction. Pain can be due to a muscle tear/strain, repetitive stress injury, and trigger points.

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Rounded shoulders and postural issues.

Rounded shoulder posture is so prevelant these days that I see it almost everyday, HECK I suffer from this myself. It is a common sign of a shortened pectoralis minor muscle, the muscle tightens and becomes short pulling the shoulders forward. This lengthens the upper back muscles, putting them on a stretch and manifesting itself as pain. Pain in the upper back between the shoulder blades is often experienced due to the pec minor pulling the shoulders forward. A band of pain just underneath the shoulder blades is also a common occurrence.

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The rotator cuff muscles (which are situated around the shoulder) keeps the humeral head (ball) centered in the glenoid fossa of the shoulder blade (socket) as the big mover muscles bring your arm overhead. Here’s where the pec minor can be a real issue: if its too tight, it will pull the shoulder blade forward, which means that as you bring your arm overhead, your humeral head will hit the “roof” of your shoulder blade (the acromion) MUCH sooner in the range of motion.

Pectoralis minor in a nutshell pulls your shoulder blade towards your ribs, out of alignment, and messes up the rotator cuff’s ability to keep the humeral head centered happily away from any impingement. In the tight pec scenario, your rotator cuff could get pinched between your humeral head and your shoulder blade. This manifests as sharp pain in the front of your shoulder. It could also show up as very diffuse, achey pain around the front and side of your shoulder, even down your deltoid…when the rotator cuff is irritated, it can refer pain anywhere from the front of your shoulder, down your deltoid and sometimes even to your elbow. BUT that’s not the only thing a tight pec minor can do. Because it lies on top of nerves and blood vessels, when it is tight, it can also cause nerve irritation or compression of other vasculature.

The pectoralis minor muscle along with the scalenes,(which are predominantly found in the neck) are known as neurovascular entrappers. Tight shortened pec minor and scalene muscles can put pressure on the axillary artery as well as nerves in the neck / shoulder area restricting circulation to the arm and causing symptoms such as numbness and tingling.

So, the pectoralis minor muscle is a small muscle that can cause big problems. ➡️ WHO IS AT RISK?

▪️People working with their arms out in front of the body. People who use computers/laptops can put enormous strain on the pec minor if the arms are not properly supported. Sitting in a chair and reaching to use the keyboard rolls the shoulders forward and shortens the pec minor putting pressure on blood vessels and nerves that run under the muscle.

▪️People who have jobs or hobbies that require holding the arms up and overhead for extended periods of time can develop problems in the pec minor.

What can be done.

All the exercises below are designed to stretch and lengthen the pectoral muscles. By increasing the range of these muscles, it will help decrease the stretch on the upper back muscles.

Doorway Lunge Stretch

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Step 1. Put your hands on the door frames above head height with your elbows bent.

Step 2. Lunge through the door until you feel a stretch then slide the hands further up or down until you feel a deeper stretch.

Step 3. Hold for 60 seconds or try a contract relax version. This can also be done one side at a time in the doorway for a stronger stretch.

Foam Roller Arm Circles:

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Step 1. Lie on a full foam roller with it length ways along your spine including supporting your head.

Step 2. Take both arm straight towards the wall behind you so that they come close to your ears.

Step 3. Start to bend the elbows as your slide your arms down by your sides trying to let your arms relax towards the floor as you do so.

Step 4. Repeat for 10-20 reps or until you feel they have relaxed off. You may also add a small 0.5 – 1 kg weight to help the stretch once it starts to get easier.

Ball Trigger Point work

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What you need: A tennis ball/hockey ball or any kind of round implement.

What to do: Place the ball on your pectoralis minor muscles, which is between your collarbone and your armpit. Lean your body and the ball onto the wall so that your head can freely move. Adjust your pressure so that the ball stays pinned against your chest as you move. Roll the ball gently from side to side, up and down, rolling deeper into spots where you feel relief. This can also be done on the floor, try and experiment and find what works best for you.

What it does: This loosens the muscles and tissues of the pec minor that tend to get extremely tight. Loosening these muscles will loosen the stretch on the back muscles.


Try these three exercises/stretches if you are having back pain. If you’d like a more tailored and specific pectoral massage/therapy work then come and visit me at my Cardiff sports massage clinic

Call me on 07798564177