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Pectoralis Major Tendon Rupture, Sports Medicine

Jeremy Schmitz, MD, ABFM and Kenneth P. Barnes, MD, MSc, CAQSM, FACSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Most commonly refers to complete avulsion of the pectoralis tendon at the humeral insertion 1

  • Ruptures at the myotendinous junction, muscle belly, or bony avulsion are possible but le...

DIAGNOSIS

HISTORY

  • Men 20 to 40 yr of age 4

  • Usually report a pop or tearing in the shoulder 4

  • Complain of pain/weakness in chest or shoulder 3

PHYSICAL EXAM

  • Swelling and ecchymosis in anterior shoulder/ches...

TREATMENT

  • Acute treatment:

    • Analgesics

    • Ice

    • Sling immobilization

  • Long-term care:

    • Tear type, patient age, activity level, and cosmetic desires determine care 4[A].

    • Most partial tears, sternoclavicular tears, a...

ONGOING CARE

  • Nonsurgical treatment:

    • Begin shoulder mobilization and gentle stretching/strengthening when tolerated 4[A].

    • Advance to resisted strengthening exercises at 6 to 8 wk postinjury 4[A].

    • Unrestri...

REFERENCES

1
Chiavaras MM, Jacobson JA, Smith J, et al. Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging. Skeletal Radiol.  2015;44(2):157–164.
2
Hasegaw...

CLINICAL PEARLS

  • Usually a complete avulsion of pectoralis major tendon at humerus

  • Most commonly occurs during weight lifting; specifically bench press

  • Patients may report a pop and present with swelling...

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