Pec Major Rupture

Pectoralis major ruptures are relatively uncommon but the incidence is increasing slowly. They generally occur in weight lifters (bench press) and contact sports sportspeople (predominantly men).

The pectoralis major muscles (“pecs”) are large and powerful muscles on the chest wall that attach to the upper arm. When torn patients often describe a tear or pop at the front of the shoulder associated with bruising in the armpit and loss of contour of the axilla (arm pit) and “drooping” of the nipple. Asymmetry is often obvious.

The diagnosis is usually clinical (on examination alone), but an MRI scan will determine whether the tendon has torn from the bone (most common) or at muscle junction.

Non-surgical treatment is reserved for less active, older patients as surgical repair yields good results in terms of both cosmesis and regaining strength. The tendon is reattached using “buttons” placed into the bone of the upper arm through a small incision at the front of the shoulder. Ideally repair should be performed in the first few weeks from injury but can be performed later.