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 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 rotator cuff tears during arthroscopy. The control group includes patients whose rotator cuff was documented as intact by MRI and/or arthroscopy (e.g., patients treated for labral, SLAP, or instability pathology). Groups are matched 1:1 on age, sex, BMI, occupation, sportive activity and dominant side. Before surgery, a 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 begin on the bursal side. 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) between patients with 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. Primary analysis: conditional logistic regression evaluating whether PM tightness is associated with rotator cuff tear presence in propensity score matched pairs.

  Preoperative assessment, Day 0

Secondary Outcomes (5)

• Tear initiation site in the 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 (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 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 and/or intraoperative arthroscopy findings. Includes patients who underwent arthroscopy for labral, SLAP, or instability pathology without rotator cuff tear, and patients with MRI-confirmed intact rotator cuff. 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

Adult patients (18-55 years) receiving care at a tertiary orthopaedic shoulder service (Gazi University Hospital, Ankara, Türkiye). Case group: patients who underwent shoulder arthroscopy and were found to have partial- or full-thickness rotator cuff tears. Control group: patients with shoulder pain whose rotator cuff integrity was confirmed intact by MRI and/or arthroscopy. Groups are propensity score matched 1:1 on age, sex, BMI, and dominant side.

You may qualify if:

• Adults 18 to 55 years old.
• Shoulder pain.
• Evaluated by MRI and/or shoulder arthroscopy.
• Willing to take part and give informed consent.

You may not qualify if:

• Previous surgery on the same shoulder.
• Recent traumatic shoulder injury such as fracture or dislocation.
• Rotator cuff tear due to major trauma.
• Neck/nerve conditions affecting the shoulder, such as cervical radiculopathy or thoracic outlet syndrome.
• Systemic inflammatory joint disease, such as rheumatoid arthritis or ankylosing spondylitis.
• Cognitive or communication problems that would prevent accurate measurements or consent.

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: May 25, 2026
• Study Completion: May 30, 2026
• Last Updated: May 28, 2026

Record last verified: 2026-04

Locations

TU (1)