Pectoralis major rupture | Treatment and Symptoms

The rupture of the pectoralis major may have serious consequences for your functionality and requires precise treatments to help you regain mobility. Although it isn’t a very recurrent condition, this type of rupture often affects young people who engage in intensive physical activities and exercises of the pectoral muscles.

Anatomy observance

By observing the anatomy of the affected region, the symptoms, types, characteristics of the lesion, and the process of diagnosis and treatment, we explore the possible prognosis for you.

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Features of the muscle

The pectoralis major muscle is of a triangular shape. It originates in the clavicle, ribs, sternum, and the aponeurosis of the external oblique muscle of the abdomen.

Greater breastplate

This muscle is the most important medial rotator for shoulder adduction. It is innervated by nerves in the medial and lateral pectorals.

Symptoms

Most people with pectoralis major ruptures report sudden pain in the medial region of the arm, close to the chest, as well as crackling sounds. These symptoms are especially pronounced when they’re performing exercises for the pectoral muscles. Swelling (edema) and discoloration of the skin from bleeding underneath (ecchymosis) may occur in the affected region or the inside of the arm.

Another common symptom is the limitation of adduction movements—such as flexing the arm close to the chest—and medial rotation. A visible sign of the rupture is often a change in the shape of the muscle.

Re-incidence

Although this isn’t a common injury, the rupture of the pectoralis major muscle may recur. This occurs for people who engage in sports and intensive physical activities, such as weight training, weightlifting, CrossFit, and jiu-jitsu.

Common among young and active patients

This condition is most frequent among young and active patients and athletes who lift specific weights. In fact, 85% of cases occur in athletes. Men between the ages of 20 and 40 years are most often affected by these ruptures—especially if they use anabolic steroids.

Indirect injury mechanism

These non-contact injuries may result from internal forces caused by your actions—such as fatigue, poor technique, or lack of fitness—and not physical contact with an object.

The indirect injury mechanism is more common in athletes because of movements such as bench presses. Additionally, when the shoulder is positioned in extension and lateral rotation, or when you’re resisting direct forces in the anteroposterior direction, you’re more prone to ruptures. In such exercises, the athlete lies under a bench and raises the bar through a structure of the device itself. Since the shoulder is 90° flexed and 90° abducted with elbows extended, the resulting strain may cause an injury.

Diagnosis

Magnetic resonance imaging, which is essential for identifying several ruptures, may not necessarily be useful in this case. It’s important to note that routine examinations, with MRI of the shoulder, may not detect the problem. This is because the resonance must be specific for such an evaluation.

Nuclear magnetic resonance

Nuclear magnetic resonance imaging is still the best method for diagnosing and understanding the standard anatomy of the lesion. This enables us to determine the best treatments for your needs.

Types of injury

The injury can be classified based on the time of injury, the affected area, and the degree of damage. Additionally, acute or chronic ruptures may take varying degrees of time to heal, with the latter lasting for more than three weeks.

Pectoralis Major Ruptures can radiate the pain and damage to other parts, influencing the muscular belly, the myotendinous transition, and the insertion of the tendon.

Partial or complete injuries

Depending on the location of the injury, it may be partial or complete. The pectoral muscle is formed by two parts: the sternal and the clavicular. The rupture of the pectoralis major may occur in only one part or even both portions in more severe cases.

The most common injury due to this rupture is to the sternal head.

Treatment

This injury can either be treated conservatively—that is, without surgery—or surgically.

In case of partial injuries (or in the tendon insertion), the muscular portion (the medial) and parts of the muscular belly can be treated non-surgically. This will require resting your muscles with a sling for support and palliative care for pain relief.

For complete lesions (or all tendon insertions), as well as the entire sternal portion, surgical treatments are necessary. These procedures must involve reinserting the injured tendon using metal anchors or screws for stabilization.

If it is an acute case, this fixation can be through an endobutton. However, in chronic cases, a tendon graft may be needed because of the inability of the tendon to reinsert itself directly into the bone.

Call a professional

The prognosis and postoperative care for pectoralis major ruptures can be positive if you turn to a competent professional from the Arthroplasty clinic as soon as possible.
We specialize in efficient and accurate diagnoses and provide the best forms of treatment for each specific case.

Talk to our team and schedule an appointment today!

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Unidade Higienópolis
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Unidade Higienópolis

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