In conservative management of thoracic outlet syndrome, strengthening the pectoral muscles is included.

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Conservative management of thoracic outlet syndrome focuses on reducing compression through posture correction and restoring balanced shoulder girdle mechanics, not on increasing chest wall strength. Tight pectoralis minor and other anterior chest muscles can pull the shoulder forward and collapse the space through which the nerves and vessels pass. So the approach emphasizes stretching the pectoralis minor and other tight chest muscles, improving overall posture to prevent anterior tilt, and strengthening scapular stabilizers such as the serratus anterior, lower trapezius, and rhomboids to maintain proper alignment and widen the outlet. Strengthening the pectoral muscles would tend to worsen anterior pull and potentially aggravate symptoms, which is why it isn’t part of the conservative plan.