Pectoralis Major Tear


Firstly, I am not a doctor or qualified in a medical profession in any way, I am just documenting my personal experiences with this particular injury.

Staying physically active plays a large role in my day-to-day routine. While I love to cut code and experiment with technology, it doesnt help me towards keeping a physically healthy body. To balance this, I mainly participate in solo sports (jogging and resistance training in the gym), this way I can exercise when I want, and how I want.

Per week, my routine generally comprises of about 25Km of real jogging (i.e. not using a machine) and 10 hours in the gym doing resistance training. Through various protein supplements and heavy resistance training I have been consistently bulking up over the last 18 months (I am fairly lean, 188cm tall and currently weight about 100KG).

In late April (24th) 2008 I went to gym planning to rip through my usual chest/shoulder program. It was about 9:00PM and the gym was basically empty, perfect! When it came to use the bench press, my right-shoulder had throbbing sensation (imagine a tooth-ache only across the front of your shoulder). This had started a few weeks prior when I played some casual indoor cricket with some colleagues from work, something I hadnt done for years. The wrenching/stretching of bowling was too much for my muscle bound shoulder, not like when I was younger.

As this throbbing sensation had been causing me to now skip several workouts already, I brushed it off thinking I could tough this one out. I got through the first light warm-up set, and the intensity of the throbbing got worse. Frustrated at my “weak” throbbing shoulder, I proceeded with my second set with full weight. When it came to lower the third rep the throbbing on the side of my armpit suddenly turned into a sharp intense pain, which was followed by a popping/tearing sensation. Still load bearing the shoulder just slumped backwards in the same way a dislocation would, getting a fully loaded barbell off me with just my left arm was nasty to say the least. Although I didn’t realise at the time, I had just torn/ripped/ruptured my right chest muscle (aka the “pec” or “pectoral” or “pectoralis major”).

To summarise the remainder of my experience so far, within the first-week my right bicep got very black and blue (with no pain) and my right chest/armpit/shoulder region felt very tight. Two weeks out from the injury the pectoral chest was still very swollen and the bicep still badly bruised, I didnt however feel much pain at all. Although not painful, it felt like I was missing a chunk of muscle around my armpit, a really strange feeling. Pressing the palms of my hands together with my arms fully extended out in front of me (pec-fly motion) really highlighted the problem, I no longer had any power with this motion, as there was no muscle.

I visited three separate doctors (general practitioners) within the first week and got varying results…from pain killer scripts to physiotherapy referrals. One gave me a referral to get some ultrasound imaging done. These confirmed a 35mm tear of the pectoralis major. Concerned I “googled” for others experiences (try searching “pectoral tear” or “pectoral rupture”), there are some useful resources out there. Some claim that MRI (Magnetic Resonance Imaging) is the most effective way of diagnosing this injury as the large amount of swelling that occurs with this injury can make ultrasound work very difficult.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2267574

http://www.thedisabledlist.com/bertrand-berry-treat-torn-pectoral-muscle

http://www.carletonsportsmed.com/chronic_tear_of_the_pectoralis_m.htm

The online research consistency indicated one thing, that early surgery is the only possible solution to a full recovery. While shocked to read this, I knew how serious the injury was from the large tearing sensation I had felt. Armed with this newly acquired knowledge I now knew what had to be done, surgery, and fast. General doctor’s (aka GP’s) have a tough job, they are expected to accurately diagnose a vast array of possible injuries and illnesses. As this particular injury is uncommon, be prepared for your GP to be a little off the ball with this one. As my family doctor had a one week backlog before he could see me, I went to the nearest first-in-first-out public medical centre and saw the first possible doctor available. I gave him the ultrasounds, and told him I wanted to see an orthopaedic surgeon ASAP. I rang the surgeon I was referred to, only to find that he was unable to work on this particular injury. Great, all that for nothing. To cut a long story short over the next week, I saw several more GP’s and got as many orthopaedic surgeon contacts and referrals as I could. I found most had backlogs of patients weeks/months long. I eventually located a private orthopaedic surgeon that was able to see me within two days. In Australia this process is extremely frustrating, costly and time consuming. My advice, be persistent and dont give up.

I was very lucky, the orthopaedic surgeon not only had a solid understanding of the injury and how to repair it, but had done several of them over her career. Within two days, the surgery was complete. As I type this post with just my left hand, my right arm is in a sling, and I have new 12cm incision running from the front of my right-hand shoulder down to the top of my bicep where the pectoral muscle was reconnected. Event timeline:

Timeline of Events

I tore my pectoral on the 24th of April 2008 and had the surgery done on the 5th of May. So there was an 11 day period between the actual injury and the surgery. 6 weeks out from my surgery I have had two post-op visits, and can personally confirm that the results (so far) have been amazing. I am positive that I will have a 100+% recovery.

At my 6-week post-operation I got the all clear to take the sling off. Although my shoulder/chest/arm muscles have badly deteriorated, most (85%) of my arm motion is now free without any pain. The pectoral muscle feels tight (like a piece of string), but like it is in tact once again, i.e. it stretches over the armpit to the shoulder once again. Three weeks ago I commenced a rehabilitation program with a physiotherapist. My orthopaedic has advised me that in another 4–5 months I can probably return to light shoulder/chest weight training.

So far the whole ordeal has cost me around AU$5,000. To be honest I would have paid anything to get it fixed, so I considered this to be cheap.