Why Pec Minor can be a major pain

The pectoralis minor muscle isn't one that is often discussed, probably because it is overshadowed by it's larger and more superficial (closer to the surface) friend, pectoralis major.  Pec major is that big muscle on the surface of the chest that is responsible for bench press type movements. Pec minor is the smaller muscle underneath that arises from the 3rd, 4th and 5th ribs and attaches to the coracoid process of the scapula and contraction of this muscle causes the scapula tilt anteriorly (forward and down).

If this muscle is too tight, it can potentially cause the following:

• rotator cuff impingement
• forward head posture leading to neck pain and dysfunction
• increase in trigger points through the upper traps and levator scapulae which may lead to headaches
• referred pain into the shoulder and arm
• thoracic outlet syndrome



A. Normal
B/C. Tight pec minor

Try rounding your shoulders forwards and downwards to contract the pec major (like in diagram C above) and then attempt to lift your arms overhead. Notice how your ROM is majorly limited? That is, in effect, what happens when pectoralis minor is too tight. Combine that with tight pectoralis major and you pretty much have no chance at achieving full ROM of the shoulders. However, our bodies are pretty clever and will try find a way around this, forcing the shoulder to get into those positions. Do this thousands of times and it is a recipe for shoulder impingement, bursitis, rotator cuff tears - you get the picture.

The trouble with pec minor is that it is a difficult muscle to stretch and trigger point due to its location. That is where your Physio or Massage therapist comes in handy! You can try doing some trigger point releasing to your pec major but if the problem is really lying underneath, no amount of lacrosse ball smashing is going to help. You need another set of hands (literally) to get in there and release it.

Pec minor trigger point referral pattern

 

Set your scapulas free

Full shoulder range of movement not only requires good mobility at the glenohumeral (ball and socket) joint of the shoulder, but also at the scapulothoracic joint and the thoracic cage.

We need good shoulder mobility for so many different movements in Crossfit - Olympic lifts, push press/jerk, pull ups, muscle ups, thrusters, etc. If you are lacking in your shoulder ROM, chances are good that at some point, you will end up with an injury.

What is your shoulder flexion ROM? Can you lift your arm straight up in front of you and bring your arm past your ear? Make sure your arm stays straight and close to your body the whole time.

Normal shoulder flexion = 180 degrees

 

 

If you cannot achieve this, we need to figure out why. The WHY is what your physiotherapist is good for, as many of the tests we perform to work it all out cannot be performed easily on yourself. There could be many reasons why your shoulder range is lacking: stiffness of the glenohumeral joint, stiffness of the scapulothoracic joint, stiffness of the thoracic spine, weakness of the glenohumeral muscles and/or weakness of the scapular muscles.

 

One of the reasons you may be lacking full shoulder flexion may be due to a tight/overactive levator scapulae muscle. As the name suggests, the levator scapulae muscle elevates the scapula. It attaches to the border of the shoulder blade and the transverse processes of vertebrae C1 to C4. Try doing some trigger point to this muscle by lying on your back and placing a lacrosse ball at the corner of your shoulder blade, near the spine (this is called SHOULDER SLACKING in the MobilizeMe app). Then take your arm and bring it up over your head, keeping the elbow straight. Keep the arm moving for 2 minutes, then re-assess your shoulder flexion ROM.  If it has improved, you can attribute at least some of your problem to tightness in the levator scapulae.

 

 

 

If you got no joy from this, then it's probably a wise move to get a professional to check it out. Don't use Dr.Google. Good luck!

 

 

Don't forget to check out the MobilizeMe app! Available for iPhone and Android!

https://itunes.apple.com/ca/app/mobilizeme/id576108153?mt=8

 

https://play.google.com/store/apps/details?id=com.hongji&feature=nav_result#?t=W251bGwsMSwxLDMsImNvbS5ob25namkiXQ

 



 

 



 

 

 



Walk before you run

In the past couple of weeks, we have been travelling around BC/Alberta on a little holiday, visiting Crossfit boxes to say hi, let them know about MobilizeMe  and even do a couple mobility seminars! I tend to pay attention to the stuff I see posted on people's whiteboards as I go. Lots of places just post the daily WOD's, others post clients PR's and goals. One of these stood out to me, as it read on the Goals board: "Kipping pullups". Then directly underneath it had "do overhead movements without pain".

Anyone see an issue with this?

If you cannot do an overhead movement without pain, then kipping pullups should not even be a blip on your radar.

I see this so often it's not even funny anymore. On one hand I love how people are so passionate and eager to get better at Crossfit, on the other hand I cringe. Crossfit has transformed the lives of countless people out there, many of whom have never been active a day in their lives but has it turned us into fanatics who don't know or understand our limitations?

99.9% of people who Crossfit are NEVER going to make the Games. And I don't say this to be cruel or unkind. I love that so many people have aspirations of making it to the top but for the average Crossfitter, it just isn't going to happen. So why the need to do movements or skills that are beyond our limits? I'm not saying that you won't ever be able to do these skills, it's a matter of time and many hours of practise, but maybe just have a look at the reasons you want to develop them.

We are all so keen to be able to do all the movements we see performed by the elite athletes at the Games level that I think we forget we need to develop the strength, stability technique and mobility required for these skills.

If you are limited by pain, go and get it checked out. Don't bury your head in the sand and pray it will go away. Pain is there for a reason, people, and generally doesn't develop overnight (unless you have suffered from an acute injury). Hundreds or thousands of repetitions done with even slightly faulty mechanics will wind up your tissues which eventually cause...PAIN.

If you are limited by strength, work on developing it. Keep in mind it takes roughly 8 WEEKS to notice muscle hypertrophy (growth) at a cellular level. Concentrating on doing your skills STRICT eg. pullups, ring dips, push ups, etc. with absolutely PERFECT form will help.

If you are limited by mobility, work on your mobility! Remember that flexibility is one of the fundamentals of Crossfit. It's not nearly as fun as PR'ing your Clean & Jerk but every bit as important. And go out and BUY YOUR OWN mobility equipment. Don't rely on your coach/box to supply it. You should have at least a roller and a lacrosse ball in your gym bag. You don't use someone else's knee sleeves do you???

Keep in mind that if you are constantly mobilizing and not getting noticeable improvements, you may have issues with your STABILITY. For example, if your shoulders are chronically tight, your rotator cuff muscles and/or scapular stabilizing muscles may be weak. I would advise getting an assessment by your Physio/Physical Therapist or other qualified professional. Make sure that you get an exercise program based on the assessment and stick to it! One coach I talked to while overseas mentioned that they now regularly include rotator cuff/Bulletproof shoulder exercises in their warm up and/or cool down.

Most of those athletes you see competing at the Games have been doing Crossfit for a few years and/or have a highly competitive athletic background. Their rise to the top hasn't been instantaneous. Walk before you run peeps. You'll still get there in the end.

Make sure you head to the App Store or Google Play and check out our Mobility App for Crossfit!

https://itunes.apple.com/ca/app/mobilizeme/id576108153?mt=8

https://play.google.com/store/apps/details?id=com.hongji&feature=nav_result#?t=W251bGwsMSwxLDMsImNvbS5ob25namkiXQ

Why does it feel like I'm walking on shards of glass?

Earlier this week on the MobilizeMe Facebook page I shared an article regarding plantar fasciitis and just wanted to share a few tips/mobility ideas to help prevent and treat this painful foot problem.

Plantar fasciitis is actually an overuse condition of the plantar fascia. The plantar fascia is a thick band of tissue that provides support for the longitudinal arch of the foot and assists with shock absorption (like when running, doing double unders or box jumps).


Causes of plantar fasciitis are numerous and can include:

• low arches in the foot (pes planus)
• high arches in the foot (pes cavus)
• over-pronation (flat foot)
• excessive plantarflexion of the foot with dorsiflexion of the toes (eg. running, box jumps)
• unsupportive footwear
• being overweight
• tightness of the calves, hamstrings and glutes

The introduction of flat-soled footwear (eg. Nano's, innov-8, etc) into mainstream wear can be partly to blame, especially if there no period of adaptation. Most people are used to wearing shoes that have moderate arch support. Going from these type of shoes to a minimalist-sole type of shoe can lead to conditions like plantar fasciitis. If you pronate/have flat feet and want to wear these types of shoes, I would advise that you wear them 1-2x/week initially, and build up slowly over time to give your feet and lower limbs a chance to build the muscular strength and stability required.

If your feet are already suffering and you feel like you're walking on glass, I would recommend getting back into a pair of supportive shoes and avoid walking barefoot or in thongs.

Treatment can include the following:

• avoiding activities that aggravate the pain
• ice post activity (a frozen water bottle is great for this - roll out bottom of foot with the frozen bottle)
• stretching/trigger point release/foam rolling of the plantar fascia, calves, hamstrings and glutes
• self massage with a golf or lacrosse ball (we have some awesome blue ones on our Facebook shop!!)
• strapping of the foot
• Kinesio-tape
• acupuncture/dry needling
• Scenar therapy
• massage
• night splints
• biomechanical correction (orthotics)
• strengthening exercises for the intrinsic muscles of the foot (see links below)

https://www.youtube.com/watch?feature=player_detailpage&v=GY-mJjXmeIc








If you are in need of a lacrosse ball, head to our Facebook shop and get yours!
https://www.facebook.com/mobilityforcrossfitters/app_251458316228
 

Shoulder extension - the missing link?

Over the weekend I was at a Crossfit competition where there was 2 big pull up workouts (team event). While watching one of the events I had a conversation with someone who said they couldn't do butterfly pull ups because their shoulder didn't like the movement. Further into the conversation I found out that they had suffered a bicep tendon rupture performing a front lever and in a previous life had spent a lot of time doing bicep curls. I asked them to show me their shoulder extension ROM and they had about 20 degrees...normal shoulder extension should be 40-60 degrees.  They were missing at least HALF to 2/3 of normal ROM. Any wonder why butterfly pull ups were not their friend?

 

 What muscles are involved with limited shoulder extension?

• Long head of biceps brachii
• Coracobrachialis
• Pectoralis major
• anterior fibers of deltoid

What movements will be affected if lacking shoulder extension?

• Pull ups (particularly chest to bar and butterfly)
• Muscle ups
• Ring dips
• Push ups
• Burpees
• Bench press/floor press

Biceps trigger point referral pattern

The long head of biceps in particular is prone to overuse and trigger points can cause referred pain into the shoulder itself. This is due to the fact that its tendon inserts into the labrum of the shoulder joint. The biceps is responsible for flexing the elbow and shoulder and also supination of the forearm (turning the palm upwards).

Some people complain of a snapping or clicking sensation with long head of biceps problems. Often, rotator cuff injuries and issues with the long head of biceps go hand in hand.


Try rolling out/trigger pointing the biceps, front of the shoulder and pecs and stretching prior to workouts that involve pull ups, muscle ups, ring dips, push ups or burpees and see if it makes a difference. I saw a lot of people over the weekend making good use of the barbell to smash out their biceps!

If improving the mobility of these muscles isn't helping, you may have a problem with scapular stability and/or shoulder joint positioning (like a forward head of humerus) and you should make an appointment with your Physio for an assessment!

No more excuses

There is so much information out there these days with regards to training, mobility, stretching, recovery, nutrition, etc. We have everything we need at the  palm of our hand, at the touch of a screen and yet it is still hard to get the things done that we really need to work on.

When is the last time you heard someone say "Well, I just PR'd my snatch so I'm done! Don't need to keep working on that!" Probably never. But when it comes to doing rehabilitation exercises or mobility, it gets easily left off the list of things to do. Why is this the case? I think I have maybe heard all the excuses in the world: it takes too long, it hurts too much, I have no time, I forgot, I didn't know what/how to do it, I couldn't remember how, I had to cook dinner/watch the kids/mow the lawn. The list of excuses goes on and on.

If you want to get better at something, you need to practise it. I don't know of anyone that could pick up the barbell and snatch perfectly the first time. It takes time, practise, sweat, tears. Mobility is no different. If you want to get better at it, you need to practise at it. And once you get better at it, you don't just stop.

If you have time to Facebook, Twitter, Instagram or watch TV, you have the time to do mobility. Stop making excuses and just do it. If not, stop complaining about your increasing number of injuries and how you can't overhead squat.

Get your roller, lacrosse ball or other favorite instrument of torture and put it in front of the TV. Whenever an ad comes on, roll out something that hurts. Take your lacrosse ball to work and mobilize your hammies. Get to the box 10-15 minutes early or stay after class. Stop making excuses and start putting the work in.

Tight abs = lower back pain?

The rectus abdominus = the 6-pack that we all want, strive for and drool over. But tightness/overuse of this show pony muscle can be driving lower back pain.

The rectus abdominus is a broad, flat muscle that runs vertical on the wall of the front of the abdomen. It extends from the pubic symphysis, pubic crest and pubic tubercle to the xyphoid process and costal cartilages of the 5th to 7th ribs. This muscle is important posturally; it's actions include flexing the lumbar spine (like when doing a sit-up), posteriorly tilting the pelvis and assisting in hip flexion. It also assists with breathing, as in forceful expiration (breathing out), keeping the internal organs intact and creating internal abdominal pressure.

Trigger points or tight spots in the lower rectus abdominus have been found to refer pain into the lower back - like a thick band of pain around the lower back and into the top of the glutes. Trigger points higher up near the ribs have been found to refer pain higher up in the back, closer towards the bottom of the scapula.



A. Trigger points in rectus abdominus and their referral pattern in the mid/lower back.

It is important to note that if you have tightness in your rectus abdominus, your iliopsoas (long hip flexor) is most likely going to be tight also.



Trigger points in iliopsoas and referral pattern in lower back and front of hip/thigh.

 

If you are suffering from lower back pain, try releasing both your rectus abdominus and iliopsoas. Lie on with a lacrosse ball, baseball or softball under your abdomen, off to the side, about a fist length away from the belly button. Contract/relax your abs as you lie on the ball and make sure to move it up/down the length of your abs.

 

Another method is to get a heavy kettlebell and place the handle lengthways or crossways under your tummy. Then get on all fours and jam the handle of the kettlebell into your stomach, trying to find any tender/tight spots. Contract/relax your abs as you need to.

 

This is a highly unpleasant and somewhat interesting position to be in; I was told that it's referred to as the "Kettlebell Hump" because that's what it looks like when you're doing it....but it is very effective. (Thanks Antony Lo - The PhysioDetective for this one!!!)

 

Maybe try it in private first....and good luck.