Pec Repair

OVERVIEW

WHAT IS A PEC TEAR?

The pectoralis major muscle originates from multiple locations, including the costal cartilage of ribs two through six, the sternum, the medial half of the clavicle. The pectoralis major muscle divides into two muscular heads: the sternal and clavicular heads. These two muscular heads converge into a singular attachment at the humerus.

The pectoralis major muscle is responsible for adduction, internal rotation and forward flexion of the shoulder. All body builders know the bench press and flies stress the pectoralis major. With extreme force, such as bench press with heavy weight and eccentric load, the force on the pectoralis exceeds its strength and tears.

  • Pectorais tears are seed exclusively seen in males and most often occurs in weightlifters. excessive tension on a maximally eccentrically contracted muscle may be an iatrogenic injury caused during open rotator cuff repair. The training of body building puts maximally stress on the pectoralis.
  • Patients experience a sharp tearing sensationwith resisted adduction and internal rotation such as with a bench press. The shoulder becomes immediately weak. Swelling develops quickly and within a few days, bruising develops on the chest and the upper arm.
  • Alkhatib starts with performing a careful physical examination. He assesses swelling and ecchymosis. He then palpates the pectorails to determine if there is tenderness and if a defect can be appreciated. He has the patient put their hand together in front of their chest and then push together. This activates the pectoralis and often the will make a visiable deformity with the pectoralis muscle moves towards the sternum.(Figure ) The arm pit also loses its normal contour.

Alkhatib obtains an MRI useful in identifying the site and extent of the rupture to may show avulsion of the pectoralis major tendon from the humerus. . Occasoinaly, an ultrasound is used to further determine if the tear is partial and exact location. The location can be directly torn from the humerus bone, at the junction of the muscle and tendon, or in the muscle itself.

Dr. Loiy Alkhatib

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