Your pectoralis major is a large and powerful chest muscle that’s shaped like a fan. It starts from two sections: your breastbone (sternum) and your collarbone (clavicle). The two sections come together as the “pectoralis major tendon,” which wraps around the bone in your upper arm (the humerus). You might commonly refer to these chest muscles as “pecs.” They help you move your arms forward and backward, rotate them at the shoulder, and extend them.
While an injury or tear to this muscle or tendon is rare, it can happen if you play sports or do things that require a lot of force such as weightlifting, wrestling, or a bench-press exercise. Doctors call this injury a “pectoralis major tear.”
How Does a Pectoralis Major Tear Happen?
An injury usually happens when you extend your arm out or rotate it externally while the muscle is contracting or tightening at a greater force than it can tolerate. This usually happens when you’re weightlifting.
For example, when you bench-press heavy weights on a bar and extend your arm to lift it, the weight of the bar forces down on your chest muscles. That pressure can cause a tear or, in severe cases, cause your tendon to snap.
When this happens, you may hear or feel a pop in your chest or shoulder, and it can cause a lot of pain. You may also notice weakness and bruising around the area.
Other forceful activities that can cause a pectoralis major tear include:
- Martial arts
Direct trauma from an accident can also cause a muscle or tendon injury in this area. Anabolic steroids, the synthetic type that some athletes or bodybuilders use to boost musclebuilding and improve physical appearance, can also weaken the tendon. Some experts believe this can make you more likely to have a muscle tear or injury. But this injury can also happen if you’ve never taken steroids.
Partial muscle tears are less common. Usually, an injury of this sort ends with a complete tear in tendons that hold the pectoralis major muscle to the bone.
What Are the Symptoms?
If your pectoralis major muscle or tendon tears or becomes injured, you might feel sudden pain or a tearing sensation in your chest.
- Pain in your chest and upper arm
- Weakness when you push your arms out
- Bruising in your chest and arm
- A dimpling, or pocket, just above your armpit where the tear is located
Who’s at Risk?
Pectoralis major tears are more common among young, physically active men between ages 20 and 40, especially athletes. This injury can cause serious disability.
How Is a Pectoralis Major Tear Diagnosed?
If you think you have a pectoralis major tear, see your doctor right away. They’ll first do a physical exam to check the shape of your chest and overall muscle mass.
To confirm your diagnosis and extent of the tear, they may order imaging tests, such as:
What Are the Treatment Options?
Your treatment will depend on whether you have a partial or full tear.
Partial tear. If you have a partial tear in the pectoralis major muscle or there are small tears where the muscle and the tendon meet, you might not need surgery. Surgery is also not recommended if you have tears within the muscle or for those who are elderly. Instead, your doctor might suggest the use of a sling and rest for the affected area. They may also ask you to apply ice, compression, and take over-the-counter pain medications to help with the pain.
Full tear. If you have a complete tendon tear, you’ll need surgery to fix it and restore full strength to the muscle. It’s best to have the surgery within 3 months after the injury to prevent the tendon from tearing again. Early repair can also help reduce your odds of scar tissue buildup and keep the muscle from shrinking.
If the tendon is completely torn from bone, there are several surgery techniques to reattach the tendon to the bone. For example, your doctor might place sutures in the torn tendon and secure it to the bone in your upper arm by making a hole or by putting anchors in the bone. But if the damage to the tendon is severe, you may need a tendon transplant to fully repair it.
How Long Does It Take to Recover?
If you have a partial muscle or tendon tear, you’ll need physical therapy around 2 weeks after the injury to regain strength and motion in your shoulder and arm.
After surgery, you’ll need to wear a sling for 3-6 weeks. During this time, you can start on small arm exercises to build strength and regain motion in the affected area. Over the next few weeks and months, you will have to work with your doctor and physical therapist to slowly add active and passive exercises. At 4 months, once your doctor clears it, you can start light weightlifting. Avoid lifting weights over your head.
After surgery, complete recovery usually takes up to 6 months. Check with your doctor before you resume regular physical activities like sports or weightlifting.