Pectoralis minor syndrome – review of pathoanatomy, diagnosis, and management of the primary cause of neurogenic thoracic outlet syndrome

Ahmed, Adil S.; Graf, Adam; Karzon, Anthony L.; Graulich, Bethany L.; Egger, Anthony C.; Taub, Sarah M.; Gottschalk, Michael B.; Bowers, Robert; Wagner, Eric R.

doi:10.1016/j.xrrt.2022.05.008

Cited by 5 publications

(16 citation statements)

References 105 publications

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“…The decrease in the thickness of the pectoralis minor muscle was also believed to have occurred because stretching exercises achieved a tem-porary but more rapid effect than stabilization exercises. This finding is consistent with that of a study by Ahmed et al [29] reporting successive elongation of the pectoralis minor muscle after stretching.…”

Section: Discussionsupporting

confidence: 93%

A Study on the Effectiveness of Face-to-face Physical Therapy and Non-face-to-face Physical Therapy in Individuals With Rounded Shoulder

Cho

Kim

Park

et al. 2023

Physical Therapy Korea

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Background: This study was carried out to determine whether non-face-to-face physical therapy would have similar exercise effects to face-to-face physical therapy. Hence, we developed an approach for patients, unable to visit hospitals due to circumstances such as the COVID-19 pandemic, to conduct physical therapy comfortably at home. Objects:This study aimed to compare the effects of a face-to-face and a non-face-to-face physical therapy treatment on improving a rounded shoulder posture. Methods:The participants with rounded shoulders were randomly divided into a face-toface group (n = 15) and a non-face-to-face group (n = 15), and each group performed exercises for four weeks. The exercise program consisted of the bare hands exercise, Thera-Band exercise, and foam roller exercise. The participants in the face-to-face group came to a designated place to perform their exercises, and those in the non-face-to-face group performed the exercises at their own home using Google Meet (Google). Acromial height, total scapular distance (TSD), shoulder pain and dysfunction index (SPADI), and pectoralis minor thickness were measured. Data analysis was performed using the R Statistical Software (R Core Team), and a normality test was performed using the Shapiro-Wilk test.Results: There were no significant differences between the face-to-face and the non-face-toface groups (p > 0.05). When comparing the differences before and after the exercises, both the face-to-face and the non-face-to-face groups showed significant differences in acromial height, SPADI, and pectoralis minor thickness (p < 0.05), and both groups showed no significant difference in TSD before and after the exercises (p > 0.05). Conclusion:The results of this study support the results of previous studies reporting that shoulder stabilization exercise and pectoralis minor stretching training improves round shoulders. In addition, this study revealed that both the face-to-face and the non-face-to-face physical therapy treatments had therapeutic effects.'lat pull-down' machine have also been used to treat rounded

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Section: Discussionsupporting

confidence: 93%

A Study on the Effectiveness of Face-to-face Physical Therapy and Non-face-to-face Physical Therapy in Individuals With Rounded Shoulder

Cho

Kim

Park

et al. 2023

Physical Therapy Korea

View full text Add to dashboard Cite

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“…T he incidence of nTOS is likely underreported, given its diagnosis is very challenging, resulting in many patients experiencing years of symptoms. This is in part due to no specific imaging modality consistently contributing to the diagnostic algorithm 3,4 . In many cases, patients also undergo a variety of other surgeries in an attempt to solve their radiating pain and dysfunction 13,14 .…”

Section: Discussionmentioning

confidence: 99%

“…To determine the length of the pectoralis minor muscle, one can manually measure using a tape measure. This involves identifying the medial aspect of the coracoid process, marking its location on the skin, and then measuring the distance to the inferior margin of the fourth rib at the sternocostal junction 4,12 . PMI is expressed as the quotient of PM length and patient height in centimeters multiplied by 100.…”

Section: Case Reportmentioning

confidence: 99%

“…The compression of the brachial plexus beneath the pectoralis minor muscle is a prevalent cause of neurogenic TOS (nTOS) and can be difficult to diagnose because of the presence of nonspecific neurological symptoms 4 . Furthermore, given the lack of a clear diagnostic criteria or algorithm, lack of provider awareness of nTOS can lead patients to be seen by many different specialties before a diagnosis is made 8 .…”

mentioning

confidence: 99%

“…Compression of the brachial plexus and subclavian vessels at different points in the supraclavicular and infraclavicular spaces can result in the development of symptoms 1,3 . In TOS, there are 3 distinct areas of neurovascular compromise, including the interscalene triangle, costoclavicular space, and the retropectoralis minor space 4,5 . One of the possible causes underlying the pathophysiology of neurogenic TOS (nTOS) involves pectoralis minor hyperactivity, starting a progressive cycle of muscle shortening leading to scapular protraction and distal displacement 6,7 .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Arthroscopic Pectoralis Minor Release After Reverse Shoulder Arthroplasty

Stern

Karzon

Hussain

et al. 2023

JBJS Case Connector

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Case:A 74-year-old male patient presenting with chronic radiating shoulder pain, paresthesias, and weakness had previously undergone reverse shoulder arthroplasty and anterior cervical discectomy and fusion for an irreparable cuff tear and cervical radiculopathy, respectively. After being diagnosed with neurogenic thoracic outlet syndrome and undergoing physiotherapy, the patient's recalcitrant condition was surgically managed with arthroscopic pectoralis minor tenotomy, suprascapular nerve release, and brachial plexus neurolysis.Conclusion:This ultimately led to complete pain relief and improved function. By sharing this case, we aim to shed light on this overlooked pathology and help prevent unnecessary procedures for others suffering from similar conditions.

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Evaluation and Management of Shoulder Dysfunction in Cancer Survivors

Lee,

Stubblefield

2024

Curr Phys Med Rehabil Rep

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Purpose of Review Shoulder dysfunction widely affects function and quality of life of cancer survivors. This paper discusses the etiology, identification, evaluation, and management of the common shoulder impairments seen in cancer survivors, particularly those with breast cancer, head and neck cancer, and Hodgkin lymphoma. Recent Findings Shoulder dysfunction can be caused by a wide range of sources, often as a sequelae of cancer treatments including surgery, systemic therapy, and radiation therapy. These can change the shoulder biomechanics leading to musculoskeletal disorders such as rotator cuff disease and adhesive capsulitis. Other etiologies include neuromuscular complications, such as post-breast surgery pain syndrome and radiation fibrosis syndrome, and lymphovascular disorders such as lymphedema and axillary web syndrome. Metastatic bone disease and primary bone cancer should be considered for those with intense shoulder pain. Detailed history and physical exam, and in some cases, imaging can assist with evaluation of shoulder issues. Exercise, physical and occupation therapy are essential in managing shoulder dysfunction. Summary Shoulder dysfunction can limit function and quality of life for cancer survivors. It is important to consider the possible etiologies as accurate diagnosis is critical for optimal treatment.

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Pectoralis minor syndrome – review of pathoanatomy, diagnosis, and management of the primary cause of neurogenic thoracic outlet syndrome

Cited by 5 publications

References 105 publications

A Study on the Effectiveness of Face-to-face Physical Therapy and Non-face-to-face Physical Therapy in Individuals With Rounded Shoulder

A Study on the Effectiveness of Face-to-face Physical Therapy and Non-face-to-face Physical Therapy in Individuals With Rounded Shoulder

Arthroscopic Pectoralis Minor Release After Reverse Shoulder Arthroplasty

Evaluation and Management of Shoulder Dysfunction in Cancer Survivors

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