The pectoralis major is the large muscle situated across the upper chest, above the pectoralis minor. It spans from the clavicle or collarbone to the sternum or breastbone — lying just underneath the breasts, and helps to control arm movements.
The pectoralis major and its tendon, which is attached to the upper arm bone (humerus) can tear and cause significant pain. It usually happens during heavy weight training and bodybuilding exercises, when there is too much strain exerted on the shoulders and chest.
Although injury to the muscle can occur suddenly during activities such as weight training and bench pressing, pectoralis major tears can also happen over time with repetitive heavy activity and sports that involve tackles such as football and rugby. This injury is uncommon but mostly affects males between the ages of 20 and 50, especially those who take steroids as it causes the pectoralis major muscle to strengthen disproportionately to the tendon.
Symptoms of pectoralis major injuries include pain at the front of the chest, a ripping or snapping sensation, deformity in the chest, muscle weakness, swelling, and bruising. While minor pectoralis major injuries can usually be resolved with rest and physical therapy exercises, severe injuries often require surgery to repair the torn muscle, allow better range of motion, and eliminate pain and discomfort.
How does pectoralis major repair work?
Pectoralis major repair surgery is typically recommended for complete or partial tendon tears that cannot heal on their own.
It usually involves open surgery where a surgeon reattaches the torn tendon back to the humerus bone with stitches or suture-anchors. Depending on the severity of the injury, small screws may also be inserted in the humerus bone.
This surgery is done under general anesthesia and typically requires an overnight stay at the hospital. It is expected that the patient will need to wear a sling for at least six months after the surgery.
Benefits of pectoralis major repair
Fixes tears and ruptures in the pectoralis major muscle
Eliminates pain and discomfort
Strengthens the muscle
Increases flexibility and range of motion
What conditions does pectoralis major repair treat?
A pectoralis major repair can treat the following conditions:
Pectoralis major repair injuries
Muscle ruptures and damage
Complete or partial tendon tears
What results can I expect?
Exact results depend on the severity of the injury. As the pectoralis major is a large muscle that controls arm movements, it can take a significant amount of time to recover from surgery. Wearing a sling is recommended for 6 weeks after the surgery. Generally, patients achieve full recovery approximately 6 months after the procedure. During this time, you should be careful not to lift heavy objects or strain the muscle.
Physiotherapy sessions may be required to regain strength in the muscle, although it may not be as strong as it once was due to the injury. Follow-up appointments with your orthopaedist are also usually recommended to monitor the progress and healing of the injury.
Work closely with your orthopaedist and follow their recommendations for exercises and activities for the best results. Your orthopaedist can give you a better idea of what to expect based on your individual needs and circumstances.
How many treatment sessions are needed?
Only 1 surgery at a time is needed for pectoralis major repairs, however, multiple physiotherapy sessions may be needed after the procedure. The exact duration will depend on the severity of the injury, your age, and medical history.
Your orthopaedic surgeon will be able to provide you with a bespoke treatment plan, tailored to your needs and requirements.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.