In this episode of “The Rebel MT” with Allison Denney, we investigate why the pride of the pectoralis major is both a good and a bad thing, and how we as bodyworkers can use this knowledge to our advantage.
Allison’s column in Massage & Bodywork magazine:
“Buddha’s Six-Pack: Serratus and Intercostals, with a Diaphragm Chaser,” by Allison Denney, Massage & Bodywork magazine, May/June 2021, page 86, www.massageandbodyworkdigital.com/i/1358392-may-june-2021/88.
“The Muscle, the Beast, and a Cup of Tea: Conquering Sternocleidomastoid Fears,” by Allison Denney, Massage & Bodywork magazine, March/April 2021, page 80, www.massageandbodyworkdigital.com/i/1338685-march-april-2021/82.
Contact Allison Denney:
This podcast sponsored by:
Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.
At Structural Elements, we view ourselves as Body Engineers. We evaluate the human body according to its structural integrity and establish proper balance between compression and tension elements. Through identifying patterns in the body, we are able to locate areas of compensation to treat the cause of the imbalance, not the site of pain. Our patients achieve lasting results as we reduce structural imbalances, improve connective tissue health, and reeducate movement patterns. Now, we have taken our education, operations, and communications infrastructure from our franchise company and made it available to the industry through (se) Connect.
(se) Connect is the only interdisciplinary knowledge sharing platform that exists in the wellness industry. Participants gain access to treatment tools, business tools, and the ability to connect with other professionals in a variety of modalities. Through our community, massage therapists, physical therapists, chiropractors, athletic trainers, acupuncturists, and others all learn to look at the body through the same lens, which allows for rich discussions on patient care and treatment options. Our training staff brings decades of experience in massage, manual therapy, acupuncture, chiropractic, and business, and we look forward to sharing that with you.
0:00:00.0 Speaker 1: With SE-Connect, you can learn a 15-minute comprehensive manual therapy treatment that will set you apart from other massage therapists. SE-Connect is the only multi-disciplinary platform with practice tools, business tools, and a community of practitioners speaking the same language. Check it out at network.structuralelements.com.
0:00:26.3 Speaker 2: Anatomy Trains is happy to announce our return to the Dissection Lab in person, January 10th to the 14th, 2022 at the Laboratory of Anatomical Enlightenment in Boulder, Colorado. We are thrilled to be back in the lab with Anatomy Trains' author Tom Myers and master dissector, Todd Garcia. Join students from around the world and from all types of manual movement and fitness professions to explore the real human form, not the images you get from books. This is an exclusive invitation, email email@example.com if you'd like to join us in the lab.
0:01:08.5 Allison Denney: Hi, my name is Allison Denney, and this is the Rebel MT podcast, where you'll hear me forcibly colliding the worlds of anatomical jargon and humor. I believe that when you know your anatomy, the what, and you know your physiology, the how, the techniques will follow, but the loads of Latin and the gobs of Greek can make a cranium convulse. It is a little overwhelming to dip your toe into the sea of anatomical knowledge, only to find that it is a bottomless ocean. You are smart, but this is intimidating. You will get there eventually. In the meantime, let's look at things differently so that you will actually want to take a swim or at least hop on a boat and take a peak at what's under the surface.
0:01:55.3 AD: The animal kingdom does funny things to attract a mate, a male peacock will spread his tail feathers to show off his colorful plumage. Male prairie chickens will secure a piece of land and compete in a dance off to contend for the local females. Winner takes all. And gorillas, well, they bang on their chests. Why do they do this? It is seemingly an inflated display of ego and a brazen show of testosterone, but there's more science behind it than one might think, and that science offers some insights that made me think about that client who has a hard time letting go on the table. When a gorilla stands tall and hits his hands to his chest, there are a couple of things happening, first, there is the attraction of the opposite sex. Okay, so of all the peculiar pageantry to demonstrate to the female counterpart, banging on the chest is not so outlandish per se. It is a display of strength. Hitting one's chest reinforces the idea that they are strong and ready to defend the honor of their partner. Females are after all, commonly attracted to strength and safety. What better way to show it than a presentation of muscle magnitude.
0:03:08.8 AD: Then there is the intimidation factor, the measuring up of one male to the next, this one is closely related to the previous point, striding hand in hand with the fact that strength is something to be proven. Toughness is daunting to a worthy component. I suspect there may even be a little avoidance in practice, because no one really wants to get in a fight, intimidation can be a handy tool in that way. And finally, there is the non-vocal communication component, this is the one that most intrigues me. Obviously, there are a lot of gestures communicating lots of verbose competitive points, but this part of why a gorilla bangs on his chest was I thought the most interesting. The noise of each beat reverberates up to a little over a half a mile, and the tone of the vibration offers a lot of information to the ears it falls upon. The larger the male, the lower the frequency. The beat made with cupped hands and not fists, has the purpose of sending out the exact information of just how big the noise maker is without having to look upon the actual gorilla.
0:04:16.9 AD: The sounds communicate exactly who the gorilla is without having to say a word. Let's take a look at each of these through the lens of a bodyworker. First the magnitude, as a therapist, having a male client on the table can often be a battle against magnitude. Finding a way to palpate heavily contracted tissue is a problematic obstacle to say the least. Second, the dominance. In a session, a person's need to be intimidating in their world can present as an inability to listen in a session. Having to dominate on a day-to day-basis is not an easy trait to drop on a whim, especially if one has never tried. And third, the pride, the character trait that runs as deep as shame. Pride and strength, pride and social dominance, pride and attraction, pride in being seen and heard.
0:05:10.9 AD: And that pride is nothing to scoff at. It is at the core of how animals function, and we as human beings are part of that animal world. So, how does this play out with our clients? The correlations between how a gorilla acts in the wild and how many men, and some women behave are not far off. I have even seen a few men in my lifetime quite literally banging on their chests when a surge of testosterone hits. But the more subtle similarities are the character traits that quite often make it difficult to work with a client with chest, upper back, and shoulder issues. The need to feel big and strong ends up competing with the need to relax and heal. When a client is on the table, and my invitation to have them let go of every muscle, every joint, every need to hand on tightly isn't heard, the last thing I want to do is get mad that he or she is not listening.
0:06:07.3 AD: Oh, and this is an easy thing to do. It's incredibly easy to feel irritated by the fact that your client isn't listening. It's easy to get frustrated by the fact that they are fighting your efforts. It's easy to become exhausted by constantly trying and not getting through. It's enough to make a massage therapist to make funny faces when the client's head is face down in the face cradle, but let's keep ourselves in check. The pride that lives in each of us is not something that is going to completely dissolve with one suggestion. Give it time, repeat your request, bring their awareness to when they are subconsciously contracting, they will get there eventually. I will talk more about techniques in a bit, but first, let's look at the pectoralis major muscle in detail. Looking at the pec major is kind of like looking at one of those hand-held paper fans from a sideways position. The key to this is that with this muscle, just like with the fan, the meeting point for all of these fibers is not at the end of the muscle where it attaches to the front of the humerus. Instead they criss-cross over each other.
0:07:11.0 AD: The top fiber is dropped down and attached to the lowest point, the middle fibers go straight and stay in the middle, and the lower fibers cross up. So the meeting point or Fulcrum actually sits just medial to or right before where they attach onto the humerus. This is the most important part in understanding what this beast of a muscle does, but I will get to that in a minute. Let's start by mapping out what exactly the pec major latches on to. Its origin is kind of like a big upside down L in the middle of your chest. Technically speaking, we are looking at the medial half of the clavicle, the sternum, and the cartilage of the first through sixth ribs. So basically, following the upside down L, the inside half of your clavicle sometimes called the collar bone, sometimes snaps in half when you fall off of a trampoline, your sternum, sometimes called your breast bone, sometimes called the chest plate, sometimes heroically cracked to save a suffocating heart, and the cartilage that extends from the sternum into the upper half of your rib cage sometimes called your heart and lung jail, sometimes called Nicholas Ribcage, sometimes popped out of place from, well, from life.
0:08:22.5 AD: This big broad mass then funnels itself to a point at the front of the shoulder and then inserts itself onto the arm at a funny landmark called the crest of the greater tubercle of the humerus. Why is this a funny landmark you ask? Because they call it a crest, like the crest of a wave or the crest of a snow-covered mountain, and so we always picture tiny surfers or skiers balancing on the edge of the crest, getting ready to ride that wave or ski that shoot, but it's not, it's just the ridge of a groove that happens to be located just below the big bump that lives on the head of the humerus. Hence, the "crest" of the "greater tubercle." Tiny extreme athletes aside, all of these attachment sites dictate what the pec major does. If you remember back from the last episode, I philosophised about the traps being so big that they are separated into three parts. Guess what? Same is true here.
0:09:22.6 AD: Creatively named for the bones they grab onto, the upper fibers are called the clavicular fibers, the middle ones are referred to as the sternal fibers, and the lower ones are dubbed the costal fibers. But if you remember that they cross over each other before finding their way to the humerus, this will help you navigate your approach. The clavicular fibers when they contract are going to pull the arm up or flex the shoulder. Whereas the costal fibers are going to pull the arm back down or extend the shoulder. The sternal fibers, like most middle siblings finding themselves having to keep the peace, bring them all together. Collectively, they bring the arm across the body or horizontally abduct the shoulder, pull the arm back down to the side or adduct the shoulder and turn the arm inward or immediately rotate the shoulder. So, the pec major as a whole, basically gets fully realised when you hug someone really tightly.
0:10:22.7 AD: But my favorite action is not one that moves the arm at all. Every once in a while, a muscle doesn't just move the bone, it inserts on to. That's the rule of thumb, you know? The origin stays still and the insertion moves. Sometimes though, because human nature loves a good curve ball, muscles will flip the switch. The pec major in this case, will move heaven and Earth when life hits you with a doozy. Not really, actually, but it does elevate the thorax during forced inhalation, when life knocks the wind out of you. I just think the idea of a muscle moving heaven and earth sounds more dramatic. So, what techniques work? For the magnitude, dominance, and pride-filled client approaches that allow them to exemplify their might seem to be a good foot in the door. There are a couple of handy ways to make this happen.
0:11:12.6 AD: Starting with the simplest, client supine, stand at the head of the table and place your hands just below the clavicle bilaterally, fingertips turned towards each other, focus your pressure into your palms and ensure that you are not pressing on the coracoid process. You know, that little misplaced shard of bone that sticks out right where the shoulder seems to start, holding firm pressure into the pec major, ask them to push one hand in a fisted position into their other palm. You will start to feel the pecs contract, suggesting that they embrace their chest, engages all those extra elements, making this a more global technique. Hold your pressure firm against their contraction, then have them release. Let your pressure continue to sink in, getting down to the depths of this thick muscle that was only letting you in superficially before. You can use a soft fist or finger pads for this as well, depending on the magnitude and pride you were dealing with.
0:12:12.5 AD: A more advanced version of this maneuver is to target one side at a time. Stand at one side of the table and have your client bring their arm over their body. You are going to hold their hand above their chest so that their arm forms an L shape. Have them form a fist and push that fist into their opposite open palm. With your free hand sink into the pectorals of that same arm. So, to make this clear, if you are standing on the left of your client, you have their right fist with one hand and your other hand is sinking into their right pecs. This is the tricky part, have them push their fist into your palm, or you resist and you're holding pressure into that contracted muscle. They may wanna show you how strong they are at this point, but this is a great moment to remind them that you are not the opposition. This is also tricky because you are going to ask them to relax and when you do, they need to really let go of their arm.
0:13:09.2 AD: You then immediately need to catch their hand and allow them to completely go limp. Side note, practice this with a friend or family member first, you will drop your client's arm a couple of times before you catch it. Once you have perfected the catch, guide their arm back down to their side as you sink into the relaxed tissue. You can add an extra myofascial element to this by starting your pressure closer to the sternum and then sliding out towards the shoulder as their arm falls to the table. This technically might be called an AET with a pin and stretch thrown in, but I just call it effective. The last trick I wanna offer up starts with your client moving to the side of the table, because I love getting them out of the normal routine. Let's say we are focused on that right side again, still supine, have them slide so far that their right arm would fall off the table, if they let it. Hold their arm at the wrist off the table at about 90 degrees, lift it up to soften the pecs and sink into the slackened tissue with your free hand.
0:14:11.1 AD: Now, as you sink in, allow the right arm to drop down beyond the table to the floor. This lengthens the pecs profoundly and coupled with the pressure of your work, this is a pin and stretch like no other. Play around with rotating the arm into internal and external rotation as you repeat this process, and play around with the placement of your compressions. The pecs are broad and multi-faceted and that detail in your work will feel like confidence to your client. Circling back around if your client feels that confidence in your work, their need to dominate, boast magnitude or exude pride starts to diminish. Their ability to let go will no longer be a battle to see who is the strongest, and the work will speak for itself.
0:15:01.7 AD: And here we are, the end of the episode. Thank you to the extraordinary crew over at ABMP for helping me get my words into your ears. And if you wanna get any of your words into my ears or more accurately into my brain via my eye balls from a computer screen, drop me a line at firstname.lastname@example.org. That's R-E-B-E-L-M-T@abmp.com. I always wanna hear your questions, comments, suggestions, or salutations. Also, if you're interested in checking out anything else I'm doing, head over to rebelmassage.com where you will find all sorts of fun things to click on, like homemade organic products for your practice, cool links to continuing education classes, thoughts I have typed up and posted here and there, and other Rebel Massage dabblings. I'm impressed you've made it all the way to the end, but because you have, allow me to offer a glimpse into our next episode.
0:15:53.8 AD: Tune in next time as we delve into the nature versus nurture conversation, the difference between being a leader and a follower and the philosophical pickle of the coracobrachialis.
0:16:10.6 S1: Members are loving ABMP Five-Minute Muscles and ABMP Pocket Pathology. Two quick reference web apps included with ABMP membership. ABMP Five-Minute Muscles delivers muscle-specific palpation and technique videos plus origins, insertions, and actions for the 83 muscles most commonly addressed by bodyworkers. ABMP Pocket Pathology created in conjunction with Ruth Werner, puts key information for nearly 200 common pathologies at your fingertips and provides the knowledge you need to help you make informed treatment decisions. Start learning today. ABMP members login at abmp.com and look for the links in the featured benefits section of your Member homepage. Not a member, learn about these exciting member benefits at abmp.com/more.