- Relatively rare injury
- Happens in weightlifters during the bench press manoeuvre
- Sudden pain or tearing sensation in the front of the shoulder and chest
- Bruising and bunching up of muscles
- Surgical repair using endobuttons
Anatomy of Pectoralis Major Muscle
Pectoralis Major is a very powerful muscle that forms the prominence of the chest. It moves the shoulder forwards and across your chest. It is this muscle that you develop with the bench press exercise. The Pectoralis Major attaches to the upper arm bone (humerus bone) and has two parts. The upper part which is known as the clavicular head, originates from the collar bone and the lower part which is known as the sternal head originates from the sternal bone.
How does Pectoralis Major Rupture?
It is a relatively rare injury. Over 50% of these injuries will happen classically in weightlifters during the bench press manoeuvre. Partial ruptures are less common. Complete rupture occurs when the tendinous attachment of the muscle to the upper arm bone tears.
What does a Pectoralis Major Tear feel like?
It happens because of a violent eccentric contraction of the muscle. Patients often describe a sudden pain or a tearing sensation in the front of the shoulder and chest. It is then followed by bruising and the muscle bunches up.
Treatment of a Pectoralis Major Muscle Tear ?
Pectoralis Major muscle is not essential for normal daily shoulder function but it is important for strenuous activities. Patients who wish to return to active athletic and manual activities will benefit from surgical repair.
After the surgery you will regain 90% of your strength back compared to around 60% in non- operative patients. The earlier the repair is performed the easier the surgery and better the results. The decision will depend on the type of tear, how old the tear is, how retracted it is, the demands and requirements of the patient and the expertise of the surgeon.
If there is a complete tear of the tendon, away from the bone and the patient is young, fit and healthy then the recommended treatment is a surgical repair to the torn tendon.
In my practice I see tears within a few weeks of injury and most often it’s a tendon avulsion which has happened from your upper arm bone. The recommended treatment is to surgically repair it as soon as possible directly to the bone using endobuttons.
What does the surgical repair involve?
It involves an incision in the front of your shoulder. Tendon is then reattached to the upper arm bone using three endobuttons.
How long does it take for a Pectoralis Major tear to heal after surgery ?
After the surgery you will be given a sling for 4-6 weeks. First part of the rehabilitation process will be to manage pain and swelling and initiate range of motion exercises to the shoulder and arm. Light strength training will start around 3 months after surgery. After 6 months you can do heavy strength training and contact sports. Total rehabilitation process can take between 9 months and 1 year after a surgical pectoralis major repair.
How long does a Pectoralis Major strain take to heal?
Pectoralis muscle strain should heal within a few days, however a moderate strain can take up to 6 weeks to heal up.
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