The Obstinate Pectoralis Minor


The obstinate pectoralis minor (PMI) can produce a hailstorm of problems throughout the body especially in the shoulders, arm, neck and respiration. Working with it effectively goes a long way in helping you help your clients with neck and shoulder issues, breathing restrictions and even wrist and elbow pain. If the iliopsoas is the hidden prankster of low back pain (Travell and Simons), the PMI is the hidden trickster of the shoulder girdle. This article reviews the anatomy of the PMI, common pathology and suggestions for working with it.

Imagine three long fingers extending on an inferior and medial diagonal path from the coracoid process to ribs 3-5 (attachments have been found on ribs 2 and 6 on some folks). This multitasking stabilizer connects the shoulder girdle (scapula and clavicle) to the thorax. The PMI seems to glory in pulling the coracoid process towards the ribs (whether it needs it or not) causing a profusion of myofascial and bio-mechanical distortions. PMI drags the glenohumeral (GH) joint with it as it pulls the coracoid process towards the ribs.

Restrictions in blood flow can occur—a portion of the axillary artery lies beneath PMI. Tingling and numbness (the distal portion of the brachial plexus passes deep to the coracoid process) can also result from the pec minor’s predilection for locking short. When the arm is abducted and externally rotated the artery and nerves are stretched around the PMI close to its coracoid attachment –hence the tingling and numbness.

A tight PMI restricts scapular mobility, interferes with the scapulo-humeral rhythm, cause limited humeral mobility and scapular winging. Humeral mobility depends on both scapular mobility and fixation of the scapula at the right time and place.

The GH joint follows the scapula. Wherever the scapula goes, the GH joint is sure to tag along. If the scapula is super-glued to the ribs GH joint movement is comprised. My mantra is “Restore scapula mobility and stability and you’ll go a long way to restoring GH joint function”.

Let’s do this kinesthetic exercise: Place one hand on the greater tubercle on top of your humerus. Now depress and protract your scapula (the actions of PMI). Can you feel how the head of the humerus went along for the ride? Next abduct the humerus to at least ninety degrees. Feels yucky, right? When the scapula is protracted and depressed the GH joint internally rotates and the greater tubercle moves anterior. That yucky feeling is the greater tubercle colliding with the acromion process. Repeated fender benders between the greater tubercle and the acromion process can result in impingement syndrome, impaired rotator cuff function, disturbances up the kinetic chain to the neck and down the kinetic chain to the elbows, wrists and hands.

One of my clients is a hairdresser who had chronic elbow and wrist pain for years. In addition to treating the plethora of trigger points in the flexors and extensors of her wrist and elbows, I treated her massively locked- short PMI, rotator cuff and serratus anterior to restore scapular mobility and weight/energy transfer throughout her upper body. She’s been pain free for several months. If I had just concentrated on her elbows and wrists the results would have been temporary. The moral of this story: always check out pec minor with any neck, shoulder, wrist and elbow pain!

My Releasing the Rotator Cuff book and DVD offers an in-depth protocol for releasing this stubborn muscle. Attract and retain awesome clients with stellar skills in working with the shoulders!

More clients (or money), please!

Here’s a great article from one of my favorite coaches, Jeanna Gabellini:
Have you ever asked for a second helping at dinner? “More rice, please!” Yum! You begin to salivate thinking of how good it will taste. I always pile more on my plate when I eat Thai food.

It should be just as easy to ask for more clients or money. “More customers, please!” They should then be served up immediately, right? Absolutely. The key is to ask for them in the same way you’d ask for food. You’d ask with delightful anticipation, complete expectation and no fear. You’d never worry about being rejected or not getting the end result when asking for a second helping of dinner, correct?

Attracting people into your pipeline is easy when you think it’s easy. Most of us have made up the myth that it requires so much effort and we need the perfect pitch or website. Trust me, great marketing materials work only because they give you more confidence.

When I began coaching, I was so passionate about the results that coaching provided that I filled my practice shortly after I decided to go full time. I had no business cards, brochures or websites. I had no resume of all my years of experience in the field. I just had passion.

Many people use my services with their #1 intention to get more clients. I don’t care whether it’s clients or money you want, the process is still the same. You have to have the perspective that it’s easy to do. Some of you let your history be your worst enemy. You’ve had some slow patches in your business or shortcomings with your finances and you let it affect the actions you take. You play your game with doubt, and it shows.

The Universe can’t deliver the goods until you are a perfect match with knowing that you darn well deserve to have an abundance of income. It’d be to your benefit to wipe your slate clean regarding any negative experiences from your past, news about the economy or fear of failing. How would you play if you knew you couldn’t fail?
Are you planning for extreme success, mediocrity or failure?
Do you know your worth, or do you second-guess yourself?
Are you in your heart or your head – or a mash-up of both?
There are definitely smart strategies to build both your customer base and your bank account. Each person’s strategies will differ based upon their personal values and passion level. I like excitement, so most of my marketing is a bit loud, bold and informal. It makes me happy. It resonates with me. If a promotional piece is formal and stuffy, it won’t feel good and I won’t get a great response. My strategy is to be consistent in reaching out to my database. I also make it easy for people to find me. I’m not hiding out.
What types of interactions thrill you in business?
How do you like to attract money?
How can you better bring together your values and passion?
What are you making harder than it has to be?
What do you need to let go of?
Who do you need to let go of?
Who can help make this easier for you?
What new knowledge will assist you in aligning with your desired result?
More fun, please! Business and money are both games. The way to win is to make it fun and easy at the same time. Put in some action hours but make it feel inspiring vs. work.

Jeanna Gabellini is a Master Business Coach who assists conscious entrepreneurs to double (and even triple) their profits by leveraging attraction principles, proven strategies and fun. Grab her FREE audio on dialing in your biz here: http://masterpeacecoaching.com/freecd

Stabilizing the Core & the SI Joint – A Manual Therapy Approach

I’m developing a new course with my colleague, Tracy Firsching, entitled Stabilizing the Core & the SI Joint – A Manual Therapy Approach. The longer I am in this wondrous field of bodywork I am convinced that leveling the sacral base and pelvis is crucial for addressing all kinds of misalignements in the body. Here’s some interesting facts about the sacroiliac joint (SIJ):

Each SI joint is comprised of irregular, articulating bony surfaces on the sacrum and ilium. They fit together like mirror images of a 3D puzzle. This provides stability, strength and restricts movement so that the considerable weight of the spinal column can transfer to the lower body. It also acts as a shock absorber. These surfaces lock into place during the push-off phase during walking to increase joint stability. The SIJ only slides 2-4mm and rotates 1-2 degrees via ligament stretching during weight bearing and forward bending. Movements are a combination of sliding, tilting and rotation. Although normal SIJ movement is small, it is essential for normal pain-free low back and pelvis function. A loss of this movement is common in people with low back and pelvic pain. Twenty-five percent of low back and pelvic pain involves SIJ dysfunction.

There are two forces that help to “lock” the SIJ: Form closure and force closure. Form closure relates to the form of the bones and how they cleverly fit together to create stability. Force closure is stabilization that result from myofascial contraction. The SIJ has NO muscles passing over the joint. Force closure is from muscles increasing tension on the ligaments. In other words it’s an additional system generated by the contractive action of core myofascial units such as the transverse abdominus, multifidi and thoracolumbar fascia/latissimus dorsi (opposite side), hamstrings and gluteus maximus (same side).
When the sacrum rocks forward into nutation, the ligaments around the SIJ and the muscles provide greater stability by force closure pulling the SIJ together. They also increase FORM closure by increasing tension on the ligaments.

Stay tuned for updates about this seminar!
Peace,
Peggy Lamb

Retire Atilla The Thumb and go Muscle Swimming!

Do your hands and body hurt after working with clients? You are not alone. It’s time for all bodyworkers to work smarter, not harder with minimum effort and maximum results. Since every muscle has an automatic sensory reflex whose job it is to resist sudden change from external forces, let’s retire Atilla the Thumb and go Muscle Swimming instead.

As manual therapists we all face the question, “How can I best facilitate tissue release and allow the muscle to return to its happy, healthy resting state while maintaining my own ecology of movement?” I stumbled across an answer to that dilemma about twelve years ago and have been refining my approach ever since in both my private practice and CE seminars. I call it Muscle Swimming because I was delightfully amazed by how effortlessly I “swam” through tissue layers when I implemented the two primary techniques of Muscle Swimming, Pin and Rock and Pin and Move. Utilizing these strategies completely transformed my sessions, both for my clients and me. My clients loved how easily and painlessly I achieved tissue depth and release. Therapeutic effects of sessions lasted longer and outcomes were easier to achieve. I felt more energetic and present since I wasn’t working so hard. I smiled more!

Muscle Swimming uses physiology to facilitate release of myofascial structures allowing the therapist to work smarter and the client to have co-ownership of the session. Active and passive movement strategies are essential ingredients in all the Muscle Swimming protocols. This powerful combination of active and passive movement maneuvers turns off hyperactivity in muscles and joint receptors. It also facilitates the separation and lifting of fascial layers. In this article we’ll focus on the wondrous portal of Pin and Rock.

Pin and Rock is a compelling strategy that serves as a portal to deep tissue work. The therapist gradually presses to find the tissue’s first barrier. Then the muscle is gently pinned, and the therapist adds slow rocking. Rocking has an immediate calming effect. It stimulates the parasympathetic system, harking us back to the time when we were rocked for nine months in the womb. Think of it as a way of introducing yourself and saying hello to the tissue.

Our first encounter with a stressed myofascial unit should be gentle and non-threatening. Passively shorten the muscle, gently pin it with multiple fingers for a broad, dispersed pressure and add a slow rhythmic rocking of the joint. In fact, the first nerves to myelinate in the human fetus are the vestibular nerves which sense movement. Our first consciousness is that we are moving beings. Be patient – wait for the tissue to soften and yield before moving to the Pin and Move protocol. Come back to this Pin and Rock maneuver whenever you sense guarding in your client. Watch the video below to see an example of Pin and Rock to melt through myofascial layers to access the iliopsoas.

Next month we’ll look at Pin and Move – using active movement to release myofascial contractures and improve proprioception.

Test for Short Iliopsoas

I have a new video up on You Tube showing an easy test for a short iliopsoas:
Test for Short Psoas

The Quadratus Lumborum – A Wonder of a Muscle

The short, thick quadratus lumborum (QL) is a wonder of a muscle. While the iliopsoas initiates walking, the quadratus lumborum provides the powerful stability so we can walk. Some researchers believe that complete bilateral paralysis of the quadratus lumborum would make walking impossible, even with braces. This magnificent muscle is an essential component in the bedrock of our bipedal freedom.

The two QLs work as a team, along with the iliopsoas and lumbar paraspinals (multifidi, erector spinae) in stabilizing the lumbar spine. Like the iliopsoas, if this fundamental stabilizer is distressed it can be like a hurricane blowing through with devastating effects. Any movement can be painful, including urination and defecation. The pain may be excruciating in any position that increases weight bearing and requires stabilization of the lumbar spine. Rolling onto either side from a supine position is painful and difficult; coughing and sneezing can be agonizing. In fact, bending forward, twisting, and sneezing or coughing at the same time can throw the quadratus lumborum into spasm. If it’s not a full-blown hurricane, an irritated quadratus lumborum can blow an ill wind of persistent aching pain and gradual loss of lower back and pelvic flexibility, range of motion, and vitality.

The Amazing Iliopsoas

I just got back from teaching my Releasing the Iliopsoas seminar in the northwest. A wise and wonderful midwife/massage therapist in Spokane told me two facts about the iliopsoas that I did not know:

1. It’s the first muscle that forms in the human fetus

2. When a woman is giving birth the iliopsoas helps to push the baby out.

I love the elegance of that!

A Brief Overview of the Physiology of Stretching

Stretching starts in the sarcomere, the basic structural unit of a muscle. The sarcomere contains those famous myofibrils, actin and myosin. When a muscle is stretched, the area of overlap between the myofibrils decreases, allowing the muscle fibers to elongate. The muscle fibers are pulled to their full length, sarcomere by sarcomere. Additional stretching takes place in the surrounding connective tissue. The muscle and collagen fibers align themselves along the same line of force as the stretch. This helps to realign disorganized fibers (both muscle and connective tissue fibers) and contributes to rehabilitating scar tissue.

New Book – The Core of the Matter: Releasing the Iliopsoas and Quadratus Lumborum

My new book, The Core of the Matter: Releasing the Iliopsoas and Quadratus Lumborum is almost here.
This book gives you the tools and strategies to restore power, ease, and fluidity to the low back and pelvis. When these muscles becomes unable to perform their stabilizing duties due to injuries, poor posture, extended stints of sitting, or stress, they can alter the biomechanics of the pelvis and lumbar, thoracic and even cervical vertebrae. Discover gentle, effective, and new deep tissue protocols for releasing these muscles using Peggy’s original and innovative Muscle Swimming approach.

“If you are a results oriented practitioner, this is the book for you. Ms. Lamb has once again masterfully condensed the broad field of somatic work into its most effective distillate.  She provides wonderful clarity and insight into an often little understood anatomy of this area of the body.” Tracy Firsching, LMT

Four Functions of the amazing Rotator Cuff

 

1. Stabilizes the head of the humerus during all shoulder joint movements.
2. Counteracts the upward pull of the deltoid during abduction and flexion of the humerus by exerting a downward pull on the head of the humerus.
3. Decelerates the arm when you throw something or swing a golf club, etc.
4. Provides movement: internal/external rotation and abduction of the humerus.

These are busy muscles that are constantly multitasking!