A torn pec muscle is a relatively common injury in bodybuilders and gym enthusiasts. In addition, we see torn chest muscles in certain contact sports such as rugby or after a fall while skiing. Therefore, finding the location of the pec tear is essential to treat the injury better. So, what is a torn pec muscle, and what do you have to do?
Anatomy and function
The pec muscle, or pectoralis major, is a large fan-shaped muscle on the chest wall. The muscle contains two heads: a clavicular head arising from the collarbone and a sternal head emerging from the sternum bone. Both heads join together to attach to the upper part of the humerus or upper bone.
The pectoral muscle’s primary function is to move the arm across the body. It also helps rotate the arm inward. One example of the two muscles working together is a typical bench press or push-up.
How a torn pec muscle occurs
These injuries occur almost exclusively in male athletes.
A tear usually occurs when the pectoralis muscle is contracted while the muscle is lengthened. Examples include weightlifters during a heavy bench press as the barbell is lowered. Sometimes, a torn chest muscle occurs after trauma, such as a fall onto an outstretched hand or a violent tug or pull of the arm backward, as in a rugby tackle.
How do we diagnose a torn pec muscle?
Generally, pectoralis muscle tears present with sudden pain in the chest wall. Often, many describe a tearing sensation. Other symptoms include:
- An audible pop or rip
- immediate swelling and bruising, sometimes extending to the upper arm and into the elbow
- Weakness in pushing the arms out in front of the body
- a dimple or abnormal contour of the chest wall muscle just above the armpit
When examining a person with a pec tear, we compare the affected side to the other side, looking for asymmetry.
Pectoralis major tear MRI
Often, we use imaging to confirm a diagnosis and assess the severity of a tear. For example, both ultrasound and MRI can diagnose a torn pec muscle. However, we think that MRI is better at assessing the severity of the tear.
Low-grade tears of the pectoralis major muscle involve the muscle only. High-grade tears involve the tendon. Tendon involvement includes the tendon’s attachment to muscle or the tendon to the bone.
Treatment of a torn pec muscle
Overall, treatment depends on the severity of the tear.
Generally, only low-grade tears involving the muscle are treated with physiotherapy and rehab.
However, high-grade tears involving a complete tendon tear should be repaired with surgery. Usually, surgeons place sutures in the pectoralis tendon and anchor these sutures through holes in the bone. In general, surgery is more successful if performed within the first few weeks of the injury. If performed later, the surgery is more difficult due to scar tissue and muscle wasting.
Physical therapy for torn pec muscle
Firstly, we use a sling to rest the pec tear. For low-grade pec tears, rest is limited to 1-2 weeks. High-grade pec tears require surgery. Immobilisation is limited to 4-6 weeks.
After rest, you start range-of-motion exercises to regain shoulder movement. We often avoid arm rotation outwards for at least eight weeks. At the same time, you begin strengthening exercises. Initially, we recommend isometric exercises—contracting the muscle without movement. Light isotonic exercises for the rotator cuff and pectoralis muscle follow this. Examples include free weights and machine-assisted weights. Overall, the aim is to regain strength without causing pain.
As strength improves, you move into endurance exercises such as the upper body ergometer and rowing. Finally, we introduce plyometric exercises that place rapid forces on the muscle to get you ready to return to total activity. Examples include burpees, press-ups with a clap, and catching a ball on a trampoline wall.
Other treatment modalities include electrical muscle stimulation and soft tissue massage.
How long should recovery take for a torn pec muscle?
Generally, low-grade tears take 4-6 weeks to recover, while high-grade tears can take 3-4 months. Remember, the grade of injury determines recovery time and how quickly you heal after surgery.
Final word from Sportdoctorlondon on torn pec muscle
A torn pec muscle may be more severe than initially thought. The tear may involve the tendon attachment. We must diagnose high-grade pectoral muscle tears early as they require surgery. If the surgery is delayed, the muscle will retract, making surgery more difficult.
You should see a sports medicine specialist to help with the diagnosis if in doubt.
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