What it Effects

• The Pec Major muscle on the chest wall
• The rupture can be musculotendinous (the point where the muscle becomes a tendon) or the muscle can avulse from its bony attachment (the tendon comes away from the bone)

Who it Effects

• Common in bodybuilders who use anabolic steroids
• Young male athletes

Mechanism of Injury

• Varies but is normally when the muscle is under a lot of tension or excessively stretched
• For example, I have seen this injury in someone who was mugged whose arm was forced back. The person had a lot of musculature around the shoulders so the first thing to go was Pec Major which ruptured completely due to being excessively stretched
• Bench press

Signs and Symptoms

• Popping/snapping sensation at point of rupture
• Immediate pain
• Pain radiating into shoulder and upper arm
• Overactive bulge of muscle on chest wall especially if there a few muscle fibres still intact
• Palpable muscle deformity
• Pain increased on arm movements
• Muscle weakness- on adduction, flexion and medial rotation of the arm
• Bruising (ecchymosis) of the anterior chest wall, axilla, and medial aspect of the arm near the insertion of Pec Major
• Swelling

Treatment

• PRICE
• Surgery

Additional Information

• This injury is extremely rare, most commonly being sustained during a bench press

If you have any questions, please use the comment form below or post a thread on the forums.