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Chest Pain

The primary muscle that causes chest pain is the large muscle located on each side of the sternum called the Pectoralis Major. Knots in this muscle cause local pain in the chest as well as refer pain down the arm. Knots in this muscle cause local pain in the chest as well as refer pain down the arm. Muscle knots in this muscle can mimic a heart attack. Other small muscles with muscle knots cause pain on the side of the chest and along the sternum bone.

Chest Muscle Pain
Photo by Manuel Lopez

Causes

Rounded shoulders: Rounded shoulders can cause the chest muscles to tighten and shorten, which may lead to discomfort or even chest pain over time. This posture also strains the upper back and neck muscles, often resulting in painful muscle knots. Improving posture and strengthening the back can help relieve these symptoms and restore balance to the body.
 
Poor posture: Poor posture, like slouching or hunching forward, can compress the chest and limit proper breathing, which may lead to chest discomfort. It also puts extra strain on the upper back and neck muscles, often causing painful knots and tension. Over time, these imbalances can make everyday movements feel stiff or uncomfortable, but small posture corrections can make a big difference.
 
Improper ergonomics: Improper ergonomics—like a poorly positioned desk or monitor—can cause you to hunch forward, tightening chest muscles and leading to discomfort. This posture also strains your upper back and shoulders, often resulting in painful muscle knots. Making small ergonomic adjustments can go a long way in easing tension and improving overall comfort throughout the day.
 
Head forward posture: Head-forward posture can cause the chest muscles to become tight and overworked, which may lead to chest pain or discomfort. At the same time, it places extra strain on the neck, shoulders, and upper back, often resulting in painful muscle knots. Gently correcting this posture can help relieve tension and restore better alignment and comfort.
 
Prolonged sitting with slouched shoulders: Prolonged sitting with slouched shoulders can cause the chest muscles to tighten and shorten, which may lead to chest pain or discomfort. This posture also strains the upper back and shoulder muscles, often resulting in painful knots and tension. Taking breaks to stretch and adjusting your sitting posture can help ease these symptoms and support better alignment.
 
Standing with slouched shoulders: Standing with slouched shoulders can cause the chest muscles to tighten and compress, which may lead to chest pain or discomfort. This posture also puts extra strain on the upper back and neck, often resulting in muscle knots and tension. Making minor adjustments to how you stand—like gently pulling your shoulders back and aligning your head—can help ease these issues and improve your posture over time.
 
Heavy lifting with arms stretched out front: Lifting heavy objects with your arms stretched out in front of you can strain your chest muscles, leading to tightness and even pain over time. This position also forces your upper back and shoulders to work harder, which can create muscle knots and tension. Using proper lifting techniques—like keeping the load close to your body and engaging your core—can help prevent these issues and protect your posture.
 
Immobilization: When the body remains immobilized for extended periods, such as during recovery or prolonged bed rest, muscles can become stiff and weak, particularly in the chest and upper back. This lack of movement often leads to poor posture, which can cause chest discomfort and painful muscle knots. Gentle stretching and gradual movement, when appropriate, can help restore flexibility and reduce tension.
Chest Pain 21-1 Pectoralis Major Lateral Margin
21-1 Pectoralis Major Lateral Margin

I Feel

Chest Pain

When chest pain appears along the outer edge of your chest muscle—the pectoralis major—it can feel like someone is pressing a fist into your chest wall, similar to when a seatbelt pinches too tightly across your chest. The discomfort usually focuses near the front of the shoulder and radiates inward, often described as a dull ache or a sharp pinch. It can mimic more serious conditions like angina or costochondritis, which makes it difficult to identify. The pain worsens significantly when you’re doing activities such as pushing open a heavy door, reaching across your body to grab a seatbelt, or lifting something overhead with both arms. This tension causes your chest to feel guarded and tight, limiting your ability to stretch or open your arms comfortably. The area becomes especially tender to touch, with soreness often felt just beneath the outer collarbone or near the front of the armpit. Pressing on that spot can almost instantly reproduce the pain

Heart Burn

That burning sensation in your chest that feels like heartburn might originate from muscle knots in the outer part of your chest muscle—the pectoralis major. It’s like the feeling of heat rising in your chest after eating spicy food, but in this case, your muscle is sending mixed signals. The burning or pressure often settles behind the breastbone or slightly to the side, and it can resemble acid reflux or even esophageal spasms. It worsens significantly when you’re slouching at your desk, carrying a backpack with chest straps, or sleeping curled up on your side. This tension makes your chest feel tight and uncomfortable, especially when trying to take a deep breath or stretch your arms wide. The muscle is often tender to the touch, especially along the outer chest wall near the armpit or just under the collarbone. That spot may feel like a small, hot knot when pressed.

Breast Tenderness

If you’re feeling breast tenderness, it might be caused by tight spots in the outer edge of your chest muscle—the pectoralis major. It’s similar to when a bruise forms under the skin and feels sore even if you don’t remember bumping it. The tenderness usually concentrates around the outer breast area and can feel like a deep ache or surface-level sensitivity. It can resemble symptoms of fibrocystic breast changes or even early signs of mastitis, which can be unsettling. The pain worsens when you’re doing activities like lifting a child, pushing a shopping cart with one arm, or sleeping with your arm tucked under your chest. This tension makes the area sore and guarded, and you might avoid touching or pressing on that side. The most sensitive spot is often just outside the breast tissue, near the front of the armpit or beneath the collarbone, and may feel like a tender knot when pressed.

Chest Pain 21-2 Pectoralis Major Sternal Section
21-2 Pectoralis Major Sternal Section

I Feel

Chest Pain

When the large Pectoralis Major muscle, specifically its outer (Lateral margin) and lower (sternal section) portions, is causing trouble, the main complaint is often a widespread pain across the chest wall. You’ll typically feel a deep, burning ache that runs across your chest and can settle right along the front of your shoulder and down the inner side of your arm. This muscle’s job is to pull your arm across your body and down, so you’ll notice the pain gets significantly worse during activities that involve forceful pushing, like bench pressing, or swinging a golf club. It can be super tender to press on the muscle along the sternum (breastbone). Issues here can sometimes be mistaken for heart-related discomfort due to the location of the pain, leaving the whole chest feeling constricted and tightl

Heart Burn

That burning sensation in the center of your chest that feels like heartburn might actually stem from muscle knots in the muscle along the sternum, the sternal part of the pectoralis major. It’s similar to the feeling of heat rising in your chest after eating something spicy—but in this case, it’s your muscle sending the wrong signals. The discomfort often feels like a deep, warm pressure behind the breastbone and can resemble acid reflux or even esophageal spasms. It worsens significantly when you’re slouching at your desk, lifting something from the floor while bent forward, or sleeping curled up on your side. This tension causes your chest to feel tight and uncomfortable, especially when trying to take a deep breath or stretch your arms. The muscle is often sore to the touch, particularly along the sternum or just below the collarbone. That area may feel like a small, burning knot when pressed.

Breast Tenderness

If you’re experiencing breast tenderness that seems abnormal, it could be caused by tight muscle knots near the breastbone, especially in the sternal part of the pectoralis major. This is similar to when a bruise develops under the skin and feels sore even if you haven’t bumped anything. The tenderness usually focuses on the inner part of the breast and can feel like a deep ache or surface sensitivity. It may resemble symptoms of fibrocystic breast changes or costochondritis (inflammation of the ribs). The pain worsens significantly with activities like lifting a child, pushing a shopping cart with both arms, or sleeping with your arm tucked across your chest. This tension can make the area sore and sensitive, and you might avoid touching or pressing on that side. The most sensitive spot is often just beside the sternum or under the upper chest, feeling like a tender knot when pressed.

Chest Pain 21-3 Pectoralis Minor
21-3 Pectoralis Minor

I Feel

Chest Pain

When the small Pectoralis Minor muscle, which is tucked deep beneath your main chest muscle, is irritated, its effect on your chest wall can be quite concerning. You’ll typically feel a persistent, deep ache right in the front of your shoulder and upper chest, sometimes settling as a tight, worrisome pain that runs along your breastbone. This muscle’s function is to pull your shoulder blade forward and down. Hunching your shoulders forward—common when sitting at a desk—shortens this muscle, making it tight and prone to spasm. You’ll notice the discomfort gets worse when you try to stand up straight or pull your shoulders back. Because of its location, tension here can easily be mistaken for heart-related pain, making the entire chest feel constricted and limited.

Chest Pain 21-4 Sternalis
21-4 Sternalis

I Feel

Pain or Discomfort Underneath the Collar Bone
That nagging pain or discomfort beneath the collarbone is often caused by tight muscle knots in a small, inconsistent muscle that sometimes runs along your sternum, the sternalis. It’s like a small nail pressing into the bone each time you move. The discomfort typically centers right along the sternum and up toward the collarbone and feels like a sharp, tight ache that worsens with breathing. This can mimic deeper issues, such as inflammation of the ribs or a sprain of the collarbone joint. The pain worsens significantly during activities that stretch the chest, such as taking a deep breath, reaching backward, or lying flat on your back without a pillow. This restriction leaves your rib cage feeling guarded and stiff, limiting comfortable torso rotation. The tissue directly over the breastbone often feels tender, like a hard cord that responds to pressure.
Chest Pain 21-5 Scalene Muscles, Anterior Medius and Posterior
21-5 Scalene Muscles, Anterior Medius and Posterior

I Feel

Chest Pain

When chest pain originates from the small, rope-like muscles along the sides of your neck—the scalenes—it can feel like your chest is being squeezed from the inside, similar to wearing a shirt that’s just a bit too tight across the chest. The discomfort usually settles around the upper chest and collarbone area and can feel sharp, tight, or like deep pressure. It can mimic conditions such as angina or pleurisy, making it easy to misinterpret. The pain worsens when you’re doing activities like turning your head sharply, lifting heavy objects with poor posture, or breathing deeply while slouched. This tension can cause your chest and neck to feel guarded and stiff, limiting your ability to turn your head or take a full, comfortable breath. The area is especially sensitive to pressure, with tenderness often located just above the collarbone or along the side of the neck near the base. Pressing on these spots can nearly recreate the chest pain instantly.

Chest Pain 21-6 Subclavius
21-6 Subclavius

I Feel

Pain or Discomfort Underneath the Collar Bone

Pain or discomfort beneath your collarbone can stem from a small yet powerful muscle called the subclavius—it’s like having a pebble stuck under a tight strap across your chest. The sensation often feels like a dull ache or a sharp, stabbing pressure right under the collarbone, and it can resemble issues like a clavicle sprain or nerve compression. You’ll notice the pain worsens significantly when you do activities like reaching overhead, pulling your shoulders forward while typing, or sleeping with your arm tucked under your chest. This tension causes the front of your shoulder to feel restricted and guarded, making it difficult to lift or rotate your arm comfortably. The area is very sensitive to touch, especially just below the middle of the collarbone where the muscle sits tightly between bone and tissue. Pressing on that spot often reveals a tender knot that feels like a bruise.

Chest Pain 21-7 Serratus Anterior
21-7 Serratus Anterior

I Feel

Side of Chest Pain

If you’re feeling a deep ache or strange discomfort along the side of your chest, the true cause might be a muscle deep beneath your arm and ribs called the serratus anterior. This muscle wraps around your ribcage and helps move and stabilize your shoulder blade. When it develops muscle knots, it can cause pain along the ribs, sometimes feeling like a sharp, shooting ache that travels along the side of your chest, back, shoulder, and sometimes down your arm. You may notice that the pain worsens significantly during activities such as taking a deep, forced breath, pushing a heavy object, or performing repetitive arm swings (like during running). Since this muscle supports both shoulder movement and breathing, tension in it can easily mimic deeper problems like a rib joint issue or a side stitch. The tissue under the armpit is often vulnerable to pressure, which can leave your chest feeling restricted and limit the depth of your breath.