Question

A 55-year-old female patient is being seen by a PT 5 days status post unilateral mastectomy. The PT notes that the patient is unable to actively adduct the shoulder in the horizontal plane. Which of the following impairments is the MOST LIKELY origin of the patient's presentation?

A. Stiffness secondary to lymphedema
B. Pectoralis minor tightness
C. Subscapularis weakness
D. Pectoralis major weakness

Answer 1

The most likely impairment causing a 55-year-old female patient's inability to adduct the shoulder in the horizontal plane post-mastectomy is pectoralis major weakness.

Step-by-step explanation:

A 55-year-old female patient is unable to actively adduct the shoulder in the horizontal plane following a unilateral mastectomy. The impairment most likely to be causing the patient’s inability to adduct the shoulder is D. Pectoralis major weakness. The pectoralis major muscle is primarily responsible for the adduction and internal rotation of the humerus. After mastectomy surgery, it is common that weakness or surgical alteration affects this muscle. It is also possible for nerves that innervate this muscle to be damaged during the procedure which can contribute to weakness. Therefore, physical therapy may focus on exercises to strengthen the pectoralis major to improve shoulder adduction.