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The "bench-presser's shoulder": an overuse insertional tendinopathy of the pectoralis minor muscle.

Abstract：

BACKGROUND:Tendinopathies of the rotator cuff muscles, biceps tendon and pectoralis major muscle are common causes of shoulder pain in athletes. Overuse insertional tendinopathy of pectoralis minor is a previously undescribed cause of shoulder pain in weightlifters/sportsmen. OBJECTIVES:To describe the clinical features, diagnostic tests and results of an overuse insertional tendinopathy of the pectoralis minor muscle. To also present a new technique of ultrasonographic evaluation and injection of the pectoralis minor muscle/tendon based on use of standard anatomical landmarks (subscapularis, coracoid process and axillary artery) as stepwise reference points for ultrasonographic orientation. METHODS:Between 2005 and 2006, seven sportsmen presenting with this condition were diagnosed and treated at the Cape Shoulder Institute, Cape Town, South Africa. RESULTS:In five patients, the initiating and aggravating factor was performance of the bench-press exercise (hence the term "bench-presser's shoulder"). Medial juxta-coracoid tenderness, a painful active-contraction test and bench-press manoeuvre, and decrease in pain after ultrasound-guided injection of a local anaesthetic agent into the enthesis, in the absence of any other clinically/radiologically apparent pathology, were diagnostic of pectoralis minor insertional tendinopathy. All seven patients were successfully treated with a single ultrasound-guided injection of a corticosteroid into the enthesis of pectoralis minor followed by a period of rest and stretching exercises. CONCLUSIONS:This study describes the clinical features and management of pectoralis minor insertional tendinopathy, secondary to the bench-press type of weightlifting. A new pain site-based classification of shoulder pathology in weightlifters is suggested.

journal_name

Br J Sports Med

journal_title

British journal of sports medicine

authors

Bhatia DN,de Beer JF,van Rooyen KS,Lam F,du Toit DF

doi

10.1136/bjsm.2006.032383

subject

Has Abstract

pub_date

2007-08-01 00:00:00

pages

e11

issue

eissn

0306-3674

issn

1473-0480

pii

bjsm.2006.032383

journal_volume

pub_type

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The "bench-presser's shoulder": an overuse insertional tendinopathy of the pectoralis minor muscle.