The incidence of reverse shoulder arthroplasty has increased since the FDA approved its use in the United States in 2004. What was once a procedure only used to manage pseudoparalysis from rotator cuff tear arthropathy currently is used to manage various shoulder pathology. As with all types of joint reconstruction procedures, a constant demand exists to improve implant designs and surgical techniques. Our results with reverse shoulder arthroplasty are similar to those reported in the literature with respect to outcomes and patient satisfaction; however, a subset of patients who undergo reverse shoulder arthroplasty experience continued anterior shoulder discomfort that limits active range of motion and overall satisfaction. In these patients, physical examination reveals tenderness at the coracoid process and the conjoint tendon as a result of tension created via distalization or lateralization of the glenohumeral joint. If the pain over the coracoid persists more than 6 months postoperatively, we lengthen the conjoint tendon. Conjoint tendon lengthening is performed via a deltopectoral approach within 6 cm of the tendon attachment. The tendon is Z-lengthened via three partial tenotomies approximately 1 to 2 cm apart, starting 1 to 2 cm distal from the origin of the conjoint tendon. Our patients have had early success with this procedure. Notably, the 6-week postoperative visual analog pain scores of the first seven patients who underwent this procedure decreased by a mean of 2.29 points (P = 0.003). The visual analog pain scores of each patient have been maintained through the most recent follow-up. In addition, no complications have resulted from this procedure. Specifically, no musculocutaneous nerve injuries, infections, or subsequent complete conjoint tendon ruptures have occurred. This video discusses the etiology of coracoid pain, demonstrates the technique and provides step-by-step instructions for tendon lengthening, and reviews the early success of our patients.