Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

Filtering by Tag: pectorals

Detangling the Pecs: Part 3

Image from  Erik Dalton

Image from Erik Dalton

This week, we've looked a little at what the pectoral muscles do, specifically the pec minor, and how restriction with the front of the chest muscles can bring the shoulders protracted and internally rotated.  Now, how can we start to create change within those muscle groups to better balance out the shoulder joint?

1) Address the restriction on the front via awareness: is it a result of your instrument? Your sitting habits? Your driving habits? Do you notice your shoulders slumping forwards in daily activities?

2) Correction with outside feedback: It can be tempting to just think "I need to bring my shoulders back and down," but that's not helpful either.  The shoulder joint is highly mobile, and even though restriction in the front may be an issue, there may be other culprits that could use attention, whether it's in the neck, the spine, or the shoulders themselves. In addition, a shoulder blade moving forward, or protracting, may also be internally rotating. (see video below)  I'd recommend seeing some sort of movement professional (PT, massage therapist, pilates teacher, trainer, body mapper, Alexander Technique teacher, etc.) and ask for some feedback.  (As always, if you're in a place of acute pain, see a doctor for a full assessment!) Although I primarily teach pilates and Yoga Tune Up®, there are many well educated movement professionals in different fields that can help you identify your issues.  One thing I find helpful is to take pictures on a phone of your shoulders/collarbones, and just use those as a reference as you start to make changes.

The infraspinatus and trees minor are key muscles to look at strengthening.

The infraspinatus and trees minor are key muscles to look at strengthening.

3) Mobilize and Work to strengthen your external rotators of your shoulder: So for every muscle group that contracts, there is an opposing muscle group that's relaxing.  The muscles on the back of the shoulder blade are primary external rotators of the shoulder, and can help bring the arm bone back and done, but without forcing it in an inorganic way.  How does one strengthen these muscles? Most movement disciplines have some form of strengthening built in of these muscle groups, but here are some of my favorites:

This may seem really easy, but if the spine and ribs are stable, and the arm bone not moving forwards or backwards, it can be a real challenge.

This may seem really easy, but if the spine and ribs are stable, and the arm bone not moving forwards or backwards, it can be a real challenge.

1) This classic strengthening exercise involves either a theraband or a set of small hand weights (like the dinky vinyl coated ones).  One can do it standing or side lying, but essentially, the goal is to keep the upper arm bones, or humerii, stable as you pulse the hands away from the body.  This video shows how to do the same exercise in standing, with a theraband.  One can also do it in standing without any resistance.

2) Reassess your plank poses, downward dogs, or even quadruped/ hands knee poses.  Many times I see students in internal rotation from the onset of class, and learning how to externally rotate the arms in weight bearing positions in critical, especially if you practice weight bearing positions.  One of my favorite Jill Miller videos is about the challenges of downward dog for the shoulder.  If you're a yoga student, this video is a must!  Here are a few other blogs about the challenges of Downward Facing Dog.

3) Look at where you may be missing range of motion in your shoulders: I love shoulder flossing, either with a theraband, Fletcher Pilates towel, yoga strap, or other device.  This great video by Christine Jablonski shows one of my favorite Yoga Tune Up® exercises.  Although this isn't a particular strengthening exercise, it can help bring awareness to where you need mobility in the shoulder.

4) Bring some length to the front of the chest via floor angels.  This is one of my favorite exercises, and it can be down with the upper half of the body on a foam roller or bolster or block.  The number one objective is to keep the ribs down (which the woman on the right is NOT doing) to really assess where your actual range of motion is. Once the spine starts moving, you've lost the intention of the exercise.  This is a classical Katy Bowman exercise, but this video  also describes it well.

Although there are many ways to strengthen the shoulder and start to bring change into the shoulder joint, here are a just a few ways to get started~

Detangling the Pec Minor: Part 2

Here's a picture from a concert I did with Edgar Meyer  last summer .  Although he's slightly rotated to the left, notice where his shoulders are and the slight internal rotation on the right side.

Here's a picture from a concert I did with Edgar Meyer last summer.  Although he's slightly rotated to the left, notice where his shoulders are and the slight internal rotation on the right side.

Yesterday, we looked at what the pectoralis minor is and what it might do to the shoulder when it's not working at its optimal length.  Let's take a look at how the shoulders function with different instruments and their holding positions.  With the cello and the bass, the left shoulder is mostly externally rotated, with the bow arm slightly internally rotated, similar to the upper string shoulder situation. In some ways, because the bass and cello are larger instruments requiring different muscle groups, the amount of internal rotation on the right side should be theoretically less, and because the bow arm is not as actively resisting gravity at the tip as with upper strings.  (Upper string players need to pronate their bow arm more to reach the upper half, and some short armed folks sometimes also internally rotate the shoulder to be there!)

James Galway,  courtesy of ClassicFm . Even with the best of postural intentions, it's easy round the upper body, bring the shoulders forward, and internally rotate the arm bones.

James Galway, courtesy of ClassicFm. Even with the best of postural intentions, it's easy round the upper body, bring the shoulders forward, and internally rotate the arm bones.

Moving into the woodwind family, the flute is one of the most asymmetrical instruments. Although the optimal position for playing flute has been discussed by many people, it's certainly a challenging instrument for shoulder, neck, and spine position.  Even with the most embodied, aware flutist, the position is certainly a tricky one, and can easily lead to some challenges in the pectorals.  Let's take a look at why.  

This woman's arms are already internally rotated, meaning that as she lowers and lifts her body, her arm bone is just going to move further and further forward, and her pecs will just contract further, but not helping to actually balance her shoulder.  Ah, stock fitness photos.

This woman's arms are already internally rotated, meaning that as she lowers and lifts her body, her arm bone is just going to move further and further forward, and her pecs will just contract further, but not helping to actually balance her shoulder. Ah, stock fitness photos.

The pectoralis major has many functions- adduction (flapping arms to the sides), internal rotation, shoulder flexion (arms overhead), extension (arms reaching back), and horizontal adduction, i.e. holding an object in front of your body.  When one is told to strengthen their chest muscles, they usually do two things: push ups and chest presses, meaning that lifting an object in front of you at chest height will require some strength.  So go grab something to hold in front of you- I'll wait.  (If I wasn't wearing pajamas in my living room, I'd take a picture of myself doing it.)  Try a heavy book or small weight, and just palpate the front muscles below the collarbone.  They have to work to hold the object, correct?  Most instruments require holding an object in front of you (voice, piano, and a few other exceptions), but often at an awkward, asymmetrical position for the shoulders.  Take a moment to think though- how many hours have you played your instrument in your life?  Even if your instrument only weighs a few pounds, your pectorals are constantly working to support you, even if in a small way.  Many of us also slightly internally rotate our shoulders when we play, which can create more havoc in these muscles. This is certainly true for instruments like clarinet, oboe, trumpet, and trombone, which are instruments held directly in front of the body.  Even if your instrument doesn't create this shape in the upper body, a lifetime of driving, texting, and head forward position may also shorten the pectorals.  What's the solution to all of this?  It's creating strength in the external rotators of the shoulder (the muscles on the back of the shoulder blade), creating awareness about posture and movement habits, avoiding movements that will just exacerbate the shoulder, and creating length in the front pectoral muscles.  More on that next time~

Detangling the Pec Minor: Part 1

With this image from gray's anatomy, you can see the pectoral minor.

With this image from gray's anatomy, you can see the pectoral minor.

When musicians complain about shoulder pain, they often direct their attention (and discomfort) at the arm bone or the back of the shoulder, or scapula region.  But one of the sneaky culprits to shoulder and neck pain, as well as shoulder and arm bone misalignment, is the pectoralis minor.  It's the mischievous sibling to the larger and more well known pectoralis major, which attaches at the clavicle, sternum, and arm bone and lies atop pec minor.  Now the pec minor is of particular interest to musicians (and honestly most desk/computer workers) because when working well, it can help to stabilize the shoulder joint, but when it's short or inhibited, the shoulder and arm bone will slide forward, in protraction and/or internal rotation.  Let's demystify those last two anatomical words first, though.

If you take a look at this man's shoulders, you can see that the one on the left sits on the table. The scapula, or shoulder blade is rooted down, whereas the right shoulder blade is elevated off the table and the front collarbone is higher on the right that the left.  This would most likely be restriction of the pectorals on the right side, which not only pulls the arm bone and scapula forward (protraction), but also can internally rotate the right arm.  What does that internal rotation look like?  In laymen's terms, it means gorilla arms.  

Credit to RES and bodyworker Barbara Loomis for this awesome comparison.  You can see the difference in her arm bones, elbows, and collarbones.  Check out her great work at  Alignment Monkey!

Credit to RES and bodyworker Barbara Loomis for this awesome comparison.  You can see the difference in her arm bones, elbows, and collarbones.  Check out her great work at Alignment Monkey!

Image courtesy of Huffington Post.

Image courtesy of Huffington Post.

So now we have a working understanding of what this muscle group can do to the shoulder, at least in standing.  But how did we get to have restricted pectorals in the first place?  For string players, our right side bow arm tends to be internally rotated and will often slide forward.  If you take a look at this image of Anne-Sophie Mutter, you can see that her right arm is moving forward from her spine and ribs. If you couple that with a lot of forceful playing, extreme pronation in the bow arm (i.e. lots of first finger and thumb pressure), and/or lots of playing at the tip of the bow that can exacerbate things.  In addition, perpetual tremolos in orchestra, i.e. a Bruckner/Mahler symphony extravaganza, especially loud sustained tremolos will ask a lot of the shoulder and forearm.   

After a long week of works requiring tremolo, my colleagues will sometimes ask me why their arm is so tired and achy!  This image shows some bow arm soft tissues that may be affected by our repertoire.  Image courtesy of  Round Earth Publishing.

After a long week of works requiring tremolo, my colleagues will sometimes ask me why their arm is so tired and achy!  This image shows some bow arm soft tissues that may be affected by our repertoire.  Image courtesy of Round Earth Publishing.

So now we have a basic idea of how the pectorals might get short, abused, or overused in string players, but what about with other instrumentalists?  And how might it affect your performance and playing and how can you help restore its natural length and function? More on that next time.

Pecs and Shoulder Movement

by Kayleigh Miller

So in yesterday's post, I covered some of the basics of the pectoral tissue and subclavius.  Now let's look at how to access and stretch this areas.

This first Yoga Tune Up®  video is just a basic primer on strengthening your pecs and then stretching them.  Most people are familiar with the arms clasped stretch, but you probably didn't realize that you're also stretching your pectoral tissues and your biceps!  It's also working the arms into internal rotation, which can bring some relief to your external rotators.  

This video, once again from Jill Miller of Yoga Tune Up® takes a familiar stretch and refines the context.  

While the model in this video looks super sassy, and is wearing blinding hot pink, the content and explanation of pec major and pec minor is valuable.  My only suggestion would be to try this with even hips (her right hip hikes up) and also try rotating the body clockwise away from the wall. 

 

 

 

 

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