When evaluating the upper cross strain patterns or nerve dysfunction traveling don the arm, be sure to take a look at pec minor. This is one of the most important muscles to treat when your client comes in with the upper cross strain patterns. Pectoralis minor is a major player when it comes to bad posture, subacromial impingement and neurogenic thoracic outlet. Some believe that pectoral overactivity results from prolonged (flexion-addicted) sitting or working with arms out in front of the body. The pec minor depresses and tilts the scapula anteriorly. the protracted shoulder girdle causes increased activation of the levator scapula and upper trapezius in an effort to maintain glenohumeral stability. The typical end result is neck and t-spine stiffness Most times this muscle is constantly in a state of isometric contraction but this contraction may also be due to protective guarding and reflex spasm due to tension, nerve compression, or lead to thoracic outlet syndrome. When the client has tingling or numbness going down the arm chances are this muscle the way it connects to the coracoid process and the 3rd-5th ribs can catch the nerves running down from the neck to the arm. With the upper cross strain patterns and poor posture, you will see a decrease in space sometimes between the clavicle and first couple ribs in turn the tight pec minor and joint dysfunction in the neck can be a contributor to nerve pain traveling down the arm. Because of the lack of space with the tight pec minor. Sometimes you will see an elevated first rib which can be a contributing factor as well.
To help clients with these strain patterns look at the Traps, Pecs, and Lats. Couple this with posture and stability exercises to help train your client towards pain free movement in their daily activities. The goal is to understand what is causing this dysfunction, and not to focus on where the pain is. Assess and work towards a common goal you and the client can achieve.