He winced when I first started trying to dig in to the area.

Palpating along the ribs, I found it.

Getting him to activate the muscle I felt it pop up under my fingers.

Okay, this is going to be a bit uncomfortable.

Treating Pec Minor is always a bit of a daunting task, especially when the patient is hesitant to have it done.

And with good reason, its usually pretty uncomfortable and can be painful.

However, as a therapist that preaches modern manual therapy, there is a less painful way.

Pain Free Massage Therapy Techniques

Yes… absolutely like most manual therapists, I have caused a fair share of pain and discomfort at my hands in the name of tissue deformation.

I have not believed in that for about 3 years now.

Here is my updated Pec Minor Release.

Patient: Supine

Massage Therapist: standing on the involved shoulder side

Test-retest: posteriorly tip the scapula to assess for loss of shoulder internal rotation, make sure you push the scapula into a set position as the involved side is often anteriorly tipped.

Technique:

• lightly place your fist or a ball into the pec major under the coracoid
  • no you don’t need to go underneath it or anything ridiculously painful
• have the patient move actively into elevation until extra tension or discomfort is felt, then have them resist into elevation to activate the scapular stabilizers
• this will reciprocally inhibit the pec minor and they (or you) should be able to elevate the shoulder into the next barrier
• continue until the shoulder is at full elevation if possible
• re-test shoulder internal rotation, if they are a rapid responder, this should change after 4-5 reps

If done correctly, this should not hurt at all, unlike most other passive or movement based “releases”

Give the repeated shoulder extension reset for home care exercises

With modern manual therapy, we don’t need to cause pain and discomfort to get positive results. Make sure when you’re treating pec minor that you test and retest before and after the treatment to see the difference you have made in the patients internal rotation, not just for yourself but also to prove to them the difference the treatment has made. After 4-5 reps in the treatment you should be able to tell the difference you’ve made, the difference is that you’ll do it pain free.

Erson Religioso

Dr. Erson Religioso III, DPT, MS, MTC, CertMDT, CFC, CSCS, FMS, FMT, FAAOMPT, graduated from D’Youville College in 1998 with a dual Bachelor’s of Science and Master’s of Science in Physical Therapy. His interests in Orthopaedics and Manual Therapy lead him to pursue a Doctor of Physical Therapy degree from the University of St. Augustine. Studying under Stanley Paris, Ph.D, PT, internationally known for his manual skills and knowledge of the spine as well as his distinguished faculty, Dr. Religioso earned his DPT and Manual Therapy Certification in 2000. He later became credentialed in Mechanical Diagnosis and Treatment of the Spine in 2000. Erson also operates several websites dedicated to Manual Therapy, www.themanualtherapist.com, www.modernmanualtherapy.com as well as www.edgemobilitysystem.com

 

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Erson Religioso

Doctor Of Physical Therapy at The Manual Therapist

Dr. Erson Religioso III, DPT, MS, MTC, CertMDT, CFC, CSCS, FMS, FMT, FAAOMPT, graduated from D'Youville College in 1998 with a dual Bachelor's of Science and Master's of Science in Physical Therapy. His interests in Orthopaedics and Manual Therapy lead him to pursue a Doctor of Physical Therapy degree from the University of St. Augustine. Studying under Stanley Paris, Ph.D, PT, internationally known for his manual skills and knowledge of the spine as well as his distinguished faculty, Dr. Religioso earned his DPT and Manual Therapy Certification in 2000. He later became credentialed in Mechanical Diagnosis and Treatment of the Spine in 2000. Erson also operates several websites dedicated to Manual Therapy, www.themanualtherapist.com, www.modernmanualtherapy.com as well as www.edgemobilitysystem.com

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