The Brachial Chain Pattern
The Brachial Chain (BC) pattern is described by the Postural Restoration Institute™ (PRI) as being muscles that tend to fire together and change the position of the shoulder, neck and ribs. The pecs, lats, scalenes, intercostals and abdominal muscles are all included in this chain, along with the diaphragm and SCM muscles. This chain is incredibly important for managing pressure in the lungs and ribcage, and our postural systems can fall into overusing it as postural support or as a compensation to deal with other patterns in the body such as The AIC Pattern or the TMCC pattern.
Effects on Posture
The most common overuse of the brachial chain is on the right (Right BC), where it's used to create compression of the right lung - there's no heart on the right side so it's a safer place to compress - which gives the right shoulder stability for people that happen to be right-handed. This will tend to look like a right shoulder that is more rounded-forwards than the left and/or lower than the left shoulder regardless of which leg is used for standing.
Other variations are possible, including an overused brachial chain on both sides (Bilateral BC) which would give the appearance of shoulders that are rounded forwards on both sides and often shows up with head forwards posture or a prominent Adam's Apple. This bilateral posture can also show up as a right shoulder that is higher than the left shoulder regardless of which leg is being stood on. This posture could point at a condition PRI refers to as Superior T4 Syndrome, which is a 'broken' version of the right brachial chain pattern.
Effects on Pain
The right brachial chain pattern can also contribute to pain in various areas of the body. The overuse of the muscles in the right arm, shoulder, ribs and neck can lead to tightness and tension in these muscles, while the same muscles on the other side can be overstrained and lengthened and have pain for those reasons.
Compensations in the body can also cause pain in areas not directly related to the right brachial chain pattern. For example, the right hip being pulled up into the compressed right ribcage can cause strain on the left side of the lower back, leading to chronic pain and discomfort. Any bilateral version of this chain will often be a driver of chronic neck pain, back pain and headaches as the PEC pattern starts over-working in locomotion.
Effects on Range of Motion
ROM tests in as relaxed a position as possible are the best way to check these patterns, and they'll tend to show up with some limitations like:
- Limited shoulder internal rotation
- Limited shoulder overhead reach
- Limited ability to bring the arm behind the body (horizontal abduction)
- Limited rotation of the ribs towards the arm
- Limited rotation at the base of the neck
- Unable to take a full breath in while one side of the ribcage is compressed
Treatment
PRI outlines both hands-off and hands-on treatment options for the brachial chain patterns. While hands-off is always better for programming the postural system, some people need physical guidance with achieving the positions they need to sense as input. In fact, some of the techniques PRI suggests for very locked up patterns require up to 3 people to guide a ribcage into the needed position! Most of the time though they involve guiding the ribs into the appropriate positions for sensing compression and expansion through contact on the lateral sternum (breastbone), lower back and upper ribs.
One of the best ways of treating this pattern is actually using a balloon! Blowing up the balloon works as resistance training for the muscles that inhibit the brachial chain, and by cueing shifts and twists in the position while doing so we can bias changes to one or both chains as needed. The biggest thing that helps an overused brachial chain pattern is inhaling while still managing the position of the ribs, and the balloon helps with this too! By keeping the inflated balloon in the mouth while inhaling through the nose and not pinching the neck of the balloon off, the position of the ribs is maintained on the outside while the air gets pulled in by the diaphragm. No more neck breathing!
Once the brachial chains know how to shut off, then we reprogram them to do so during walking arm swing and standing shifting so normal alternating compression and decompression can happen all the time.
To get a comprehensive assessment and treatment plan for an overused brachial chain, you can always reach out and book a free consultation call with me to see how PRI can help you