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

Br J Sports Med. 2007 Aug;41(8):e11. doi: 10.1136/bjsm.2006.032383. Epub 2006 Nov 30.


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.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Adult
  • Analysis of Variance
  • Cumulative Trauma Disorders / diagnosis*
  • Cumulative Trauma Disorders / drug therapy
  • Cumulative Trauma Disorders / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Injury Severity Score
  • Male
  • Middle Aged
  • Pectoralis Muscles / diagnostic imaging
  • Pectoralis Muscles / drug effects
  • Pectoralis Muscles / physiopathology*
  • Risk Factors
  • Rotator Cuff / drug effects
  • Rotator Cuff / pathology*
  • Shoulder Joint / physiopathology
  • Shoulder Pain / diagnosis*
  • Shoulder Pain / drug therapy
  • Shoulder Pain / etiology
  • Sports / physiology
  • Statistics, Nonparametric
  • Tendinopathy / diagnosis*
  • Tendinopathy / drug therapy
  • Tendinopathy / etiology
  • Treatment Outcome
  • Ultrasonography, Doppler


  • Adrenal Cortex Hormones