The video featured below is a pectoralis major myofascial technique.
The pectoralis major myofascial technique was one of the many techniques covered in the Module IV: Sinew Channel Assessment & Myofascial Technique class course held in April 2023 in San Diego, CA.
The technique will be revisited during the upcoming June 14th-18th Assessment & Treatment of Injuries (ATI) for the Neck, Shoulder and Upper Extremity, which is the last class of Module IV and of the 2022-2023 SMAC Program.
Mod IV ATI is waitlist only but, with enough interest, we will open a second section, so make sure to register soon!
The ATI class is a comprehensive class covering assessment of injuries and treatment including advanced acupuncture techniques, along with motor point needling for muscle imbalances and distal point needling along the injured or related channels.
Common Issues with the Pectoralis Major Muscle
Manual techniques can greatly enhance the therapeutic outcome in treatments.
This particular muscle, the pectoralis major, is frequently locked-short due to the prevalence of desk work, driving, stress, and various occupational situations that place it in a prolonged shortened position.
Also, people have a tendency to overwork this muscle compared to the scapular retractors, such as the rhomboids and middle and lower trapezius. It can also be imbalanced in relation to the glenohumeral external rotators, such as the infraspinatus.
Using the Pectoralis Major Myofascial Technique
So, when, why and how would you apply this pectoralis major myofascial technique in an acupuncture treatment?
In Sports Medicine Acupuncture, we teach a workflow that utilizes manual techniques after the acupuncture needling. This is because the acupuncture has done so much to influence the muscle imbalances and the practitioner need not apply too much force with the manual techniques to get results.
Essentially, the body is proprioceptively primed if the acupuncture treatment was effective. The same holds true for corrective and therapeutic exercise. Both the manual techniques and corrective exercises are more efficient if applied after the acupuncture treatment, due to the changes acupuncture elicits.
To understand why we would use this technique, we need to review the muscle actions to help us understand when the muscle is held posturally in a locked-short position. Actions include glenohumeral internal rotation and the muscle also has a role in scapular protraction/abduction.
If a patient presenting with a neck or shoulder injury comes into your clinic and this patient tends to ‘live’ more in glenohumeral internal rotation and scapular protraction, then this technique would apply.
Or, if they have a difficult time engaging the scapular retractors and these muscles are not strong enough to overcome the tension and resistance of the pectoralis major, then this technique would also be applicable.
This leads us to the how.
This technique could be paired with acupuncture to motor points or trigger points of the pectoralis major to help increase the therapeutic outcome.
The acupuncture would reduce tension in the muscle and the manual technique would stretch and elongate the fascia after this neuromuscular change to the muscle. This approach would be very helpful if the pectoralis major is quite overactive and shortened and you plan on giving a pectoralis major stretch after treatment.
Or, it can be used after acupuncture to the weak, inhibited, and locked-long scapular retractors and/or glenohumeral external rotators. The acupuncture technique would be more tonifying in nature and the manual technique would reduce fascial holding in the antagonist muscle, so that these scapular retractors and shoulder internal rotators have less to pull against.
This approach would make sense if you plan on prescribing exercises to engage these more inhibited muscles. The acupuncture would effectively wake up these muscles, the manual technique would reduce what they have to pull against, and giving an exercise to engage these muscles to open the chest would be much easier to perform for the patient after this combination was used.
Of course, you might needle the scapular retractors, the shoulder external rotators, and the pectoralis major, but this decision making has to be factored in with patient tolerance/dosage.
Feel free to comment and let us know “when, why and how” you would use this type of technique.