Pectoralis Minor Syndrome

Pectoralis Minor (PecMinor) Syndrome - compression of the brachial plexus between the coracoid process the contracted Pectoralis Minor Muscle.

Very common cause of PecMinor Syndrome is the pathomechanical protraction of the shoulders (postural distortion - rounded shoulders) resulting from either a Rothbarts Foot or the PreClinical Clubfoot Deformity.

Clinical picture - pain or tenderness in the anterior chest wall and axilla, tenderness over the pectoralis minor tendon, and neurovascular symptoms:

Vascular symptoms can include:

1. Swelling or puffiness in the arm or hand

2. Bluish discoloration of the hand

3. Feeling of heaviness in the arm or hand

4. Pulsating lump above the clavicle

5. Deep, boring toothache-like pain in the neck and shoulder region which seems to increase at night

6. Easily fatigued arms and hands

7. Superficial vein distention in the hand

1. Chest Pain

2. Muscle weakness and atrophy of the gripping muscles (long finger flexors) and small muscles of the hand (thenar and intrinsics)

3. Difficulty with fine motor tasks of the hand

4. Cramps of the muscles on the inner forearm (long finger flexors)

5. Pain in the inner arm, inner elbow traveling down into the fourth and fifth fingers of the hand

6. Tingling and numbness in the neck, shoulder region, arm and hand

7. Pain in the front of the shoulder

8. Pain in the upper back between the shoulder blades

1. The patient brings their arms up as shown with elbows slightly behind the head. 

2. The patient then opens and closes their hands slowly for 3 minutes (See Photos Below)

Courtesy of Nicholas Institute Sports Medicine Athletic Trauma

 

3. A positive test is indicated by pain, heaviness or profound arm weakness or numbness and tingling of the hand.