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PECTORALIS MUSCLE tears are terribly common, but can occur in weight lifters or other athletes
involved in intense contact sports. A partial or complete tear of the Pectoralis Major muscle can be
disabling or even produce permanent loss of shoulder function in the athlete.
The Pectoralis Major is a large fan-shaped muscle at the front of the chest wall. It originates from the
side of the sternum, the upper 6 ribs, and from the collarbone. It is the muscle under the breast area.
The muscle has three separate triangluar bellies and they all converge into a broad tendon which
attaches onto the humerus (arm bone) below the shoulder. See diagram below.
The Pect allows adduction and internal rotation of the arm and shoulder( moving your arm inward
towards your torso—like a tennis player moving his arm into the backhand position) .
When the Pect is completely torn, a gap can be seen and felt just in front of the arm pit and the
individual has limited motion as described above. Pain and swelling also occur and blood loss as
well-- as there are adjacent vessels that can be torn. Not a bad idea to get a blood count after a
substantial Pect injury.
These usually occur from either blunt trauma or forced shoulder motion into the other direction—
abduction and external rotation ( the throwing position).
Commonly, it occurs in bench pressers who are lifting a heavy barbell and are uncontrollably coming
down with it. The weight could shift to one side of the body-forcing the shoulder into abduction and
external rotation with undue force. The Pect, which was firing and contracting in one position, is
suddenly forced by the huge downward weight into the opposite position and the muscle or tendon
snaps. Incidently, good and alert spotters can perhaps prevent these injuries.
The same can occur in a football game. Or with a fall-- causing blunt trauma.
Remember, anabolic steroids may strengthen muscles, but they weaken tendons. And, with the above
example with our bench presser, the tendon can snap, thus producing a disability and perhaps
requiring surgery.
Pectoralis Major Injuries, like all others are graded 1-3.
Grade 1 would be a minor muscle tear and is treated with rest and a sling. It should heal in 3-6 weeks,
depending on the severity.
Grade 2 is a larger muscle tear and would usually be treated the same as Grade 1. Or, possibly a
partial tendon rupture. The recovery period would obviously be longer. But, if the tear is fairly large,
then surgical repair could be considered
Grade 3 implies a complete tear of the tendon from the bone or at the junction adjacent to the muscle.
The better results are with surgery to repair the tear or to re-attach the tendon to the humerus.
Studies have shown that athletes who are not managed surgically for Grade 3 injuries only regained
around 75% shoulder function and strength, but with successful surgery, the results approach 100%.
Therefore surgery would be recommended for the athlete, but not necessarily for the sedentary,
couch-potato- type individual. Without surgery, a cosmetic gap or skin deformity will persist along with
a degree of weakness. I did have a patient --a doctor friend --who completely ruptured his pectoralis
major muscle from weight lifting. After considering his options,he elected not to have it surgically
repaired. He did fairly well and was satisfied,although I am sure that he must have lost some strength.
Surgical recovery requires 6 weeks or rest –some of that time in a sling- and a few more months of
therapy and rehab to regain strength and function.
After this injury, routine x-rays are necessary to rule-out a different injury such as a fracture. We
cannot see the muscle on an x-ray, but, also, an MRI would next be indicated to grade the tear and
determine treatment recommendations.
Finally, this is also an injury that is not uncommon in the elderly who have weak muscles and who may
fall or jam their arm. The injury should be recognized, but the treatment will usually be conservative
and non-surgical.
CHEST MUSCLES
DELTOID
PECTORALIS MAJOR
involved in intense contact sports. A partial or complete tear of the Pectoralis Major muscle can be
disabling or even produce permanent loss of shoulder function in the athlete.
The Pectoralis Major is a large fan-shaped muscle at the front of the chest wall. It originates from the
side of the sternum, the upper 6 ribs, and from the collarbone. It is the muscle under the breast area.
The muscle has three separate triangluar bellies and they all converge into a broad tendon which
attaches onto the humerus (arm bone) below the shoulder. See diagram below.
The Pect allows adduction and internal rotation of the arm and shoulder( moving your arm inward
towards your torso—like a tennis player moving his arm into the backhand position) .
When the Pect is completely torn, a gap can be seen and felt just in front of the arm pit and the
individual has limited motion as described above. Pain and swelling also occur and blood loss as
well-- as there are adjacent vessels that can be torn. Not a bad idea to get a blood count after a
substantial Pect injury.
These usually occur from either blunt trauma or forced shoulder motion into the other direction—
abduction and external rotation ( the throwing position).
Commonly, it occurs in bench pressers who are lifting a heavy barbell and are uncontrollably coming
down with it. The weight could shift to one side of the body-forcing the shoulder into abduction and
external rotation with undue force. The Pect, which was firing and contracting in one position, is
suddenly forced by the huge downward weight into the opposite position and the muscle or tendon
snaps. Incidently, good and alert spotters can perhaps prevent these injuries.
The same can occur in a football game. Or with a fall-- causing blunt trauma.
Remember, anabolic steroids may strengthen muscles, but they weaken tendons. And, with the above
example with our bench presser, the tendon can snap, thus producing a disability and perhaps
requiring surgery.
Pectoralis Major Injuries, like all others are graded 1-3.
Grade 1 would be a minor muscle tear and is treated with rest and a sling. It should heal in 3-6 weeks,
depending on the severity.
Grade 2 is a larger muscle tear and would usually be treated the same as Grade 1. Or, possibly a
partial tendon rupture. The recovery period would obviously be longer. But, if the tear is fairly large,
then surgical repair could be considered
Grade 3 implies a complete tear of the tendon from the bone or at the junction adjacent to the muscle.
The better results are with surgery to repair the tear or to re-attach the tendon to the humerus.
Studies have shown that athletes who are not managed surgically for Grade 3 injuries only regained
around 75% shoulder function and strength, but with successful surgery, the results approach 100%.
Therefore surgery would be recommended for the athlete, but not necessarily for the sedentary,
couch-potato- type individual. Without surgery, a cosmetic gap or skin deformity will persist along with
a degree of weakness. I did have a patient --a doctor friend --who completely ruptured his pectoralis
major muscle from weight lifting. After considering his options,he elected not to have it surgically
repaired. He did fairly well and was satisfied,although I am sure that he must have lost some strength.
Surgical recovery requires 6 weeks or rest –some of that time in a sling- and a few more months of
therapy and rehab to regain strength and function.
After this injury, routine x-rays are necessary to rule-out a different injury such as a fracture. We
cannot see the muscle on an x-ray, but, also, an MRI would next be indicated to grade the tear and
determine treatment recommendations.
Finally, this is also an injury that is not uncommon in the elderly who have weak muscles and who may
fall or jam their arm. The injury should be recognized, but the treatment will usually be conservative
and non-surgical.
CHEST MUSCLES
DELTOID
PECTORALIS MAJOR
PECTORALIS MUSCLE INJURIES By Edward Staub, M.D. |
| The following medical articles are intended only for general patient information and education. They are not necessarily specific to any one patient's needs and, therefore, should not be construed as formal medical advice or treatment. Obviously, if you have a similar medical problem, you should consult a physician and not rely on these articles in lieu of treatment. If you reside in Dr. Staub's area, he will be delighted to accept you as a patient, but his ultimate opinion and recommendations will be based on his personal examination of you. |
| Edward Staub, M.D. drstaub.com |
Orthopaedic Surgeon, Sports Medicine, Knee, Hip, Shoulder, Ankle, Spine
