Arthroscopic Pectoralis Minor Release

The pectoralis minor (PM) originates at the ribs medially and inserts at the medial border of the coracoid process. Pathologic shortening of the PM can be found in overhead athletes. A shortened PM is associated with anterior and internal rotation of the scapula, leading to scapular dyskinesis and anterior shoulder pain. Cases refractory to physical therapy and self-stretching exercises can be treated with isolated PM release. This procedure has been shown to be a safe and effective means of decreasing self-reported pain and activity limitations in patients with no other shoulder pathologies. We describe arthroscopic PM release in the beach-chair position in an athlete with recalcitrant shoulder pain and scapular dyskinesia.