Treatment of Persistent Pectoralis Minor Hyperactivity and Compensatory Trapezius Hypertrophy Using Arthroscopic Release

Case: We report on a 20-year-old male patient with shoulder pain and severely altered scapulothoracic kinematics due to pectoralis minor muscle hyperactivity and compensatory trapezius hypertrophy. After failed conservative treatment, an isolated arthroscopic release of the pectoralis minor tendon was performed, resulting in substantial pain relief and improved range of motion in the 6-week follow-up and sustained benefits 6 years later. Conclusion: Persistent pectoralis minor hyperactivity may be the cause of altered scapulothoracic movement, resulting in pronounced hypertrophy of the trapezius muscle. It can be safely treated with an isolated arthroscopic detachment of the pectoralis minor tendon.