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

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.

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.