Pectoralis Minor Tightness Test

The pectoralis major and pectoralis minor tightness test plays a crucial role in diagnosing shoulder dysfunction and postural abnormalities. Medical professionals frequently encounter these conditions in clinical practice, making accurate evaluation essential for proper treatment planning.

Pectoralis Minor Tightness Test

The pectoralis minor muscle, though smaller than its major counterpart, plays a significant role in scapular positioning and shoulder function. This muscle works in conjunction with the rhomboids and levator scapulae to maintain proper scapular stability during arm movements, particularly during extension.

In the pectoralis minor tightness test, the patient is positioned supine with their arm in approximately 30 degrees of forward flexion. The examining clinician places the heel of their hand over the patient’s coracoid process. The examiner then applies gentle pressure, attempting to retract the scapula toward the examination table.

In normal circumstances, this movement should occur smoothly and without causing discomfort to the patient. The scapula should maintain contact with the examination table. However, a positive test is indicated by either discomfort during the posterior movement or resistance to achieving full scapular retraction.

See Also: Pectoralis Minor Muscle Anatomy

For a more quantitative assessment of pectoralis minor tightness, clinicians can employ a simple measurement technique. With the patient in a supine position, arms relaxed at their sides, and elbows flexed so that their hands rest on their body, measure the distance between the examination table and the posterior border of the acromion. A distance exceeding 2.54 centimeters (one inch) suggests pectoralis minor tightness.

Pectoralis Major Contracture Test

The pectoralis major contracture test is a fundamental examination technique that helps clinicians evaluate the flexibility and potential contracture of the pectoralis major muscle. During this examination, the patient assumes a supine position on the examination table. The patient is instructed to clasp their hands behind their head, creating a position that requires full horizontal abduction of the shoulders. The clinician then observes as the patient attempts to lower their elbows toward the examination table.

A positive test is indicated when the patient’s elbows fail to make contact with the examination table. This finding suggests significant tightness or contracture of the pectoralis major muscle. The inability to achieve full range of motion can contribute to various shoulder dysfunctions, including limited mobility and altered scapular mechanics.

Clinical Implications

Understanding and identifying pectoralis tightness is crucial as it can lead to various shoulder and postural dysfunction. Pectoralis minor tightness specifically can result in increased scapular protraction and posterior tilting of the scapula’s inferior angle. These alterations in normal biomechanics may contribute to shoulder impingement, thoracic outlet syndrome, and other upper extremity disorders.

Treatment Considerations

When positive findings are identified, treatment typically involves a comprehensive approach including stretching exercises, manual therapy techniques, and postural education. Regular reassessment using these standardized tests helps monitor progress and adjust treatment plans accordingly.

Resources & More

1. Journal of Orthopaedic & Sports Physical Therapy: https://www.jospt.org
2. Weber C, Enzler M, Wieser K, Swanenburg J. Validation of the pectoralis minor length test: A novel approach. Man Ther. 2016 Apr;22:50-5. doi: 10.1016/j.math.2015.09.015. Epub 2015 Oct 9. PMID: 26483216. Pubmed