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Pectoralis Major Muscle Rupture

The pectoralis major muscle is the large muscle in front of the upper chest. There are two parts of the pectoralis muscle, the pectoralis major and the pectoralis minor. The pectoralis major is the larger of the two, and works to push the arms in front of the body, such as in doing a push-up or bench press exercise.

The pectoralis major muscle, or most commonly its tendon that attaches to the arm bone (the humerus), can rupture. Athletes commonly call this a "pec rupture" but it is more accurately called a pectoralis major muscle rupture. Pectoralis major ruptures are uncommon injuries that occur almost exclusively in men between the ages of 20 to 50. While partial tears can occur, these are less common, and usually a complete rupture of the tendinous attachment of the muscle to the bone occurs.

How does a pectoralis major muscle rupture occur?
These injuries generally occur during forceful activities. A larg number of pectoralis major ruptures occur during weightlifting, particularly during a bench press exercise. Other causes of a pectoralis major rupture include football, wrestling, rugby, and other causes due to trauma.

It is known that anabolic steroid use can weaken the tendon, and this is thought to be a contributing factor in many pectoralis major muscle ruptures in body-builders and weight-lifters. However, these injuries can certainly occur in patients who have never used steroids.

What are the symptoms of a pectoralis major muscle rupture?
Patients who experience a pectoralis major rupture feel sudden pain, and often a tearing sensation in their chest. Symptoms include

  • Pain in the chest and upper arm

  • Weakness in pushing the arms out in front of the body

  • Bruising in the chest and arm

  • A dimpling, or pocket, formed just above the arm pit where the rupture occurred

Treatment of a Pectoralis Muscle Rupture

Surgery is most often recommended for complete tears of the pectoralis muscle tendon. Patients who have partial tears, tears within the muscle, or elderly and low-demand patients, may be able to avoid surgical treatment. 
By repairing the torn tendon, patients have a good chance at returning to high-level sports and activities. Ideally the repair is performed in the early period following the injury. By performing the repair within several weeks of the injury, scar tissue and muscle atrophy are minimized.

The repair is performed by placing sutures in the torn tendon, and then securing these sutures to the arm bone with either holes in the bone or anchors inserted in the bone.

Sources:

Petilon, J, et al. "Pectoralis Major Muscle Injuries: Evaluation and Management" J Am Acad Orthop Surg, Vol 13, No 1, January/February 2005, 59-68.

Schepsis AA, et al. "Rupture of the pectoralis major muscle: Outcome after repair of acute and chronic injuries" Am J Sports Med 2000;28:9–15.

By Jonathan Cluett, M.D., About.com Guide

Created: October 14, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

 

 

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