Pectoral Strain

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By: Justin Carmel, PT, DPT

What is a Pectoral Strain?

A pectoral strain is a tear in the major muscle across the front aspect of the chest, commonly known as the “pec”. A pectoral strain can include a small tear muscle belly or tendon attachment area, or it could be a large full thickness tear, also known as a complete rupture. 

Pectoral Strains can be classified as 1 of 3 Grades. Grades are based upon the total quantity of muscle fibers torn and the overall function that has been lost. Grade 3 tears indicate the most severe type of tear. The vast majority of tears are typically Grade 2 tears. A muscle strain is the most common muscle injury that occurs to the human body. Read our article about the various types of muscle strains.

Anatomy Of A Pectoral Strain or Chest Muscle

The pectoral muscle or chest muscle, also known as Pectoralis major, is a large fan-shaped muscle on the chest wall. The pectoral muscle contains two specific heads: a clavicular head, which arises from the collarbone and a sternal head, which arises from the sternum, the vertical bone the is in the middle of the chest. Both the sternal head and clavicular head merge together to attach to the upper part of the humerus, which is your upper arm bone.  To learn more, please read muscles in the chest. 

Pectoral Muscles Pecs Chest musclesPectoral Anatomy

The primary function of the Pectoral muscle is to move the arm across your body. It also helps rotate the arm inwards. A typical bench press or push-up movement would be a good example of the two muscles working together.

Click to watch this VIDEO about Muscle Strains.

How Does A Pectoral Strain Happen?

A Pectoralis major strain typically occurs when pushing a heavy object away from your chest. This can occur during weight training when performing bench press exercises. During the bench press, large forces the muscle is required to generate to lift and lower the bar, combined with an overstretching of the muscle, can place too much stress on the Pectoralis major. This can cause the Pectoralis major muscle to tear.

Bench Press Pectoral TearPectoral Strain

How Do You Know You Have Pectoral Strain?

Some telltale signs of a pectoral strain include:

  • bruising
  • swelling in the upper chest/shoulder region
  • disfigurement of the upper arm and chest. 

More often than not an individual with a pectoral strain will experience immediate pain and loss of strength when pushing with the involved upper extremity. For the most part the pain will be localized to the chest and the front portion of the shoulder. Sometimes there will be discomfort in the armpit, but the pain can also radiate into the upper arm and neck as well.

How Do You Treat Or Fix A Pectoral Strain?

Generally, treatment for a pectoral strain depends on the severity of the tear. Often times, low-grade tears involving the muscle only can be treated with physical therapy. Although, high grade-tears will often need to be repaired with surgery if the tendon attachment is completely torn. Typically, surgeons will place sutures in the Pectoralis tendon attachment and anchor these sutures through holes in the bone. In most cases, surgery is more successful if it is performed within the first few weeks of the initial injury. When surgery is delayed, it can be more difficult due to scar tissue and wasting of the muscle.

When Should You Go To The Doctor For a Pectoral Strain?

Typically, more severe pectoral strains present with sudden pain in the chest wall and many individuals will describe a tearing sensation. Some other common symptoms of a more serious pectoral strains include an audible pop or rip, immediate swelling and bruising sometimes extending to the upper arm and into the elbow, weakness in pushing the arms out in front of the body, and a dimple or abnormal contour of the chest wall muscle just above the armpit. 

When medical professionals examine someone who has a suspected pectoralis muscle tear, they look to compare the affected side to the other side looking for asymmetry. A torn pec muscle may be more serious than initially thought, especially if the tear involves the tendon attachment. It is crucial that high-grade pectoral muscle tears are diagnosed as early as possible if they require surgery. If the surgery is delayed, the muscle may retract making surgery considerably more difficult.

How Do You Prevent A Pectoral Strain?

Over time, repetitive pushing activities may cause the tendons of the pectoral muscle to degenerate, thus resulting in a strain. Additionally, muscle imbalances, weakness, excessive tightness, and abnormal biomechanics, especially when combined with excessive training, can also contribute to the development of a pectoral strain. 

Pecs Chest musclePect Strain

On the other hand, more acute strains or tears to the Pectoralis muscle happen when an external force goes directly through the muscle and tendon that is greater than they are able to withstand. This often occurs with weight training, especially when performing a bench press, chest press, or pectoral fly, and is more likely to happen when using free weights than machines. Furthermore, some basic things that can be done to prevent a pectoral strain, include warming up properly, gradually increasing weight or resistance, making sure to train the upper back muscles frequently, and alternating with BW exercises, machines, and free weights.

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If you have a pectoral strain or any other injury, the Jacksonville Orthopaedic Institute can help. To schedule an appointment with a JOI Orthopedic and Sports Medicine Doctor, call (904)JOI-2000schedule online, or click the link below. To see a JOI Rehab Physical Therapist in 1 of our 12 locations, call (904)858-7045.