Chest / Rib Pain

chest painTo state the obvious, any left sided chest pain should be taken seriously and checked out by a medical doctor before assuming that your pain is not related to your heart.

Here we will discuss two sources of chest and rib pain that can create very uncomfortable feelings that are easily treated once they are properly identified:

  • Pectoralis Major and Pectoralis Minor Muscle Syndromes
  • Active trigger points in the serratus anterior muscle


The Pectoral Musclespecs

The pectoralis major is a large muscle in the front of the chest that attaches to your sternum and clavicle, inserting into your arm. Its actions are to adduct (bring towards the body) the arm, medially rotate the arm and to aid in flexion of the arm at the shoulder joint.

The pectoralis minor is a smaller muscle beneath the pectoralis major.  It protracts and depresses the scapula (as when you pull your shoulder forward) and elevates the ribs when the scapula is fixed.

Both the pectoralis major and minor aid in respiration and can harbor active trigger points that cause chest pain.

We call this condition False Cardialgia because when it occurs on the left side of the body, it often sends people to the doctor in fear of a heart condition.  Active trigger points in the pectoralis major and minor muscle can cause:

  • Pain in the chest
  • Pain on the front of the shoulder
  • Pain down the arm below the elbow
  • Hypersensitivity of the breast tissue


The pectoralis minopec minor brachialr muscle may create additional symptoms if it is tight and irritates or compresses the brachial plexus of nerves that innervates the arm.  Symptoms can range from intermittent tingling in the hand or fingers to numbness in the hand or pain anywhere in the shoulder or arm.

These symptoms are often misdiagnosed as other things, and simple compression tests done by your therapist can confirm or rule out the presence of nerve irritation from the pectoralis minor muscle.

The pectoralis major and minor muscles are typically tight when you see someone who has “rolled or rounded” shoulders.   They are important to stretch on a regular basis for most of us in order to avoid problems.



The Side Stitch Muscle    serratus-anterior-yoga-anatomy

The serratus anterior is a muscle that originates on the first 8 ribs and inserts onto the medial border of the scapula.  It acts to stabilize the scapula on the chest wall, as well as to provide protraction and upward rotation of the scapula.

An active trigger point in this muscle can cause:

  • Pain on the side of the body beneath the axilla
  • Pain down the arm to the 4th and 5th fingers
  • Pain below the shoulder blade

serratus-anterior-trp-combined  Additional symptoms include:

  • Pain in the chest when breathing
  • Rib pain
  • Inability to take a deep breath
  • Pain when laying on the affected side
  • Sharp pain in the side, like a side stitch during running
  • Pain reaching behind the body
  • Pain when pulling the shoulder back

How Massage Can Help

Identifying active trigger point in all of these muscles and eliminating them brings immediate relief to the area.  Prior to trigger point therapy, the affected and surrounding muscles are relaxed and the connective tissue surrounding the muscles is treated if needed.  After treatment, your therapist will stretch each affected muscle in order to help restore proper length.  1-2 sessions are typically necessary.