Trigger points (TrPs), or muscle “knots,” are a common cause of stubborn & strange aches & pains, and yet they are under-diagnosed. The 14 Perfect Spots (jump to list below) are trigger points that are common & yet fairly easy to self-treat with massage — the most satisfying & useful places to apply pressure to muscle. For tough cases, see the advanced trigger point therapy guide.
The “pecs” are popular: of 700+ muscles, the pectoralis major is one of just a dozen or so that most people can name and point to. It also harbours one of the most commonly-encountered and significant trigger points in the human body, and can produce pain much like a heart attack in both quality and intensity. And yet it’s little known.
Pectoralis major basics: the hugging muscle
The pectoralis major covers the top half of your chest. It is mostly an arm mover, although it also stabilizes the joint between your sternum and collar bone. It is the hugging muscle: it powerfully pulls and rotates the arms towards the center of your body.
Like all the big flexors, it’s crazy strong. The pectoralis major is so large that it can always do its job with at least some of its fibers, no matter what position the shoulder is in.
(The pectoralis minor, by the way, is quite a different muscle. As its name suggests, it is much smaller. It is completely covered by the pectoralis major, and does not move the arm at all!)
A manly muscle: the pectoralis gender gap
The pectoralis major is also, interestingly, one of the only muscles in the human body that is almost always much larger in men than it is in women, which accounts for much of the difference in upper body strength between the genders. Even the strongest women usually have relatively thin pectoralis major muscles — something I learned from massaging thousands of people during my massage therapy career.
Regardless, Perfect Spot No. 9 is a good massage location for both men and women.
Where is Perfect Spot No. 9?
Spot No. 9 is easy to find by touch: it’s on the edge of a distinctive pocket or hollow directly underneath your collarbone. The pocket is a small, unmuscled space between the deltoid and the pectoralis major. If you explore right below your collarbone, it is easy to find the soft spot between these two large muscles. Once you’ve found it, press towards the sternum against the edge of the hollow — that’s pectoralis major you’re pressing — and you’ve found Perfect Spot No. 9.
How to massage Spot 9
Thumb pressure is often adequate to stimulate this spot, but many people — especially men, with their larger pectorals — may need knuckles or even an elbow to get a clear “signal.”
Although No. 9 is a specific spot on the edge of the pectoralis major, it’s also quite effective to massage the entire space underneath the clavicle, using the big knuckles. You might need some oil or lotion for this, of course. Another trick is to trap a small ball between the chest and a wall.
Glide or roll towards the centre, catching Spot No. 9 along the way. Try stretching the muscle at the same time, or at least elongating it a bit.
How does Spot No. 9 in the pectoralis major feel?
This spot feels good because the pectoralis major is partly responsible for the common problem of a collapsed chest, the shoulders rolled forward and inward. Almost everyone feels tight in the chest because of this, particularly people who routinely work or play with computers (which is almost everyone, these days).
Pressure on Spot No. 9 tends to relieve that uncomfortable sense of constriction and stagnancy in the chest, creating a sense of having more space to breathe in, which is quite pleasant.
Bonus pectoralis major tip: strength training
A lot of men would like to have better developed and well-defined pectoralis major muscles for aesthetic reasons, because “huge pecs” are pretty much the definition of a masculine trait. Unfortunately, few men understand which exercises will achieve this effect!
The confusion arises from the fact that the bottom half of the pectoralis major performs some different functions than the top half. To build up the pectoralis major, you need to exercise the bottom half of the muscle. While all pectoralis major fibres adduct and internally rotate the shoulder, only the lower fibres extend the shoulder. Therefore, the best pectoralis major training exercises include some resistance to shoulder extension. Those exercises are:
- chin ups or front lat (latissimus dorsi) pull-downs with a wide grip1
- a standard bench press or a dumbbell press on a decline bench (that’s with the feet higher than the head)
- barbell pullover, in which you lie on your back, holding a barbell over your head, and then lift it over your face
- cable crossover, in which you pull weighted cables from high and outside towards the center of your body
Note that standard wide-position push ups are a good general pectoralis major exercise, but do not isolate any part of the pectoralis major.
About Paul Ingraham
I am a science writer in Vancouver, Canada. I was a Registered Massage Therapist for a decade and the assistant editor of ScienceBasedMedicine.org for several years. I’ve had many injuries as a runner and ultimate player, and I’ve been a chronic pain patient myself since 2015. Full bio. See you on Facebook or Twitter.
- Descriptions of the chest exercises mentioned in the last section, and many more.
Appendix A: Is trigger point therapy too good to be true?
Trigger point therapy isn’t too good to be true: it’s just ordinary good. It can probably relieve some pain cheaply and safely in many cases. Good bang for buck, and little risk. In the world of pain treatments, that’s a good mix.
But pain is difficult and complex, no treatment is perfect, and there is legitimate controversy about the science of trigger points. Their nature remains somewhat puzzling, and the classic image of a tightly “contracted patch” of muscle tissue may well be wrong. What we do know is that people hurt, and it can often be helped.
The Perfect Spots are based on a decade of my own clinical experience as a massage therapist, and years of extensive science journalism on the topic. Want to know more? This is the tip of the iceberg. I’ve written a whole book about it …
Not too good to be true.
Just ordinary good. Trigger point therapy isn’t a miracle cure, but it is a valuable life skill. Practically anyone can benefit at least a little & many will experience significant relief from stubborn aches & pains. The first few sections are free.
Appendix B: All the perfect spots
There’s also a more detailed index of the spots and other trigger point resources.
- Massage Therapy for Tension Headaches — Perfect Spot No. 1, in the suboccipital muscles of the neck, under the back of the skull.
- Massage Therapy for Low Back Pain — Perfect Spot No. 2, in the erector spinae and quadratus lumborum muscles in the thoracolumbar corner
- Massage Therapy for Shin Splints — Perfect Spot No. 3, in the tibialis anterior muscle of the shin
- Massage Therapy for Neck Pain, Chest Pain, Arm Pain, and Upper Back Pain — Perfect Spot No. 4, an area of common trigger points in the odd scalene muscle group in the neck
- Massage Therapy for Tennis Elbow and Wrist Pain — Perfect Spot No. 5, in the common extensor tendon of the forearm
- Massage Therapy for Back Pain, Hip Pain, and Sciatica — Perfect Spot No. 6, an area of common trigger points in the gluteus medius and minimus muscles of the hip
- Massage Therapy for Bruxism, Jaw Clenching, and TMJ Syndrome — Perfect Spot No. 7, the masseter muscle of the jaw
- Massage Therapy for Your Quads — Perfect Spot No. 8, another one for runners, the distal vastus lateralis of the quadriceps group
- Spot No. 9 is this page.
- Massage Therapy for Tired Feet (and Plantar Fasciitis!) — Perfect Spot No. 10, in the arch muscles of the foot
- Massage Therapy for Upper Back Pain — Perfect Area No. 11, the erector spinae muscle group of the upper back
- Massage Therapy for Low Back Pain (So Low That It’s Not In the Back) — Perfect Spot No. 12, a common (almost universal) trigger point in the superolateral origin of the gluteus maximus muscle
- Massage Therapy for Low Back Pain (Again) — Perfect Spot No. 13, The Most Classic Low Back Pain Trigger Point
- Massage Therapy for Shoulder Pain — Perfect Spot No. 14, The Most Predictable Unsuspected Cause of Shoulder Pain
- Signorile JF, Zink AJ, Szwed SP. A comparative electromyographical investigation of muscle utilization patterns using various hand positions during the lat pull-down. J Strength Cond Res. 2002;16:539–546. PubMed #12423182 ❐