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Pectoralis Minor Injuries

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{{SEO |Key=shoulder, trauma, acute, Pectoralis Minor, muscle |Description=Pectoralis Minor Injuries refer to injuries of the muscle most commonly at its attachment to the coracoid process. While associated with pushing type mechanism, they are much less common than than pectoralis major injuries.

Other Names

  • Pec Minor Tendinitis
  • Bench Presser's Shoulder
  • Bench-Presser's Shoulder
  • Pec Minor Tendonitis

Background

  • This article covers injuries to Pectoralis Minor
  • In general, the literature is very sparse on the subject

Epidemiology

  • Rare, needs to be updated

Pathophysiology

Etiology

  • Primarily seen in physical active individuals
  • In one study of 7 patients, 3 cases were dominant arm, 4 were nondominant[1]
  • Mean duration of symptoms was approximately 4.5 weeks
  • Onset was generally subacute and gradual
  • Frequently associated with bench press exercise

Pathoanatomy


Risk Factors

  • Sports[1]
    • Rugby
    • Swimming
    • Bodybuilding
    • Weight lifting

Differential Diagnosis


Clinical Features

  • General: Physical Exam Shoulder
  • History
    • Patients tend to describe the pain as moderate-severe
    • Limiting ability to participate in sports and ADLs
  • Physical
    • Patients tend to have tenderness at the coracoid process, especially juxto-medially
    • Bench press and active contraction should reproduce the symptoms

Evaluation

  • Radiograph
  • Ultrasound
    • Typically normal
  • Diagnostic injection[1]
    • There is no diagnostic gold standard
    • Medial coracoid tenderness and pain on performance of active contraction test and/or the bench-press maneuver
    • Immediate reduction/disappearance of this tenderness/pain after injection of a local anaesthetic agent

Classification

  • N/A

Management

Nonoperative

  • First line therapy
  • Corticosteroid Injection
    • Bhatia et al sucecsfully treated 7 athletes with a single ultrasound guided corticosteroid injection into the enthesis[1]
  • Relative rest
  • Physical Therapy including stretching exercises for anterior chest and pec minor
  • Gradual return to sports

Operative

  • Unknown

Rehab and Return to Play

Rehabilitation

  • Unknown

Return to Play

  • Typically 12 weeks before return to previous level of play

Complications

  • Unknown

See Also


References


  1. 1.0 1.1 1.2 1.3 Bhatia DN, de Beer JF, van Rooyen KS, et al. The “bench-presser’s shoulder”: an overuse insertional tendinopathy of the pectoralis minor muscle. British Journal of Sports Medicine 2007;41:e11.
Created by:
John Kiel on 24 February 2020 23:27:52
Authors:
Last edited:
13 November 2020 13:52:12
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