Pectoral Muscle Pain

When you feel pain in the chest, during some movement of the shoulder and scapula, it may be Pectoral muscle pain. Also, you feel the limiting arm move and relieve with rest.

What is Pectoral muscle pain?

• The pectorals are 4 muscles that are located on both sides of the chest.
• This muscle pain arises due to many causes of injury in the pectoral muscle and also due to occur strain in the muscle pain.
• This muscle pain must be required to differentiate from the other cause of chest pain.
• The patient feels the limiting arm movements and decreasing the function of the arm.
• Some condition of this muscle pain is released by rest and using an ice pack but some need complex surgery.
• This muscle pain is also released by physiotherapy treatment and pain medication.

Anatomy of the pectoral muscles

In the human body, there are 2 pectoral muscles (Chest muscles) on each side.
The larger muscle is called the pectoralis major and the smaller muscle is called the pectoralis minor, these muscles lie on the front of the chest.

The pectoralis major:
The pectoralis major muscle is larger.
This muscle arises at the clavicle ( collar bone and sternum & breast bone and ribs ), which is connected to the humerus bone.
This muscle is help in many movements of the shoulder.

The pectoralis minor:
The pectoralis minor muscle is smaller and it is situated under the pectoralis major.
This muscle arises from the ribs and also connects to the scapula ( shoulder bone ).
This muscle stabilizes the scapula during the motions of the arm.

Causes of Pectoral muscle pain

• This muscle pain is caused by injury, generally due to weight exercises.
• The bench press most often occurs in the injury of this muscle.
• Many injuries to this muscle cause the pectoralis muscle to tear.
• This pectoralis muscle tear occurs in loss from the collar bone and ribs on the attachment of the arm.
• This tear may be partial or complete and sometimes it becomes too intensely painful.
• Sometimes occur to sprain in the muscle.
• Complete rupture of the muscle.
• When they occur a direct injury in the muscle is also pectoral muscle pain.
• When the patient falls onto the chest or heavy objects are falling on the chest, it causes muscle damage.
• Some sports such as rugby and American football also injure the pectoralis muscles and produce pain.
• The pectoralis minor is not injured by direct injury because this muscle is situated deep under the pectoralis major so this muscle is injured by overuse.
• This pectoralis minor muscle is injured when the patient is participate in weight training, swimming, rugby, and bodybuilding.

Symptoms of the Pectoral muscle pain

• The patient feels pain at the attachment of the muscle to the humerus bone and the front of the armpit.
• The pain of the pectoralis minor is generally sub-acute and the onset of pain is gradual.
• In the area of pain present tenderness and trigger points of the pain.
• Swellings and spasms are also present in the pain region.
• Sometimes inflammation also occurs in the pain region.
• Breathing problem
• Weakness in the shoulder motion.
• Sometimes the patient present with visual bruising.
• When they occur touching and pressing the place which increases the pain.

Which condition needs to contact the doctor?

When you feel any symptoms of this muscle pain along with the chest pain, you just need to contact the doctor and go to the hospital immediately.
The doctor is taken to first the examination of this muscle pain.
In the examination doctor first, take to history and ask some question about the muscle pain and try to know about the cause of the muscle pain.
The doctor observes the swelling or redness and bruising at the site of pain.
On palpation, palpates to swelling and spasms of the pain region.
The doctor examines the ROM ( range of motion ) and strength of the shoulder motion.
The doctor is also suggesting ultrasound ( US ) and magnetic resonance imaging (MRI) scan which is help to diagnose the pectoral muscle tears.
After the proper examination, the doctor suggests the treatment of the muscle pain.

Treatment for pectoral muscle pain

RICE Principle

In the initial phase of muscle, the pain doctor recommends to RICE principle to relieve the muscle pain.

• R-rest: The patient is do the rest after the muscle pain, in the rest you used to sling for the rest of the muscle.
• I-ice; You can also apply ice on the site of pain to release the muscle pain, you can also apply an ice pack and frozen peas on the site of pain to release the swellings and pain.
• C-compression: You can also use to compression bandage to release the swelling and spasms.
• E-elevation: You elevate the affected arm with the help of a pillow to relieve the swelling.

Pain medication

You are used to Non-steroidal anti-inflammatory drugs specifically NSAIDs like ibuprofen and aspirin for the release the muscle pain.
The dosage of the medicine depends on the severity of the pain and depends on the doctor’s advice.
You can also use volini gel and defiance gel to the location of pain to release the pain

Treatment of the pectoralis major muscle strain :

Strains and partial tears of the pectoralis major muscle are handled by conservative treatment.
The healthcare provider has put the affected arm in a sling for to rest of the muscle during conservative treatment.
In the strain place also used ice packs and pain medicines which is help to reduce discomfort.
This injury takes to 4 to 6 weeks the healing muscle.
Normally in athletes and others who are participating in the competitive sport for that surgical treatment is a more satisfactory option to restore the best possible function.

Treatment of the pectoralis minor muscle injury:

The health care provider is also prescribed to relieve whatever activity which is triggered the pectoralis minor strains combined with rest and pain medicines.
If the pain is more severe, the doctor injects a mixture of a local anesthetic and a corticosteroid into the pectoralis minor tendon.
The health care provider also uses ultrasound ( US ) for precise placement of the injection.

Physiotherapy treatment for pectoral muscle pain

The physiotherapy treatment includes electrotherapy, stretching, and strengthening exercises, which are used to relieve muscle pain.

Electrotherapy for pectoral muscle pain:
The electrotherapy treatment includes ultrasound therapy, SWD short wave diathermy, transcutaneous electrical nerve stimulation ( TENS ), and Interferential therapy (IFT) machine which are used for pain relief and swelling of the location of the pain.
On the trigger points and tender points apply to ultrasound for release to pain and swellings.
In the place of pain apply SWD, TENS, and IFT machine to reduce the pain & swelling or spasms.

Stretching for pectoral muscle pain:

• Doorway Pectoral Stretch
• Camel Pose
• Floor Angels
• Behind-the-back Elbow-to-elbow Grip
• Above-the-head Chest Stretch
• Bent-arm Wall Stretch
• Extended Child’s Pose on Fingertips
• Side-Lying Parallel Arm Chest Stretch

Doorway Pectoral Stretch:
The patient’s position is to stand in an open doorway.
Then lift each arm to the side, flexed at 90-degree angles with the palms forward, after then rest the palms on the door frame.
Then slowly step forward with one foot.
The patient is feel stretched in the shoulder joint and chest and must be careful to stand upright and don’t lean forward.
Maintain this stretching exercise position for 10 to 20 seconds.
Then back to the starting position and relax.
Repeat this stretching exercise 3 times in 1 session and do it 3 sessions every day.

Camel Pose:
The patient’s position is in a kneeling position on the ground with the knees hip-width apart and hands on the waist.
Then tuck the toes and place them flat against the ground.
After then slowly reach back and place one hand on each heel.
Hold the chest lifted, shoulders back and down, engage the core slowly push the hips forward.
Maintain this stretching exercise position for 15 to 20 seconds and repeat this stretching exercise and do it 3 times every day.

Floor Angels:
The patient’s position is lying flat on the back with the feet hip-width apart and flat on the ground.
Place both arms to the side at a 90-degree angle with palms facing upwards toward the roof.
Maintaining contact with the ground at all times then slowly bring arms up over the head till fully extended.
Slowly bring both arms back to 90 degrees and back to the starting position.
Repeat this exercise 10 times for 3 sets, and must be remembered for this stretching to keep the back flat against the ground and ribs tucked at all times.

Behind-the-back Elbow-to-elbow Grip:
The patient’s position is in a sitting and standing position starting with the arms hanging by our sides and shoulders pressed down away from the ears.
Then gently squeeze the shoulder blades together and enlarge the chest.
Bring the arms behind the back and hold elbow to elbow.

Above-the-head Chest Stretch
The patient’s position is in a sitting or standing position, interlock the fingers, then flex the elbow joint and lift the arms above the head.
Then gently squeeze the shoulder joint blades together and move the elbow joint and hands backward.
Change the height of the hands to emphasize the shoulder joint and chest means hands are behind the head, hands are on top of the head, and the hand is also a few inches above the head.

Bent-arm Wall Stretch
The patient’s position is to assume a split stance, the Right leg in the front and the left leg in the back, in a doorway, and at the end of a wall.
Then bring the left arm up to shoulder height and position the palm and inside of the arm on the wall surface or doorway.
The patient’s arm looks like a goalpost.
Then gently press the chest via the open space to feel the stretch.
Moving the arm higher and lower which is allow to you stretch the different sections of the chest.
Then repeat this stretching exercise on the opposite side and do this exercise every day.

Extended Child’s Pose on Fingertips:
The patient’s position is in kneeling on the ground.
Try to Touch the big toes together and the patient is sitting on the heels.
After then, separate the knee joint about as wide as the hip joint, flex the forward from the hip joint and walk the hands out as far in front of them as possible.
With the arms extended palms are facing down then come up onto the fingertips as if the ball is underneath the palms and melts the chest toward the ground.

Side-Lying Parallel Arm Chest Stretch
The patient’s position is lying prone on the stomach then bringing both arms out to the sides then palms facing down to create the letter, T.
Then begin to roll onto the right side by pushing with the left hand.
Raise the left leg, flex the knee joint and place the left foot behind you on the ground for stability.
After the rest, the right temple is on the ground.
Must keep the left hand on the ground for balance.
For the feel of the extra stretch, raise the left hand toward the roof.
Then repeat this stretching exercise on the opposite side.

Exercise for pectoral muscle pain:

• Incline push up
• Flat bench press
• Incline bench press
• Decline bench press
• Push-up
• Cable crossover
• Chest dip

Incline push-up:
In this exercise, the patient’s starting position is with the hands on the wall and a countertop of the height surface.
Then walk the feet back so that the body makes roughly a 45-degree angle with the ground.
Maintain the body straight and spine neutral and lower the chest to the surface bending against it.
Pause for a moment, and after that back to the starting position.
This resistance must be light adequately and do complete up to 10 to 20 repetitions.
For comfortable exercise, a step nearer to the hands
To make the more difficult exercise, step farther away.

Flat bench press:
The patient’s position is to lie on the back of the bench with the knees flexed and feet flat on the ground.
Grasp the barbell, with the thumb, wrapped around the barbell and palms facing toward the feet.
Push the arms straight toward the roof which lifts the weight off the rack.
Then move the weight over chest level.
Flexing the elbow joint down at a 45-degree angle slowly lowers the weight of the chest, and must keep the bar around in line with the nipples.
Then pause for a moment after that press the weight and return to the starting position.
Repeat this exercise and do this exercise in 3 sets of 8 to 12 repetitions every day.

Incline bench press:
The patient’s position is lying on the back on the incline bench with the knees flexed and feet flat on the ground.
The patient is grasping the barbell, with the thumb which is wrapped around the barbell and palms facing toward the feet.
Press the arms straight toward the roof to lift the weight off the rack.
Position the weight above the collarbone, and then slowly lower the weight down to the chest, around in line with the mid-chest to just above the nipples.
Then pause for a moment after that press the weight to return to the starting position.
Do this exercise in 3 sets of 8 to 12 repetitions every day.

Decline bench press:
The patient’s position is lying on the back on the decline bench, with the knees joint flexed and ankles which are secured behind the ankle rests.
The patient is having a barbell, with the thumb wrapped around the barbell and palms facing toward the feet.
Press the arms straight to lift the weight off the rack, and position the weight above the lower chest to the upper abdomen region.
After then slowly flex the elbow joint to lower the weight down to the chest, around in line with the nipples.
Then pause for a moment after that press the weight to return to the starting position.
Do this exercise in 3 sets of 8 to 12 repetitions every day.

Push-up
The patient’s position is to Start on the hands and knees and step back into a high plank position.
The hands must be just wider than the shoulders and the legs should be straight with the quads.
The Hamstrings muscle is engaged and must be held the spine neutral.
Support the core muscle and flex the elbow joint at a 45-degree angle to lower the chest toward the ground,
Keeping a straight line from head to heel.
Press the chest away from the floor till the elbow joints are straight.
Then Repeat and complete 8 to 12 repetitions every day.
Do this exercise in 3 sets every day.

Cable crossover:
The patient’s starting position is the standing position away from a set of high pulley cable machines and a resistance band anchored overhead.
Set light to the moderate weight which is add to the challenge but gives sensation.
Grasp the hands or the ends of the band as they step forward with 1 foot, then keep enough tension and control on the handles to keep them in front of the chest.
Contract the chest muscles and bring the handles down forward across the body at around the belly button level.
The hands are crossed to add intensity to the serratus anterior muscles.
Maintain for a moment and then slowly back to the start.
Then repeat this exercise to the opposite side.
Do this exercise in 3 sets of 8 to 12 repetitions every day.

Chest dip:
The patient’s position is in the standing position which is facing the two parallel bars and grasping them, palms facing in.
Then straighten the elbow joint and press into the hands, raising the body so that it is in line with the hands.
After then, flex the elbow joint and lower the chest toward the hands.
Pause, and then press return into the starting position.
Repeat this exercise in the 3 sets of the 8 to 12 repetitions every day.

FAQ

Author: Dr.Hasti Rupapara