What is the pectoralis major?
The pectoralis major is a powerful chest muscle that helps the arm rotate inward and move closer to the body. It can also assist in moving the arm forward or backward. The muscle originates from two points: the sternum (breastbone) and the clavicle (collarbone). These two sections of the muscle come together into the pectoralis major tendon, which is attached to the humerus (upper arm bone), near the biceps tendon.
What causes tears of the pectoralis major?
Injury to the pectoralis major tendon is relatively uncommon, but can result in significant disability in athletes. They occur almost exclusively in otherwise healthy males between the ages of 20 and 40 years old, and are especially common in those who participate in bodybuilding and weightlifting. While partial tears can occur, these are less common, and usually, a complete rupture of the tendon occurs where it attaches to bone on the humerus.
What are the symptoms?
Patients who experience a pectoralis major rupture feel a sudden pain, and often a popping sensation in their chest. Other symptoms include:
- Pain in the chest and upper arm
- Weakness in pushing the arms out in front of the body
- Bruising and swelling over anterior chest wall or upper arm
- Palpable defect just above the armpit where the rupture occurred
- Asymmetry of normal chest contour, especially compared to uninjured side
How are pectoralis major injuries treated?
Non-surgical – Conservative treatment is an option in patients with partial tears, muscle belly injuries (rather than tearing at the tendon insertion site), or in patients with low levels of activity. Non-operative management consists of initial immobilization, rest, ice, analgesics, and physical therapy. However in young, athletic individuals, this has been shown to result in inferior outcomes.
Surgical – Surgery is typically required to repair pectoralis major injuries, and is the gold standard for acute tears in high level athletes and most young, active patients. Dr. Potts may recommend surgical treatment with a pectoralis major tendon repair, which involves reattaching the torn tendon back to its original attachment on the humerus (upper arm bone).