The Role of Pectoralis Minor Tightness in the Development of Rotator Cuff Tears

NCT07228936 | Recruiting DMC

• 1 other identifier: E-77082166-302.08.01-1273486
• Study Type: observational
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates whether tightness of a small chest muscle called the pectoralis minor is associated with the development of partial rotator cuff tears in the shoulder. Using a propensity score matched case-control design, the study compares patients with rotator cuff tears (case group, n=45) to patients with intact rotator cuffs (control group, n=45). Adults aged 18-55 with shoulder pain who are evaluated by MRI and/or shoulder arthroscopy at Gazi University Hospital may be invited. The case group includes patients found to have partial rotator cuff tears during arthroscopy. The control group includes patients whose rotator cuff was documented as intact by MRI. Groups are matched 1:1 on age, sex, BMI, and dominant side. Before surgery, two trained clinician measures shoulder posture and pectoralis minor length using simple external tools (a digital caliper and ruler-like square). For arthroscopy patients, the surgeon records general arthroscopic findings. No extra procedures are added for research. We expect to include 90 participants total. The primary hypothesis is that pectoralis minor tightness is more prevalent in patients with rotator cuff tears compared to controls. A secondary hypothesis is that tears in patients with pectoralis minor tightness more often partial-thickness bursal side rotator cuff tear. Results may help clinicians understand shoulder mechanics and improve prevention or rehabilitation strategies.

Conditions

Shoulder Impingement Syndrome; Rotator Cuff Injuries; Pectoralis Minor Tightness; Pectoralis Minor Muscle Tension

Keywords

rotator cuff; Rotator Cuff Injuries; Posture; Scapula; Pectoralis Muscles; Arthroscopy; Shoulder Joint; Pectoralis Minor

Outcome Measures

Primary Outcomes (1)

• Pectoralis minor muscle length difference between case and control groups

  Comparison of pectoralis minor (PM) muscle length (mm) and pectoralis minor index between patients with partial rotator cuff tears (case group) and patients with intact rotator cuffs (control group). PM length is measured as the linear distance from coracoid tip to rib attachment using a digital caliper. The pectoralis minor index was calculated by dividing the pectoralis minor length by the patient's height and multiplying the result by 100.

  Preoperative assessment, Day 0

Secondary Outcomes (6)

• Case group

  Intraoperative, Day 0 (index arthroscopy)

• Forward shoulder posture

  Preoperative assessment, Day 0

• Medial Scapular Border Thoracic Distance

  Preoperative assessment, Day 0

• Thoracic Kyphosis and Proximal Kyphosis(Cobb angle)

  Preoperative imaging review, Day 0

• Scapular index (Coracoid-Sternum/Acromian lateral tip - thoracic spine)

  Preoperative assessment, Day 0

Study Arms (2)

Rotator Cuff Tear (Case)

Patients who underwent shoulder arthroscopy and were found to have partial rotator cuff tears during surgery. Pectoralis minor length, medial scapular distance, and forward shoulder posture were measured preoperatively. Propensity score matched 1:1 with the control group on age, sex, BMI, and dominant side.

Intact Rotator Cuff (Control)

Patients presenting with shoulder pain whose rotator cuff was documented as intact by MRI findings. Propensity score matched 1:1 with the case group on age, sex, BMI, and dominant side.

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Inclusion criteria consisted of patients aged 18-55 years who were scheduled to undergo surgical treatment for a partial-thickness rotator cuff tear (case group) and individuals aged 18-55 years with no evidence of rotator cuff or other shoulder pathology on magnetic resonance imaging (control group). Patients were excluded if they had a history of trauma, thoracic outlet syndrome, systemic inflammatory disease, prior surgery on the affected shoulder, and declined participation in the examination.

Sponsors & Collaborators

• Gazi University: lead

Study Sites (1)

Gazi University Hospital

Ankara, Cankaya, 06500, Turkey (Türkiye)

RECRUITING

Related Publications (9)

• Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003 Mar-Apr;11(2):142-51. doi: 10.5435/00124635-200303000-00008.

  PMID: 12670140 BACKGROUND

• Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am. 2006 Aug;88(8):1699-704. doi: 10.2106/JBJS.E.00835.

  PMID: 16882890 BACKGROUND

• Cools AM, Struyf F, De Mey K, Maenhout A, Castelein B, Cagnie B. Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med. 2014 Apr;48(8):692-7. doi: 10.1136/bjsports-2013-092148. Epub 2013 May 18.

  PMID: 23687006 BACKGROUND

• Borstad JD, Ludewig PM. The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. J Orthop Sports Phys Ther. 2005 Apr;35(4):227-38. doi: 10.2519/jospt.2005.35.4.227.

  PMID: 15901124 BACKGROUND

• Oyama S, Myers JB, Wassinger CA, Daniel Ricci R, Lephart SM. Asymmetric resting scapular posture in healthy overhead athletes. J Athl Train. 2008 Oct-Dec;43(6):565-70. doi: 10.4085/1062-6050-43.6.565.

  PMID: 19030133 BACKGROUND

• Ludewig PM, Reynolds JF. The association of scapular kinematics and glenohumeral joint pathologies. J Orthop Sports Phys Ther. 2009 Feb;39(2):90-104. doi: 10.2519/jospt.2009.2808.

  PMID: 19194022 BACKGROUND

• Peterson DE, Blankenship KR, Robb JB, Walker MJ, Bryan JM, Stetts DM, Mincey LM, Simmons GE. Investigation of the validity and reliability of four objective techniques for measuring forward shoulder posture. J Orthop Sports Phys Ther. 1997 Jan;25(1):34-42. doi: 10.2519/jospt.1997.25.1.34.

  PMID: 8979174 BACKGROUND

• Du WY, Huang TS, Hsu KC, Lin JJ. Measurement of scapular medial border and inferior angle prominence using a novel scapulometer: A reliability and validity study. Musculoskelet Sci Pract. 2017 Dec;32:120-126. doi: 10.1016/j.msksp.2017.08.004. Epub 2017 Aug 15.

  PMID: 28827031 BACKGROUND

• Borstad JD. Measurement of pectoralis minor muscle length: validation and clinical application. J Orthop Sports Phys Ther. 2008 Apr;38(4):169-74. doi: 10.2519/jospt.2008.2723. Epub 2007 Nov 21.

  PMID: 18434665 BACKGROUND

MeSH Terms

Conditions

Shoulder Impingement Syndrome; Rotator Cuff Injuries

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries; Rupture; Tendon Injuries

Central Study Contacts

Cagatay Delice

CONTACT

+90 546 5819056; cgty_166@hotmail.com

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: STUDY CHAİR GAZİ UNİVERSİTY

Study Record Dates

• First Submitted: November 13, 2025
• First Posted: November 14, 2025
• Study Start: March 18, 2025
• Primary Completion: June 25, 2026
• Study Completion: June 30, 2026
• Last Updated: June 25, 2026

Record last verified: 2026-06

Locations

TU (1)