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The pectoralis major muscle is a strong, large muscle located on the front of the chest. It allows the arm to rotate inward, move closer to the body, and move forward and backward. The pectoralis major muscle originates from two points, the sternum (chest bone) and clavicle (collar bone), which merge at the pectoralis major tendon attached to the upper arm's humerus bone beside the biceps tendon. The pectoral muscle is strong but can be torn in athletes and other active individuals.
Benc pressing is the most common cause of pectoralis major tear.
Pectoral tears most commonly occur in male athletes due to weightlifting and other athletic activities. It typically arises during bench press or eccentric contractions. Eccentric contraction is defined as an external force that is greater than the force the muscle can generate. Pectoral tendon tears usually occur in men aged 20 to 40.
What are the Tear Regions of the Pectoral Muscle?
Tear at the attachment of the tendon to the arm bone (humerus) (most common injury)
Tear at the muscle-tendon junction
Tear within the muscle
Tear of the muscle from the chest bone (sternum) (least common injury)
What are the Symptoms of Pectoralis Major Tear?
The most prominent symptom of a pectoral tear is sudden, sharp pain in the front of the upper arm, in the area where the pectoral tendon attaches. Patients may also experience swelling and bruising in the chest area, as well as visible deformity. Tears can initially go unnoticed and be mistaken for a mild strain; however, the deformity becomes noticeable as bruising and swelling subside, and only then do patients consult a doctor.
How is a Pectoral Muscle Tear Diagnosed?
Diagnosing a chest tear during a physical examination is not difficult. In most cases, the shape and volume of the injured muscle are visibly different from the uninjured muscle. In my practice, I use ultrasound as part of the physical examination to confirm the diagnosis. However, MRI imaging remains the gold standard method for definitive diagnosis.
Treatment of Pectoral Muscle Tear
Most cases of pectoral muscle tear are treated surgically. Surgery allows patients to return to full functionality during athletic activities. For the first few days after the injury, patients can effectively alleviate pain and swelling using the RICE (rest, ice, compression, and elevation) protocol.
Surgical Treatment of Pectoral Tear
Surgery involves making an incision between the pectoral muscle and the deltoid muscle, reaching the area where the pectoral muscle has detached from the bone. The detached tendon is sutured to the bone (humerus) at its original location using one or two suture anchors.
If the injury is chronic, a successful repair can still be achieved with surgical treatment. However, a tendon allograft could be needed to perform the repair.
