A muscle strain is a condition wherein there is a partial or complete tearing of the muscle. It can occur anywhere in the body but it commonly occur in the pectoral muscle .
The pectoral muscle is the muscle group that is found at the front of the chest. Pectoralis major is the largest of these muscles and originates from the breastbone, ribs and collarbone. This muscle attaches to the humerus or the upper arm bone. They are responsible for shoulder and hand movements so they are essential for activities of daily living. These muscles are important in activities such as lifting heavy objects and driving. Figure 1 shows the pectoralis major [1, 2].
Torn Pectoral Muscle
The pectoralis major can rupture while doing forceful activities and this commonly occur in males between the ages of 20 to 50. There are 4 different types of pectoral muscle tear and they differ depending on the degree of the damage [1, 3]:
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- Type 1: Tendon is ruptured from the upper arm bone insertion
- Type 2: Rupture occurs between the tendon and the muscle
- Type 3: Rupture is in the muscle itself
- Type 4: Pectoral muscle is torn from the breast bone
Causes of Torn Pectoral Muscle
The primary cause of the muscle strain is a force that overwhelms the muscle. This can be obtained through weight training especially in performing chest press or bench press using free weights. The muscle strain can also occur as a result of gradual weakening and degeneration. This puts the individual at higher risk for injury [2, 3].
Signs and Symptoms of Torn Pectoral Muscle
Pain is the first symptom that will be experience by the individual during the activity that caused the tear of the muscle. If the tear is only minor, the activity can still be performed but with increased pain and stiffness upon resting.
Torn Pectoral Muscle (minor)
A severe tear will cause a disabling pain that may prevent continuing with the activity. The aching pain that is felt may be localized to the chest area but may radiate to the upper arm area [1, 4].
Other symptoms that may be experienced may include tenderness in the chest area, bruising, muscle spasm, swelling and weakness. In severe cases, there may be muscle wasting and a noticeable deformity may be noticed on the location of the muscle tear [1, 4].
Diagnosis of Torn Pectoral Muscle
Health History and Physical Examination
The medical history will focus on the event that have caused the injury and the pain that is being experienced needs to be characterized further. Physical examination will start with the visual inspection of the chest area. There may be a difference that will be seen between the appearance of the injured and non-injured side. The physician will also perform some actions such as internally rotating the arm and pulling it to the side to assess the pain and the decrease in muscle mass that will occur with the movement .
Magnetic Resonance Imaging (MRI) and ultrasounds are very beneficial in providing a visualization of the injury so these tests are performed to confirm the diagnosis of a torn pectoral muscle .
Treatment of Torn Pectoral Muscle
R. I. C. E.
The RICE technique should be done for the first 2 days. RICE stands for rest, ice, compression and elevation. Ice packs may be applied for 10-15 minutes every hour with the frequency decreasing as the symptoms resolve .
A surgical procedure is usually advised to repair the torn pectoral muscle in order to the full strength of the muscle. The procedure is contraindicated to those who have a partial rupture of the tendon, damage occurred in the center of the muscle and elderly patients. In this procedure, an incision will be placed in between the pectoralis major muscle and the shoulder. After this, the tendon will be re-attached using different techniques. If the damage to the muscle is severe, there may be a need to perform a tendon transplant to complete the repair process .
After undergoing the procedure, the patient is advised to wear a sling for about 3-6 weeks. Assisted active and passive exercises will be done over the next few months and partial weight lifting will be allowed during the fourth month. They will be able to return to their usual activities after 6 months .
- Physio Advisor. (2014). Pectoral Strain. Retrieved from Physio Advisor: http://www.physioadvisor.com.au/14703550/pectoral-strain-torn-pectoral-physioadvisor.htm
- Sports Injury Clinic. (2013). Pec Major Tendon Strain (Rupture). Retrieved from Sports Injury Clinic: http://www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/pec-major-tendon-strain
- Pec Tear. (2015). Pectoralis major rupture. Retrieved from Pec Tear: http://www.pectear.com/pectears/pectear.htm
- MD Health. (2015). Pulled Chest Muscles. Retrieved from MD Health: http://www.md-health.com/Pulled-Chest-Muscle.html
- Kohen, R. (2011, January 10). Pectoralis Major Tendon Injury: An Overview. Retrieved from HSS: https://www.hss.edu/conditions_pectoralis-major-tendon-injury-overview.asp