Working with the pecs is hard enough, but add the fact that half the population has breast tissue, and we have a whole other complication. The pectoralis major (or pec major) is a massive muscle. Mirroring the traps in the back, they have three fiber directions, act as their own antagonist, and span a majority of the torso. But they’re not on the back. They live on the front of our bodies. So, when there’s an issue with this powerhouse, we can’t always start working in the same way that we might with the traps, or the quads, or the hamstrings. The pec major takes a little more finesse.
The pectoralis major is big. Reaching from the medial half of the clavicle, the costal cartilages of the true ribs, and the entire sternum, its broad span at the chest offers a lot of potential for issues. Their convergence at the front of the shoulder—the fibers twisting around themselves like a teenager in love—is the secret behind their strong hold onto the upper humerus. When all these fibers act together, they are a force to be reckoned with. They’re capable of both a fully encompassing hug and a massively painful punch. Approaching them can be equally as perplexing.
Working with the Pecs
No matter who you are working on, the best starting point is the clavicle. The upper fibers attach here and are typically the easiest to access. Begin by sliding along the inferior aspect of the clavicle from the sternum toward the shoulder. You can be situated at the head of the table, the side of the table, or the opposite side of the table, depending on the work your client needs. The goal is to work this attachment so the stiff, tendonous attachments loosen their grip and offer a little slack.
Ideally, repeating this work along the sternum would create even more slack, but this is where things get complicated. My stance is this: Always ask permission before working with the sternum. Some people might think you’re silly, but others might think it’s the kindest thing you do. And some people might say no. If you get the green light, though, remember that this is not only the attachment site for the pec major, it’s also an anchor for breast tissue, and it’s more importantly where people hold their hand when their heart hurts. There’s a lot going on here.
Always ask permission before working with the sternum. Some people might think you’re silly, but others might think it’s the kindest thing you do.
Working in this region, along the clavicle, the sternum, and into the thick costal cartilages, is about the closest you can get to working directly with breath. As you compress into these attachments, you can create work that is short, soft, slow, intense, or gentle—or any combination in between, but you want to include breath. Inviting your client to breathe into these landmarks, either as you compress in or as you let go, brings a dimension to their breathing pattern they probably hadn’t noticed before. As you are aware, most people breathe up into their shoulders. Shining a light on the relationship between the client’s breath and the pec major can be eye-opening.
Shoulder the Load
If you’ve been successful with these first couple of steps, it’s time to switch your directive to where all these fibers converge at the shoulder. Their devious twist before they grab onto the upper anterior humerus is an excellent map indicating what each of these fibers do: the upper fibers crossing over to the lower aspect and the lower fibers reaching toward the upper part. But this also makes for a convenient bundle at which to address all three fiber groups at once. Plus, the arm moves! So, working into the lateral pec major at the shoulder while moving the arm around is an expert move.
With one hand, lift the client’s arm off the table slightly and pull it away from their torso. Using your other hand, either with a flat palm or a soft fist or even specific finger pads, work through the anterior deltoid and into the pec major. Sliding medially as you bring the arm in various positions, you will be able to feel the upper, middle, and lower fibers shortening and lengthening under your pressure—as will your client. They may even indicate that you found a point of tension. Amazing!
Play around with flexion, extension, internal rotation, and external rotation as you pin and stretch and ultimately release a substantial portion of this seemingly difficult muscle.
A Deeper Dive—Bonus Tip
I cannot write an article about working on the pec major without offering guidance for your clients with breasts. For this work, and especially approaching the pecs from the arm, offer your client permission to hold onto their drape and secure their own breast tissue as you work. This gives them a sense of safety, and it gives you the ability to work without managing a drape at the same time. Engaging your client and giving them a sense of safety is always a win.
Granted, you may not be able to work through every part of the pec major, but use your knowledge of where this muscle is and how it works to your advantage. You might choose to end the session by allowing your client’s arm to fall to the floor—palm up and at a 90-degree angle from their torso—and ask them to breathe through their clavicle, down into their sternum, send it out through their shoulder, and down to their fingertips. Sometimes, acknowledging the edges of a muscle and the breath underneath is the exact cue a client needs to access their pec major.
