A pectoralis major rupture is a partial or complete tear of the pectoralis major tendon, which connects the pectoralis major muscle to the arm (humerus). When the tendon ruptures, there is a loss of connection between the pectoralis major muscle and the humerus, resulting in loss of function of the muscle.
What Is a Pectoralis Major Tendon Rupture?
The pectoralis major muscle is needed to perform powerful pressing or pushing movements with the arm. A rupture is a partial or complete tear of the tendon that connects the pectoralis major muscle to the humerus.
Often, the injury involves the tendon pulling off the humerus. Occasionally, the muscle may tear in the mid-belly or at the junction between the muscle and tendon.
Causes and Risk Factors
Causes include:
- A direct blow or injury to the chest
- A fall from a height
- Maximum bench press
- Catching oneself during a fall
Risk factors include:
- Sports that require excessive muscle stress, such as bench press weightlifting
- Contact sports
- Wrestling
- Poor physical conditioning, including strength and flexibility
- Previous pectoralis major tendon injury
- Cortisone injection into the pectoralis major tendon
- Anabolic steroid use
Symptoms
Signs and symptoms may include:
- A pop, rip, or tearing sensation with severe, sharp, and often burning pain in the chest at the time of injury
- Tenderness, swelling, warmth, or redness, followed later by bruising around the pectoralis muscle-tendon, chest, and armpit region
- Pain and weakness when trying to forcefully push or press with the arm
- Loss of the normal contour of the armpit region, especially when pushing the hands together in front of the body
- A noticeable gap between the ends of the tendon and bone where they separated
Treatment
Pectoralis major ruptures can be treated non-operatively as long as patients do not mind the potential visible deformity and permanent loss of pressing strength.
Surgical treatment is otherwise required to repair the tendon, followed by six weeks of sling immobilization and six to nine months of rehabilitation.
Delayed surgery, greater than three weeks after injury, and complex muscle-tendon junction tears may require pectoralis major tendon reconstruction surgery to create a new pectoralis major tendon using another tendon graft, such as the iliotibial band of the thigh.
Recovery and Outcomes
Surgery is required to restore the muscle connection and function. Surgical outcomes are good after six to nine months of rehabilitation.
Following surgical treatment, sling immobilization is required for six weeks, followed by six to nine months of rehabilitation. Surgery can restore near-full function and strength.
When to See Dr. Chudik
Notify Dr. Chudik’s office if symptoms persist.Call 630-324-0402 or request an appointment online.