Effects of Pectoralis Minor Exercises on Shoulder Pain, Scapular Dyskinesis and Thoracic Expansion in Adhesive Capsulitis Patients

Effects of Pectoralis Minor Stretching and Strengthening Exercises on Shoulder Pain, Scapular Dyskinesis and Thoracic Expansion Among Patients With Adhesive Capsulitis: A Randomized Controlled Trial

The goal of the current study is to evaluate the effects of pectoralis minor stretching and strengthening with mobility and stability exercises in patients aged 40-70 years with adhesive capsulitis. The main questions it aims to answer are:

Does the combination of pectoralis minor stretching and strengthening with mobility and stability exercises significantly reduce shoulder pain compared to mobility and stability exercises only? Does the combination of pectoralis minor stretching and strengthening with mobility and stability exercises improve scapular dyskinesis (scapular movement patterns) and thoracic expansion more effectively than mobility and stability exercises? Participants will be assigned to either an experimental group receiving pectoralis minor stretching and strengthening exercises with mobility and stability exercises or a control group receiving mobility and stability exercises only, and will complete standardized assessments of shoulder pain, scapular dyskinesis (scapular movement patterns) and thoracic expansion before and after the intervention.

This clinical trial is designed to evaluate the combined effects of pectoralis minor stretching and strengthening with mobility and stability exercises on shoulder pain, scapular dyskinesis (scapular movement patterns) and thoracic expansion in individuals with adhesive capsulitis. It is commonly linked to reduce pectoralis minor tightness and improve pectoralis minor strength and interventions that target both mobility and stability as well as pectoralis minor correction may offer improved clinical outcomes of shoulder pain, scapular dyskinesis (scapular movement patterns) and thoracic expansion. All participants will undergo baseline assessment, including shoulder pain measured with the Numeric Pain Rating Scale, scapular dyskinesis assessed using the modified scapular assistance test, and thoracic expansion measured using a cloth measuring tape.

Participants will be randomized into two groups (Control Group and Experimental Group). Participants in the control group will perform mobility and stability exercises. Mobility Exercises are passive range-of-motion exercises combined with joint mobilization techniques such as pendulum exercises, wall crawls, and towel stretches. Stability Exercises are isometric rotator cuff exercises. Participants in the experimental group will perform mobility and stability exercises as described in the control group, plus pectoralis minor exercises. Pectoralis minor stretching exercises are unilateral corner and foam roller stretches. Pectoralis minor strengthening exercises are scapular push-ups (protraction-focused), scapular protraction with resistance bands, and wall slides with scapular protraction.

The interventions will occur 4 times per week for 6 weeks, with each session lasting approximately 30-40 minutes. Participants will be advised to avoid any external treatments during the study period. Post-intervention assessments will be conducted immediately after six weeks post intervention. This study aims to clarify whether the integration of pectoralis minor exercises results in superior clinical outcomes compared to mobility and stability exercises alone in the management of adhesive capsulitis.

Inclusion Criteria:

• Age: 40 - 70 years
• Gender: Both Male & Female
• Clinical diagnosis of adhesive capsulitis (Thawing stage).
• Reduced thoracic expansion.
• Scapular dyskinesis

Exclusion Criteria:

• Presence of rotator cuff tear, labral tears, or glenohumeral arthritis confirmed through imaging
• Post-stroke hemiparesis,
• Winged scapula due to lesions of long thoracic nerve or spinal accessory nerve.
• Rotator cuff repair
• Capsular release
• Arthroplasty