Torn Pectoral Muscle

A complete guide from diagnosis to a full recovery.

A torn pectoral muscle is a relatively rare injury. But it’s increasing in frequency as more people lift weights to get in shape.

Unfortunately, there’s still not much information on what to do if it happens to you. Especially from the point of view of someone who has had this injury and gone through the recovery.

In 2018, I suffered a severe pec tear while bench pressing. So this article is intended to share my experience and give you an idea of what to expect before and after treatment.

Torn Pectoral Muscle Bench Press

Torn Pectoral Muscle Injuries

A pectoral tear is severe tissue damage that occurs when the chest muscles and tendons are subjected to extreme loads or stresses.

Most often this type of injury occurs in men 20-40 years old engaging in weightlifting, contact sports, or wrestling. But it can also happen to female weightlifters or athletes.

Pectoral Muscle Anatomy

If you’re not familiar with anatomy, the pectorals are the large muscles of your chest. Their primary function is to pull your upper arm forward and across your body.

In the diagram below, you see that the chest muscle (red area) is composed of several fiber bundles. The muscle fibers connect to tendons (white ends) that attach to your sternum, clavicle, and upper arm bones.

Pectoral Muscle Anatomy

A pectoral injury could result in a partial or complete tear of the muscle or the tendon. So doctors created a classification system based on the type and location of the tear.

Type (1-3) indicates whether the injury is a strain, partial tear, or complete tear. And a complete tear, also called a complete rupture, is further categorized by location within the muscle or tendon.

Based on a review of 330 injuries, 97% of complete tears occur at the muscle-tendon junction and the humerus attachment point1.

Classification Of Pectoral Muscle/Tendon Injuries
  1. Strain or contusion
  2. Partial tear
  3. Complete tear
    1. Sternum/clavicle insertion
    2. Mid muscle
    3. Muscle-tendon junction (22% of complete tears)
    4. Tendon off humerus – no bone (75% of complete tears)
    5. Tendon off humerus – with bone
    6. Mid tendon
Torn Pectoral Muscle Location

Causes

At least half of all torn pectoral muscle injuries occur while performing the bench press exercise1,2,3. Generally, tears happen while lowering the weight. Or at the sticking point where maximum muscle contraction occurs.

Another common cause of pec tears is when the arm is forcefully pulled away from the body. This mostly occurs in sports like football and rugby or hand-to-hand combat. But it can also happen if you fall on your arm while it is extended.

Top 5 Causes Of Pectoral Muscle Tears3
  1. Weightlifting (bench press)
  2. Combat
  3. Sports
  4. Fall
  5. Other major trauma
Torn Pectoral Muscle Causes

What Does A Torn Pec Muscle Feel Like?

A pectoral tear is a catastrophic mechanical failure of tensile strength. In other words, the muscle and tendon fibers abruptly break. As a result, most people report a sudden pop or tearing sensation.

My experience was more like a series of escalating pops and tears in the split second the barbell was coming down. Whereas my rugby teammate described it as one huge pop when he tore his pec during a game.

The reason for our different experiences has to do with the muscle loading at the time of the injury. As an analogy, think of your muscle like a rope made of many smaller fibers.

Rope Breaking

Before the rope breaks, individual fibers fray. If you pull the rope with gradual tension, you might feel the fibers individually giving out as it snaps. But if you yank the rope hard, you’ll feel one big snap.

In the same way, your pec could tear in a series of little pops or one big pop. Either way, when a complete tear happens, you immediately know something isn’t right!

Torn Pectoral Muscle Symptoms

If you felt a sudden pop or tear in your armpit area, you can expect some symptoms to follow. Individual symptoms will vary, but here are the most frequently reported.

Common Symptoms Of A Torn Pectoral Muscle
  1. Sharp pain in armpit area followed by dull pain
  2. Physical deformation of the pectoralis muscle
  3. Limited range of motion, especially in the following days
  4. Bruising of outer chest, front of shoulder, and inner arm

During the actual injury, you feel severe sharp pain in the chest/shoulder. But it quickly gives way to dull aching pain. I expected it to get worse as the adrenaline wore off, but it wasn’t that bad considering the severity of the injury.

With a full rupture, you will also be able to see and feel the physical deformity of the pectoral muscle. The contour of the outer pec moves inward, leaving a space between the chest and shoulder.

Surprisingly, even with a complete tear, you will still be able to move your arm. Although you will have a limited range of motion and it will restrict more as swelling and bruising set in.

Within the first 24 hours, you will see bruising in the outer chest, front of the shoulder, and inner arm. For me, the bruising was pretty minor, just a few specs on my chest and bicep.

But a friend of mine had some epic bruises after tearing his pec while benching. Below is his post pec tear bruising compared to professional wrestler Triple H.

Images courtesy of Matthew Sonak – co-owner of Epic Interval Training @epicfairfieldcounty

Diagnosis Of A Torn Pectoral Muscle

If you have a complete rupture of the pectoral muscle, it will be pretty apparent from the symptoms. But partial tears are harder to detect. Either way, you will need a diagnosis from a medical professional in order to receive proper treatment.

When you visit your physician or urgent care, they will most likely begin with a physical examination of the affected area. And, in most cases, some sort of imaging tests will follow.

Physical Examination

This type of examination starts with the doctor or physician’s assistant asking you some questions about how the injury happened and what symptoms you have. Then they will visually inspect the area looking for asymmetries.

Next, the doctor will feel the front of your chest to assess the contour of your pectoral muscle and check for any gaps. In addition, they will test your range of motion and strength compared to the other arm.

Imaging Tests

After the physical examination, your doctor will most likely set up a test to see what’s going on inside your body. These tests could be X-ray, ultrasound, or magnetic resonance imaging (MRI).

An MRI is the best for seeing the soft tissue in specific areas. This is the test where you lay inside a tube-shaped machine that takes cross-sectional pictures of the inside of your body.

The end result is like slicing a loaf of bread and looking at individual slices. With these images, the doctor can very accurately diagnose the severity of your injury.

Torn Pectoral Muscle MRI

To the untrained eye, an MRI scan looks like a black and white bone-in steak. But doctors can see exactly what’s out of place.

Torn Pectoral Muscle Treatment

Once your doctor makes a diagnosis, they can come up with a treatment plan based on your specific injury. In some cases, you might not need surgery. But surgery is usually the better treatment option.

Non-surgical Treatment

Non-surgical treatment involves:

  • Resting the damaged muscle
  • Taking anti-inflammatory medication to reduce swelling
  • Physical therapy to recover as much range of motion as possible

However, without surgery, you will never regain full range of motion or strength. And you will always have some physical deformation of the pectoral muscle.

For this reason, non-surgical treatment is typically only recommended for people over the age of 60. Or those that don’t lead an active lifestyle where they need full mobility.

Surgical Treatment

For 95% of full pectoral tears, surgery is the best option to make a complete recovery. It’s generally suggested that surgery should occur within the first 6 weeks after the injury. But successful outcomes are possible after that.

Surgical treatment involves:

  • Outpatient surgery with general anesthesia
  • A 3-4″ incision is made where the pec meets the shoulder
  • 2-3 small holes are drilled in the upper humerus bone
  • The pectoral muscle and tendon are sutured to anchors in the bone
Torn Pectoral Muscle X-ray

This x-ray image shows the two metal anchors drilled into my upper arm bone to secure the pectoral tendon.

Torn Pectoral Muscle Recovery

After surgery, you will be sent home to rest and begin the long recovery process. The good news is, it’s all uphill from here.

Everyone’s recovery will be slightly different depending on your age, overall health, and how diligently you stick to your recovery plan. But I’ll walk you through the process and major milestones of my own torn pectoral recovery.

Torn Pectoral Muscle X-ray
Day 0

When you wake up from surgery, you’ll be in a big sling with a pad securing your arm to your body. I was also fitted with a blue shoulder cuff that had ice water running through it to help reduce swelling.

You’ll have to have someone drive you home due to the anesthesia. And it’s a good idea if they stay with you for the first 12 hours. At this stage, you’re going to be very groggy and all you’ll want to do is sleep.

Week 1

The pain immediately after surgery is much worse than the injury itself! Of course, the doctor gives you pain medication. But I stopped taking it after about 7 days when the pain was manageable. You don’t want to become reliant on pain meds.

For the first week, you pretty much rest and try not to move your arm too much so the sutures and stitches can heal. I had surgery on a Thursday and took some time off from work until the following Wednesday. By then I felt comfortable getting out of the house.

Week 2

At 10 days after surgery, I was back in the gym, which may sound crazy. But I only did very light leg exercises with my arm securely in the sling. It felt good to get my blood flowing and definitely lifted my spirits. But listen to your body and your doctors, don’t push too hard too soon.

Physical therapy started 2 weeks after surgery. In the first session, the therapist just took my arm out of the sling to test the range of motion. It was painful when he moved my arm and the range of motion was only about 60 degrees.

Torn Pectoral Muscle Rehab

A big part of the mental recovery for me was focusing on what I could control, like my diet. And I think being active (while being careful) helped speed up my physical recovery.

Week 3

In week 3, I was able to start doing isometric exercises and light band work during physical therapy. This helped to start rebuilding the strength and range of motion.

The rehab sessions continued along with at-home band work and stretching. In addition, I was doing light workouts at the gym for my lower body and left (good) side.

At 23 days after surgery, it had been 31 days since my injury. In that timeframe, I lost 20 lbs of body weight, most of which was lean mass.

Torn Pectoral Muscle Rehab

10 days before the pec tear vs 23 days after surgery. The purple stuff is the glue that holds the stitches and incision shut. Losing muscle that took years to build was one of the hardest parts of the journey for me.

Week 4-8

After 4 weeks of diligent physical therapy, my range of motion increased from 60 degrees to 120 degrees. Putting me about 2 weeks ahead of my doctor’s recovery schedule. They even let me take the huge foam pad out from behind my sling.

When I went in for my 6-week follow-up, the doctor gave me the all-clear to ditch the sling for good. Although, normally they suggest keeping the sling on for 8 weeks.

Physical therapy continued until 8 weeks after surgery. At that point, I had regained nearly full range of motion and was turned loose to continue my rehab exercises on my own.

Month 3-6

The 3 to 6 month period is when you need to be the most careful. While you can resume working out on your own, the tendon isn’t all the way healed yet. This is when about 5% of patients reinjure their pec1.

So during the first 6 months, be careful not to do any chest pressing movements or high-risk activities where your arm could be pulled abruptly. As long as you are cautious, the risk of reinjury is very low.

6 Months

After about 6 months of rest, rehab, recovery, you should be cleared to resume a full workout routine including bench press. But start very light and build your strength up gradually.

6 months is also the minimum amount of recovery time before you could return to sports like football or rugby. Of course, you should listen to your doctor and follow recommendations pertaining to your individual situation.

1 Year & Beyond

Keep in mind, the 6-month milestone is when you can get back to all your normal activities. You will still have a large degree of muscle atrophy and diminished strength in the pectoral muscle.

To get back to where you were before the injury can take a year or more. By 1 year after my injury, I had regained a good amount of size and strength. But you can see below the pec is still smaller and indented.

 
 
 
 
 
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A post shared by Fitness Coach Jeremy Fox (@jeremyfoxfitness)

Today it’s been over 3 years since my injury and I’ve built back up about 90% of the muscle size and strength. While I can still see a slight difference in size and shape, other people have no idea I tore my pec.

When I asked my orthopedic surgeon about recovery, he said I would never get the amount of chest mass I had pre-injury. I’m not there yet, but my goal is to prove him wrong!

Final Thoughts

A torn pectoral muscle is a painful and devastating injury for anyone, but especially lifters and athletes. The process of recovering physically and mentally from this kind of traumatic event can take months or even years.

Fortunately, with surgery and rehabilitation, you can make a full recovery and get back to doing what you love. The important thing is that you be your own health advocate when seeking out diagnoses and treatment options.

Find a good doctor, then make it your job to execute his or her treatment plan. And click here to learn more about the mental aspects of overcoming any serious injury.

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