Pectoralis Minor Index: Does Ethnicity Hold Relevance? Estimation of Pectoralis Minor Length in the Indian Population and Its Correlation with Hand Length



Pectoralis Minor Index (PMI) is a proposed parameter to evaluate the pectoralis minor length (PML), eliminating the effect of subject’s variability of height. Neither a PMI standard value nor any cutoff value to label a shortened pectoralis minor (PM) has been accepted yet, which can be applied to every individual. Moreover, the length of the PM has never been correlated to any fixed reference in the body. Hence, we estimated the PML in the Indian population and investigated its correlation to the individual’s hand length.


A cross-sectional study was conducted including 100 adult subjects without any shoulder pathology. Subjects with history of fracture/treatment involving upper limb/spine were excluded. Two assessors evaluated the height, PM length and hand length of subjects. PMI and hand correlation was evaluated using their mean values.


Mean PML and PMI for dominant and non-dominant shoulder were calculated to be 18.11/18.21 cm and 10.53/10.59, respectively. Mean hand length of dominant and non-dominant hand was found to be 18.27 cm and 18.31 cm, respectively. Pearson correlation coefficient between right/left PML with right/left hand length was 0.67 and 0.63, respectively, suggesting a good correlation (p < 0.01).


PMI varies in different ethnic groups, which makes PMI a less reliable indicator for managing shoulder pain in ethnic groups where reference values are yet not available. Contralateral PMI can be used as a reference value in unilateral shoulder pathologies with short PML. Hand length can become an important parameter in evaluating painful shoulders even in bilateral pathologies. Hand length can be used as an easy and quick technique to compare the PML and effect of physiotherapy in patients with diagnosis of short PML, attending follow-up OPD. Though, a study comparing PML of normal subjects and patients with shoulder pain will be further required in different ethnic groups for further validation of this study.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Fig. 1
Fig. 2
Fig. 3
Fig. 4


  1. 1.

    Luime, J. J., Koes, B. W., Hendriksen, I. J., Burdorf, A., Verhagen, A. P., Miedema, H. S., et al. (2004). Prevalence and incidence of shoulder pain in the general population; a systematic review. Scandinavian Journal of Rheumatology,33, 73–81.

  2. 2.

    Van der Windt, D. A., Koes, B. W., de Jong, B. A., & Bouter, L. M. (1995). Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheumatic Dis,54, 959–964.

  3. 3.

    Lewis, J. S. (2009). Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment? British Journal of Sports Medicine,43, 259–264.

  4. 4.

    Borstad, J. D., & Ludewig, P. M. (2006). Comparison of three stretches for the pectoralis minor muscle. Journal of Shoulder and Elbow Surgery,15, 324–330.

  5. 5.

    Kibler, W. B., Sciascia, A., & Wilkes, T. (2012). Scapular dyskinesis and its relation to shoulder injury. Journal of the American Academy of Orthopaedic Surgeons,20(6), 364–372.

  6. 6.

    Lewis, J. S., & Valentine, R. E. (2007). The pectoralis minor length test: a study of the intrarater reliability and diagnostic accuracy in subjects with and without shoulder symptoms. BMC Musculoskeletal Disorders,8, 64.

  7. 7.

    Struyf, F., Nijs, J., Baeyens, J. P., Mottram, S., & Meeusen, R. (2011). Scapular positioning and movement in unimpaired shoulders, shoulder impingement syndrome, and glenohumeral instability. Scandinavian Journal of Medicine and Science in Sports,21, 352–358.

  8. 8.

    Borstad, J. D., & Ludewig, P. M. (2005). The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. Journal of Orthopaedic and Sports Physical Therapy,35, 227–238.

  9. 9.

    Muraki, T., Aoki, M., Izumi, T., Fujii, M., Hidaka, E., & Miyamoto, S. (2009). Lengthening of the pectoralis minor muscle during passive shoulder motions and stretching techniques: a cadaveric biomechanical study. Physical Therapy,89, 333–334.

  10. 10.

    Cools, A. M., Johansson, F. R., Cambier, D. C., Velde, A. V., Palmans, T., & Witvrouw, E. E. (2010). Descriptive profile of scapulothoracic position, strength and flexibility variables in adolescent elite tennis players. British Journal of Sports Medicine,44, 678–684.

  11. 11.

    Tate, A., Turner, G. N., Knab, S. E., Jorgensen, C., Strittmatter, A., & Michener, L. A. (2012). Risk factors associated with shoulder pain and disability across the lifespan of competitive swimmers. Journal of Athletic Training,47, 149–158.

  12. 12.

    Harrington, S., Meisel, C., & Tate, A. (2014). A cross-sectional study examining shoulder pain and disability in division I female swimmers. Journal of Sport Rehabilitation,23, 65–75.

  13. 13.

    Struyf, F., et al. (2014). Interrater and intrarater reliability of the pectoralis minor muscle length measurement in subjects with and without shoulder impingement symptoms. Manual Therapy.

  14. 14.

    Yeşilyaprak, S. S., Yüksel, E., & Kalkan, S. (2015). Influence of pectoralis minor and upper trapezius lengths on observable scapular dyskinesis. Physical Therapy in Sports.

  15. 15.

    Lee, J.-H., et al. (2015). Comparison of scapular posterior tilting exercise alone and scapular posterior tilting exercise after pectoralis minor stretching on scapular alignment and scapular upward rotators activity in subjects with short pectoralis minor. Physical Therapy in Sport.

  16. 16.

    Borstad, J. D. (2008). Measurement of pectoralis minor muscle length: validation and clinical application. Journal of Orthopaedic and Sports Physical Therapy,38, 169–174.

  17. 17.

    Jain, S. N., & Shukla, Y. U. (2013). To find the intra-rater reliability and concurrent validity of two methods of measuring pectoralis minor tightness in periarthritic shoulder patients. Indian journal of physical therapy.,1(2), 34–38.

  18. 18.

    Rosa, D. P., Borstad, J. D., Pires, E. D., & Camargo, P. R. (2016). Reliability of measuring pectoralis minor muscle resting length in subjects with and without signs of shoulder impingement. Brazilian Journal of Physical Therapy.

  19. 19.

    Williams, J. G., Laudner, K. G., & McLoda, T. (2013). The acute effects of two passive stretch maneuvers on pectoralis minor length and scapular kinematics among collegiate swimmers. International Journal of Sports Physical Therapy,8(1), 25–33.

Download references

Author information

Correspondence to Tarun Verma.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

This cross-sectional study had no ethical issues. Anthropometric measurements were taken after informed consent.

Informed consent

Informed consent for submission of data for publication was taken from each participant. All the subjects were healthy individuals. No intervention was done.

Authorship declaration

All authors listed meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors and all authors are in agreement with the manuscript.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sharma, A., Sharma, A., Mishra, A. et al. Pectoralis Minor Index: Does Ethnicity Hold Relevance? Estimation of Pectoralis Minor Length in the Indian Population and Its Correlation with Hand Length. IJOO (2020) doi:10.1007/s43465-019-00003-7

Download citation


  • Ethnic variation
  • Pectoralis minor shortening
  • Shoulder impingement
  • Pectoralis Minor Index
  • Hand length