Pectoralis Major and Minor Pain: Causes, Symptoms, Treatment, Recovery, Exercises

The pectoralis major is the most important thick and fan-shaped muscle that is situated at the anterior part of the chest in a male human body. In females this important muscle is spread underneath the breast. A well-developed pectoralis major is very much evident in men who exercise regularly. Another pectoral muscle called pectoralis minor lies underneath the pectoralis major. The pectoralis major and minor muscles are mostly used by human to control the movement of the arm. The contractions of the pectoralis major help to pull the humerus bones to create all forms of movements. The pectoralis minor helps to depress the shoulder points thereby drawing the scapula inferior near the thorax and throwing its inferior angle in posterior position. The pectoral muscles also play a vital part in deep inhalation, and expanding the ribcage to create space for the lungs to expand.

Six separate sets of muscle fibers are identified within the pectoralis major muscle. This enables each portion of the pectoralis major muscle to be moved separately by the nervous system.

• Unusual postures like head leaned forward for a long time, shoulders deliberately pushed forward, sunken-chest posture etc often cause pain in pectoralis major.
• Sitting in front of computer or working at a stretch on a desk may cause distorted postures and thus the pain in pectoralis major.
• Sudden jerks during weight lifting with the arms out in front of the body may cause pain in the pectoralis major muscles.
• Use of hedge trimmer or power saw may cause distortion in pectoralis major leading to pain in that muscle.
• Already fatigued muscles if further used for heavy jobs may lead to simple to severe pain in the muscles.
• Intensive anxiety over a long period of time or recurring panic attacks may cause a pain in pectoralis major.
• Pain from an earlier heart attack, or angina pain, may activate the trigger points in this muscle once again.

• Trauma to the chest caused by a car accident.
• Whiplash from a car accident can cause pectoralis minor pain.
• Major or minor fracture or strain of the upper ribs.
• Use of crutches for a long time can also cause pectoralis minor pain.
• Hyperventilation or heavy breathing
• Mental stress for a long time.
• Carrying heavy backpack or similar things over a period of time.
• Keeping the head forward for a long time, and sunken-chest posture that are common in people who work on computers for longer periods.
• Previous or irregular cardiac pain from a heart attack or angina pectoris.

• Pectoralis major pain may occur in the form of chest pain, shoulder pain particularly frontal part, and pain in the inside of arm to the elbow. This pain may sometimes be confused as cardiac pain which can be confirmed by medical experts.
• Impaired lymphatic drainage may cause the breast to enlarge.
• In females pain in the breast or hypersensitivity in nipple may occur along with the chest pain.
• Pain may spread into the ring finger and little finger of the hand.
• A pain in between the shoulder blade may occur simultaneously.
• Pain may be felt while stretching the hands on two sides.
• Severe pain may cause a feeling of constriction in the chest which much resembles to that of angina pectoris.
• Pain may be irregular which is felt while actively using the upper arms.
• Pain may be one-sided initially, but if not treated may spread to the other side of the chest.
• Symptoms associated with Sternocleidomastoid muscle pain may occur secondary to symptoms described here.

• Pain in the anterior shoulder extended up to the chest region may be a symptom of pectoralis minor pain.
• A depressed pectoral girdle with more perturbation of the scapula on the affected side may be a symptom of pectoralis minor pain.
• A feeling of pain coming from the inside part of the elbow that is often confused with the pain of “golfer’s elbow” or medial epicondylitis may be a symptom of pectoralis minor pain.
• Pain that is originating in the inside of the arm and extending up to the middle, ring and little finger may be a symptom of pectoralis minor.
• Numbness in the forearm, hand, and fingers may be a symptom of pain in pectoralis minor.
• Difficulty in stretching the arm forward and up may be painful due to problem in pectoralis minor.

The treatment of pectoral muscle pain depends on the severity of the pain and area of injury; however, normally the treatment process involves the following interventions.

• Rest: The patient is asked to take complete rest so that the pectoral muscles are not used for any activity whatsoever. The patient suffering from pectoralis major and minor pain should avoid all sort of physical activities that can make the condition worse and enhance the level of pectoral muscle pain. Rest enables the pectoral muscles to restore any minor damages through their own immunity system.
• Pain Relief: For immediate relief of pain, ice packs are applied to reduce the inflammation in the affected area and ease the swelling to some extent. In some situations, mild analgesics are applied to decrease the intensity of immediate pectoralis major and minor pain.
• Surgical Repair: Surgical treatment for pectoralis major and minor pain may be required for pulled chest muscles which is called Grade III injury. In such situations the muscles are ruptured beyond normal healing processes.
• Physiotherapy: This is the most essential part of any treatment process in pectoralis muscle pain. Many patients suffering from pectoralis major and minor pain get immense benefit from physiotherapy. In most of the situations, medical advisors prescribe for physiotherapy under expert supervision. Stretching, light resistance and strength training exercises are highly beneficial during the recovery period. The following are the normal physiotherapy techniques applied on the patients depending upon the severity of the pain:
  • Soft tissue massage
  • Ultrasound therapy
  • Joint mobilization and manipulation therapy
  • Ice treatment
  • Heat treatment
  • Posture correction therapy
  • Anti-inflammatory therapy
  • Progressive exercises to improve flexibility and strength.

For most patients affected with pectoralis major and minor pain of not severity in nature or belonging to Grade I and II type of injuries, i.e. where a mild strain, pulled muscles, and tear of few fibers etc. have taken place, the recovery period can be in between a few days to a few weeks. However, for those who sustained a Grade III type of pectoral muscle injuries, it may take several weeks to few months to recover.

Certain exercises are advised to practice regularly by expert physiotherapists to keep the pectoral muscles in proper condition. Normally, following exercises are advised at first followed by more intensive exercises:

• Static Pectoral Push up
• External rotation of shoulder
• Shoulder flexion
• Resistance Band Adduction.

The physiotherapist can advise when it is suitable to start the initial exercises and eventually progress to more intensive exercises. Normally, addition of exercises, increase over time and frequency of exercises and practicing more advanced exercises should take place steadily provided there is no recurrence of previous pectoralis muscle pain symptoms.

Pain in chest should not be ignored as it may lead to more severe situation if not attended in proper time. In many instances the symptoms of petoralis major and minor pain seems quite similar to angina pectoralis when the differentiation could be made by a cardiac specialist. Proper treatment, rehabilitation under expert supervision and regular exercises in post-recovery period are must to recover from the pectoralis major and minor pain or keep the pain in control. Learning correct postures and correct techniques can reduce the occurrence of pain or damages in pectoralis major and minor muscle among sports persons.