Understanding Pectoral Strains or a Rupture: Causes & Treatment

By Ehren Allen, Certified Manual Therapist/Physical Therapist

Pectoral Rupture or Pec Tear

Pectoral strain and rupture are common injuries that can impact both the general public and weightlifters. These injuries involve the pectoral muscles, located in the chest, being overstretched or torn. By understanding the causes, symptoms, treatments, and recovery process, individuals can better manage these injuries and reduce the risk of them happening again.

What is the Pectoralis?

The Pectoralis major is a large muscle in the front of the chest.  There is one on each side and it attaches to and sternum, ribs, and collar bone (clavicle).  The other end of the muscle attaches to the arm near the shoulder.  The pectoralis majors are common muscles to strengthen in the gym.  These muscles are worked with bench press and push-ups (as well as many other exercises).  The pectoralis majors are a focus for many bodybuilders and with folks working on general fitness.

The pectoralis minor is a smaller muscle that helps to connect the shoulder blade (scapula) to the front of the rib cage.  It helps to pull the shoulder blade forward.  It is less common injury than the pectoralis major.

What Causes Pectoral Strain and Rupture?

Pectoral strain and rupture can happen because of several factors. A strain is where just some of the muscle fibers are injured or torn.  A rupture is where the muscle pulls away from the attachment and is a much more serious injury.  Knowing these causes can help prevent these injuries and aid in a proper recovery. Here are the usual culprits:

1. Overdoing it or Repetitive Strain: Repetitive activities that put a strain on the pectoral muscles, like continuous weightlifting or sports movements, can lead to a strain or even rupture over time. The continuous stress on the muscles without sufficient rest can result in injury.

2. Sudden Forceful Movements: Unexpected and powerful movements, like lifting heavy objects without the right technique, can put too much strain on the pectoral muscles. This sudden overload can force the muscles to stretch beyond their limit, causing a strain or even a rupture.

3. Inadequate Warm-up or Stretching: Neglecting to warm up correctly before physical activities can increase the risk of pectoral muscle injuries. Without the right warm-up and stretching, the muscles may not be ready for the stress put on them, making them more susceptible to strain or rupture.

4. Muscle Imbalances: Muscle imbalances, where some muscles are stronger or tighter than others, can contribute to pectoral strain or rupture. When the pectoral muscles and the opposing muscles are imbalanced, the strain on the pectoral muscles can increase, making them more prone to injury.

By recognizing these causes, individuals can take suitable precautions to minimize the risk of pectoral strain and rupture. It’s crucial to listen to your body, maintain a balanced workout routine, and consult with a healthcare professional or a physical therapist for advice on injury prevention and rehabilitation.

What Do I Do with a Torn Chest Muscle? 

The first thing to do is to apply ice to the area where the muscle is painful or injured.  If all movements of the shoulder or arm on the injured side are painful, use a shoulder sling.  It is important to get evaluated by an orthopedic physician as soon as possible.  If you feel you have ruptured the pectoral muscle, you should seek immediate care.

What are the Symptoms of a Tear to the Pectoral Muscle?

A pectoralis tear can vary in the level of pain.  Typically, a torn pectoralis very painful.  There can be severe bruising in the chest, shoulder, and arm.  There may be a gap in the muscle tissue visible with a pectoral tear.

Using or lifting the arm on the side of the torn pectoral would likely be painful and weak.  There may also be swelling in the chest region and shoulder with severe soreness.

Identifying Pectoral Strain and Rupture: Symptoms and Diagnosis

There are several key symptoms and ways to diagnose pectoral strain or rupture. Understanding these symptoms and diagnostic procedures can help in effective treatment and recovery.

Common signs of a pectoral strain or rupture are pain and tenderness in the chest area. Individuals may feel discomfort, soreness, or a sharp pain in the affected region. This pain can get worse with movement or activities that engage the pectoral muscles.

Another symptom to look out for is swelling and bruising. When the pectoral muscles are strained or ruptured, inflammation can occur, leading to localized swelling. In some cases, there might also be bruising in and around the affected area.

Individuals with a pectoral strain or rupture may also experience a limited range of motion. This can show up as difficulty in performing certain movements or feeling a tightness in the chest muscles. It’s important to avoid activities that cause pain or worsen the limited range of motion to prevent further damage.

Diagnosing a pectoral strain or rupture typically involves a physical exam and imaging tests. During the exam, a healthcare professional will check the affected area for signs of muscle weakness, pain, or deformity. Imaging tests like X-rays, MRIs, or ultrasounds may be recommended to confirm the diagnosis and evaluate the extent of the injury.

Can a Pec Tear or Rupture of the Pectoral Muscle Heal on its Own?

The quick answer is a mild and partial tear of the pectoralis major may be able to heal on their own over time.  Physical therapy is typically recommended to limit scar tissue and flexibility issues.  Ice and stretching may be helpful for the first few weeks.  Progressive strength training is typically part of physical therapy as the swelling and pain decrease.

If there is a complete tear of the tendon away from the bone, surgical repair is typically necessary.

Treating Pectoral Strain and Rupture

There are several treatment options for a pectoral strain or rupture that can aid in healing and relieve pain. The choice of treatment depends on the severity of the injury and the individual’s specific circumstances. Here are some common treatment options:

Rest, ice, compression, and elevation (RICE): This initial treatment approach is often recommended for mild to moderate pectoral strains or ruptures. Resting the affected area, using ice packs to reduce swelling, applying compression bandages, and elevating the arm can help alleviate pain and promote healing.

Physical therapy exercises: Once the initial pain and swelling subside, a physical therapy program may be recommended to restore strength and flexibility to the pectoral muscles. These exercises are designed to gradually increase range of motion and improve muscle function.

Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter pain relievers like ibuprofen or naproxen sodium can help reduce pain and inflammation associated with pectoral strains or ruptures. However, it’s important to consult a healthcare professional before taking any medication.

Surgery for severe cases: In severe cases where conservative treatments don’t provide relief or if the pectoral muscle is completely ruptured, surgery may be necessary. The surgeon will assess the extent of the injury and determine the most appropriate surgical technique to repair the muscle.  The physical therapy after the surgery is also crucial to a good outcome.

Remember, each person’s treatment plan may vary, and it’s crucial to consult with a healthcare professional to determine the best course of action for your specific condition.

How long does it take to recover from a Torn Pec?

The healing and rehab process can take anywhere from 6 months to a year after a surgical pectoralis repair.  The first part of the rehab process consists of managing the pain and swelling and initiating a range of motion in the shoulder and arm.  Light strength training usually begins about 2 to 3 months after surgery.  It can take up to a year to regain normal strength in the repaired pectoralis major.

Recovering from a pectoral strain or rupture requires a carefully planned rehabilitation timeline to ensure proper healing and prevent further injury. Here are some key aspects to consider:

Recovery

Rehabilitation Timeline: The timeline for rehabilitation can vary depending on the severity of the injury. Generally, it takes a few weeks to several months for a pectoral strain to completely heal. It’s important to follow the guidance of your physician or physical therapist to determine the appropriate duration of your rehabilitation program.

Gradual Return to Activities: Getting back to activities too quickly can lead to re-injury or complications. It’s important to slowly increase your level of activity, starting with low-impact exercises and gradually progressing to more strenuous activities. This step-by-step approach allows the injured muscles to rebuild strength and flexibility.

Proper Warm-Up and Stretching Techniques: Before participating in any physical activity, it’s essential to warm up your muscles and perform stretching exercises. This helps increase blood flow, improve muscle elasticity, and reduce the risk of injury. Incorporate dynamic stretches that target the pectoral muscles when you have been cleared by your physician.

Strength and Flexibility Exercises for Prevention: Building strength and flexibility in the pectoral muscles can help prevent future strains or ruptures. In the late stages or your rehab, you can start exercises like push-ups, chest presses, and dumbbell exercises into your workout routine. Also, include exercises that target the surrounding muscles, like the shoulders and upper back, to maintain overall muscle balance and stability.

If there is no surgical repair, the length of recovery depends on the severity.  As with all muscle and tendon strains, managing inflammation and beginning early mobility are important.  Strengthening typically begins when pain and acute inflammation have decreased.

What does a Torn Pec feel like?

A mild pec strain can feel like a sharp pain or a pulling or tearing sensation in the pectoral muscle.  A severe tear or rupture is commonly described as the worst pain imaginable.  There is a spectrum of severity though.

Most pectoralis tears occur with traumatic movement of the arm backward or with weightlifting too much with the bench press.  Prolonged anabolic steroid use can weaken connective tissue and increase to the risk of tearing a muscle or tendon such as the pectoralis major.

Related Shoulder Articles:

• What is a Pectoral Strain
• Muscles in The Chest
• Types of shoulder surgery
• Rotator cuff exercises

JOI and JOI Rehab

We hope that this article was helpful for you.  If you think you have a pectoral strain or rupture, we are here to help.  Our JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.

You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.

To make appointments with JOI Rehab, please call 904-858-7045.

Author: Kathryn Trumble, DPT, ATC