Article Text

Download PDFPDF
The “bench-presser’s shoulder”: an overuse insertional tendinopathy of the pectoralis minor muscle
  1. Deepak N Bhatia1,
  2. Joe F de Beer1,
  3. Karin S van Rooyen1,
  4. Francis Lam1,
  5. Donald F du Toit2
  1. 1Cape Shoulder Institute, Plattekloof, Cape Town, South Africa
  2. 2Department of Anatomy, University of Stellenbosch, Plattekloof, Cape Town, South Africa
  1. Correspondence to:
 Dr D N Bhatia
 Cape Shoulder Institute, Suite no 4, Medgroup Anlin House, 43 Bloulelie Crescent, Plattekloof, Cape Town, South Africa;thebonesmith{at}


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.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 29 November 2006

  • Competing interests: None.