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What Happens If The Pectoral Muscle Ruptures?

What is a Pectoral Pain?

The pectoral muscles, also known simply as pectorals, are a group of four muscles that lie paired on each side of your chest. Pectoral pain or pectoral muscle pain can happen due to various causes. Pectoral pain can restrict your arm movement and also reduce the functioning of your arm. Pectoral pain can also occur due to a pulled muscle or muscle strain. A person with a pectoral strain may experience sudden and sharp pain in the area. Here’s everything you need to know about pectoral pain.

Understanding the Pectoral Muscles

Pectorals is an umbrella term used to refer to the four muscles that lie in pairs on either side of your chest. Pectoral muscle pain can be caused by several reasons, and it often restricts your arm movements while also reducing function. It is important to be able to differentiate between chest pain that is caused by the pectoral muscles from other, more serious causes of chest pain.(1, 2)

Pectoral pain can be of different levels of severity, and some conditions can simply be treated with rest and ice packs, but others may require a complicated surgery and physical therapy.

As mentioned above, the pectoral muscles lie in pairs, the larger of the pectoral muscles are known as pectoralis major, and the smaller is known as the pectoralis minor. These muscles are located on the front of your chest.

The pectoralis major is a much larger group of muscles. It begins at the collar bone (clavicle), the breast bone (sternum), and your ribs. It is attached to the humerus, which is the large bone in the arm. Pectoralis major helps carry out many of the movements of the shoulder.(3, 4)

On the other hand, the pectoralis minor is a smaller pair of muscles that are located just under the pectoralis major. This muscle originates from the ribs and is attached to the shoulder bone (scapula). The pectoralis minor helps lend stability to the scapula when you move your arm.(5, 6)

Causes of Pectoral Pain

Most of the time, pectoral muscle pain is caused by injury, especially caused by weight exercises. The bench press is usually associated with such a type of injury. Pectoral pain tends to develop at the attachment of the pectoral muscle to the humerus and towards the front of the armpit. In some cases, a severe injury can cause a tear in the pectoralis muscle. In severe injuries, the muscle may also tear loose from the collar bone and ribs or even from the place of attachment at the arm.(7, 8, 9, 10)

Tears may either be partial or complete, and they are excruciatingly painful. Pectoral muscle tears are classified as:

  • Contusion or sprain
  • Partial tear
  • Complete rupture

Any type of direct injury can also cause pectoral pain. Heavy objects falling on the chest, taking a fall and hitting the ground on your chest, or getting injured to the pectoralis muscles while playing contact sports like American football and rugby can all cause pectoral pain. In most cases, injuries that cause pectoral pain tend to occur if you use free weights. In such type of pain, you can pinpoint exactly when the pain began.(11, 12, 13)

But what about the pectoralis minor? Can that cause pectoral pain? The pectoralis minor is located deep under the pectoralis major. This muscle, though, does not get injured by any type of direct injury. However, it can get injured due to overuse. You may experience pectoralis minor pain if you frequently participate in weight lifting or weight training, swimming, bodybuilding, or rugby. The onset of pain from pectoralis minor is usually gradual, and you won’t be able to figure out exactly when it began. You can roughly date back the pain to when you increased the intensity of your exercise or the intensity of playing a sport. The pain from pectoralis minor, though, can be severe enough to prevent you from playing sports.(14, 15)

What Happens If The Pectoral Muscle Ruptures?

One of the most severe causes of pectoral pain is a rupture of the pectoral muscle or a complete tear. Ruptures can happen at any of the two sites – either the musculotendinous junction or the location where the tendon is inserted into the bone. The musculotendinous junction is the place where the underbelly of the muscle joins up to the fibrous tendon.

Some of the common activities that can cause such type of a pectoral muscle rupture include boxing, windsurfing, weightlifting, and jiu-jitsu. Rupture of the pectoral muscle affects the pectoralis major, and it causes a sudden and sharp pain. The pain is so intense that you won’t be able to continue doing the activity you were participating in. Since the muscle has been torn loose from the humerus, it bunches up inside your chest, and you will notice swelling on your chest.(16, 17, 18)

Other Causes of Chest Pain

Chest pain does not always have to be because of pectoral or other muscle problems. It can also be related to the heart. In such a case, you should watch out for the following symptoms along with chest pain or chest discomfort:

These could be the symptoms of a heart attack, and in this case, you need to seek immediate medical assistance or call your local emergency number like 911.

These symptoms could also indicate a lung or heart disorder. It is best to consult a doctor at the earliest.

Pectoral pain is also associated with swelling over some parts of the chest, restricted arm movements or even loss of some arm movements, and some visible bruising.

Pressing or touching the area should increase the pain.

Treating Pectoral Pain

Most partial tears or strains of the pectoralis major can be managed by traditional treatment. Your doctor will put the impacted arm in a sling to give rest to the muscles.

Using pain medications and ice packs to help relieve the pain and discomfort can help. However, it usually takes at least four to six weeks for the muscle to heal. Surgery is a better option for athletes and sportspersons who take part in competitive sports so that the muscle can be restored to its best possible function.

Your doctor can usually diagnose pectoral muscle tears based on the activity you were doing when the pain began. An ultrasound can confirm rupture or tear of the pectoral muscle. In case of surgery, your surgeon will also prescribe an MRI scan to get a more detailed look at the true extent of your injury.

You will be told to reduce whatever activity you were doing that triggered pectoralis minor strains along with pain medications and rest. If the pain is severe, your doctor may administer a corticosteroid and a local anesthetic into the pectoralis minor tendon. Again, an ultrasound might be used to locate the precise placement of the injection.

Conclusion

Resistance and strength training are popular fitness activities. Experiencing pectoral muscle injuries is a common incident in such activities, especially if proper warm-up, equipment handling, and technique are not followed. In fact, free weights are known to cause nearly two-thirds of all direct injuries to the pectoral muscle. Using resistance machines for training can be a safer option.

In cases of pectoral pain, it is always better to show it to a doctor to rule out any serious causes of the pain, such as a tear or rupture.

References:

  1. Porzionato, A., Macchi, V., Stecco, C., Loukas, M., Tubbs, R.S. and De Caro, R., 2012. Surgical anatomy of the pectoral nerves and the pectoral musculature. Clinical Anatomy, 25(5), pp.559-575.
  2. Ganesan, K., Acharya, U.R., Chua, K.C., Min, L.C. and Abraham, K.T., 2013. Pectoral muscle segmentation: a review. Computer methods and programs in biomedicine, 110(1), pp.48-57.
  3. Ariyan, S., 1979. The pectoralis major myocutaneous flap. Plast Reconstr Surg, 63(1), pp.73-81.
  4. Tobin, G.R., 1985. Pectoralis major segmental anatomy and segmentally split pectoralis major flaps. Plastic and reconstructive surgery, 75(6), pp.814-824.
  5. Borstad, J.D. and Ludewig, P.M., 2006. Comparison of three stretches for the pectoralis minor muscle. Journal of shoulder and elbow surgery, 15(3), pp.324-330.
  6. Terzis, J.K., 1989. Pectoralis minor: a unique muscle for correction of facial palsy. Plastic and reconstructive surgery, 83(5), pp.767-776.
  7. Wurm, M., Imhoff, A.B. and Siebenlist, S., 2018. Surgical repair of acute pectoralis major muscle ruptures. Operative Orthopädie und Traumatologie, 30(6), pp.390-397.
  8. Hodgkinson, D.J., 1997. Chest wall implants: their use for pectus excavatum, pectoralis muscle tears, Poland’s syndrome, and muscular insufficiency. Aesthetic plastic surgery, 21(1), pp.7-15.
  9. Abat, F., Gelber, P., Monllau, J. and Sánchez-Ibáñez, J., 2014. Large tear of the pectoralis major muscle in an athlete. Results after treatment with intratissue percutaneous electrolysis (EPI®). J Sports Med Doping Stud, 4(2).
  10. Rijnberg, W.J. and Van Linge, B., 1993. Rupture of the pectoralis major muscle in body-builders. Archives of orthopaedic and trauma surgery, 112(2), pp.104-105.
  11. Petilon, J., Carr, D.R., Sekiya, J.K. and Unger, D.V., 2005. Pectoralis major muscle injuries: evaluation and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 13(1), pp.59-68.
  12. Wolfe, S.W., Wickiewicz, T.L. and Cavanaugh, J.T., 1992. Ruptures of the pectoralis major muscle: an anatomic and clinical analysis. The American Journal of Sports Medicine, 20(5), pp.587-593.
  13. Kretzler, H.H. and Richardson, A.B., 1989. Rupture of the pectoralis major muscle. The American Journal of Sports Medicine, 17(4), pp.453-458.
  14. Morais, N. and Cruz, J., 2016. The pectoralis minor muscle and shoulder movement-related impairments and pain: Rationale, assessment and management. Physical Therapy in Sport, 17, pp.1-13.
  15. Gutiérrez-Espinoza, H., Araya-Quintanilla, F., Gutiérrez-Monclus, R., Ríos-Riquelme, M., Álvarez-Bueno, C., Martínez-Vizcaino, V. and Cavero-Redondo, I., 2019. Does pectoralis minor stretching provide additional benefit over an exercise program in participants with subacromial pain syndrome? A randomized controlled trial. Musculoskeletal Science and Practice, 44, p.102052.
  16. Dunkelman, N.R., Collier, F., Rook, J.L., Nagler, W. and Brennan, M.J., 1994. Pectoralis major muscle rupture in windsurfing. Archives of physical medicine and rehabilitation, 75(7), pp.819-821.
  17. Kretzler, H.H. and Richardson, A.B., 1989. Rupture of the pectoralis major muscle. The American Journal of Sports Medicine, 17(4), pp.453-458.
  18. de Castro Pochini, A., Ejnisman, B., Andreoli, C.V., Monteiro, G.C., Silva, A.C., Cohen, M. and Albertoni, W.M., 2010. Pectoralis major muscle rupture in athletes: a prospective study. The American journal of sports medicine, 38(1), pp.92-98.
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:June 30, 2022

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