Dominic Stone
An injury to the pectoralis major muscle can result in a lump in the armpit or chest. This is caused by the bunching of the pectoralis muscle. The pectoralis major muscle is a powerful chest muscle that causes the arm to move forward, rotate inward, and move closer to the body. The injury is usually caused by activities that involve a large amount of force, such as bench-press exercises during weightlifting, and can also occur in other high-impact sports such as wrestling, rugby, or American football.
| Characteristics | Values |
|---|---|
| Cause of injury | Activities involving a large amount of force, such as bench press exercises during weightlifting, or other high-impact sports like wrestling, rugby, or American football |
| Occurrence | Fairly uncommon, mostly affecting men aged between 20 and 50, particularly those who use steroids |
| Symptoms | Sudden severe pain in the chest or upper arm, weakness, bruising, swelling, difficulty moving the arm, a tearing sensation, a popping sound, a change in the contour of the upper arm and armpit, and a lump in the armpit or chest caused by bunching of the pectoralis muscle |
| Treatment | Depending on the severity and location of the rupture, treatment options include surgery, immobilization in a sling, passive and active exercises, and light weightlifting after several months |
| Recovery | It can take at least six months to recover from a pectoralis major rupture and around a year for full strength to return; minor tears usually heal within a few weeks |
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What You'll Learn
Pectoralis major rupture
A pectoralis major rupture involves either a partial or total tear of the muscle or tendon. It is a rare injury that occurs when there is tearing of the pectoralis major muscle due to excessive tension on a maximally contracted muscle or as a result of direct trauma. The pectoralis major is a large, powerful chest muscle that contributes significant strength to the upper arm, enabling it to move forward, rotate inward and move closer to the body.
The rupture typically occurs in males between the ages of 20 and 40, specifically those who engage in weightlifting, particularly the bench press. It has also been associated with anabolic steroid use, as steroids strengthen the muscle disproportionately to the tendon. Other high-impact sports that can cause this injury include wrestling, rugby, martial arts, gymnastics, and American football.
The first sensation felt when the pectoralis major muscle is torn is sudden pain in the chest or armpit, often accompanied by a tearing or “popping” sensation. There may also be visible changes in the contour of the upper arm and armpit, with swelling and bruising in the affected areas. The injury can often be identified through a physical examination by a sports medicine physician, and imaging tests such as an MRI scan or ultrasound may be used to confirm the diagnosis and determine the extent of the tear.
Treatment for a pectoralis major rupture depends on the severity and location of the injury, as well as the patient's activity level and daily living needs. Nonsurgical treatment options focus on relieving pain and maintaining arm function, but patients treated without surgery will have a permanent strength deficit and cosmetic changes. Surgical repair involves reattaching the tendon to the bone through various techniques, and it can take at least six months to recover, with a return to competitive activity around this timeframe.
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Symptoms of a torn pectoral muscle
A torn pectoral muscle, or pectoralis major injury, is a rare condition that is becoming an increasingly common cause of disability. It can occur due to various reasons, including acute traumatic events or chronic overuse. The pectoral muscles are the pectoralis major and the pectoralis minor, which are the larger and smaller muscles of the chest, respectively.
Minor tears may allow for continued activity with minimal hindrance, but pain and muscle stiffness may increase as the muscle cools down. In contrast, more severe tears can cause excessive pain, muscle tightness, weakness, and spasms, making it impossible to continue the activity.
If you suspect a torn pectoral muscle, it is essential to stop the activity immediately to prevent further injury and excessive bleeding. Applying ice and consulting a sports medicine professional or a doctor as soon as possible is advisable. They may recommend rest, pain medication, physical therapy, or, in severe cases, surgery to repair the torn tendon or muscle.
The treatment for a torn pectoral muscle depends on the extent of the injury and the patient's health. Minor tears may heal with conservative management, while complete tears may require surgery, especially in younger and athletic individuals. Recovery from a torn pectoral muscle can take several months, and full strength may not return for up to a year.
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Treatment and recovery
If you suspect you have a pectoral muscle injury, it is important to cease the activity immediately and consult a sports medicine professional as soon as possible, ideally within the first couple of days. Quick treatment with a cold compress or ice pack can help prevent further injury and reduce pain and swelling. In the first few days, it is important to avoid activities that increase blood flow to the injured muscle, such as hot showers, heat rubs, and massage.
Minor injuries may be treated with rest and physical therapy. Severe inflammation and swelling can be reduced with treatments such as Circulation Boost, which increases blood flow to the injured area, nourishing injured soft tissue and speeding up healing. Once the inflammation has been reduced, it is recommended to nourish and strengthen the pectoral tissue and surrounding area. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.
For complete tears of the muscle, surgery is often required to reunite the torn ends of the muscle. Depending on the location of the rupture, different surgical procedures may be possible. If the tendon has torn off the bone, open surgery may be performed to place sutures into the bone and reattach the tendon. Recovery after surgery typically involves sling use, gradual rehab, and a return to full activity within about six months. It can take at least six months to recover from a repaired pectoralis major rupture and around a year before full strength returns.
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Causes of pectoral muscle tears
Pectoralis major tears are relatively rare but can cause serious disability. They are most common among young, physically active men between the ages of 20 and 40, especially athletes and weightlifters. The pectoralis major is a powerful chest muscle that causes the arm to move forward, rotate inward and move closer to the body.
Pectoralis major tears often occur during eccentric muscle contractions, particularly during activities that require a lot of force, such as bench pressing or weightlifting. Other common causes include contact sports, such as wrestling, rugby, and American football, as well as direct trauma from accidents. The injury typically occurs when the muscle contracts while stretching out, resulting in a rupture of the pectoralis major tendon or "pec tear". This usually happens when the arm is extended and externally rotated, with the weight forcing down on the chest muscles, causing a tear or, in severe cases, a snapped tendon.
Anabolic steroid use, particularly prolonged use, can also increase the risk of pectoralis major tears by weakening the tendon and connective tissue. However, it is important to note that this injury can occur even without steroid use. Additionally, the risk of injury can be mitigated by building strength and flexibility in the pectoral muscles through exercises such as push-ups, chest presses, and dumbbell exercises.
The treatment for a pectoralis major tear depends on the severity and location of the injury, as well as the patient's health. Minor tears may heal on their own over time with rest, ice, compression, and pain medications. Physical therapy is often recommended to limit scar tissue formation and improve flexibility. For complete tears, especially in younger and athletic patients, surgery is usually required to restore function. The ruptured tendon is repaired back to its original location on the upper arm, and the patient is immobilized in a sling for several weeks before gradually reintroducing active exercises.
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Lump characteristics and diagnosis
A pectoralis major rupture can result from activities that involve a large amount of force, such as bench-press exercises during weightlifting, or high-impact sports like wrestling, rugby, or American football. It can also be caused by severe trauma or accidents. The pectoralis major muscle and its tendon, which attaches to the upper arm bone, can become partially or totally torn. This can result in a sudden onset of pain in the chest and upper arm, along with bruising and weakness.
Following a pectoralis major injury, it is important to cease the activity immediately to limit the severity of the injury. Icing the injured area can help control swelling and prevent further damage to the pectoralis muscle. A sports medicine professional should be consulted as soon as possible, ideally within the first couple of days.
Lump characteristics:
- A pectoralis major rupture may cause a lump in the armpit or chest due to the bunching of the pectoralis muscle.
- Lumps caused by an injured pectoral muscle are typically firm, smooth, and movable.
- They may be painful if pressing on a nerve or growing around blood vessels.
- Lumps associated with an injury are typically benign and harmless.
Diagnosis:
- A physical examination by a sports medicine physician or consultant is often the first step in diagnosing a pectoralis major injury.
- Ultrasound or MRI scans can be used to determine the presence and extent of the injury, including whether it is a partial or complete tear and its location in the tendon or muscle.
- Grading the injury properly is important to determine the appropriate treatment.
- In some cases, a physical examination may be sufficient to diagnose a lump, while a medical history and examination are typically relied upon for diagnosing muscle strains.
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Frequently asked questions
Yes, an injured pectoral muscle can cause a lump. This is due to the bunching of the pectoralis muscle, which can be identified through a physical examination.
Symptoms of a pectoralis major injury include sudden pain in the chest or upper arm, bruising, weakness, and visible changes in the arm or armpit.
A pectoralis major injury is caused by a tear in the pectoralis major muscle and its tendon. This can be due to activities that involve a large amount of force, such as weightlifting or high-impact sports such as wrestling, rugby, or American football.
The treatment for a pectoralis major injury depends on the severity and location of the rupture. In some cases, surgery may be required to repair the tendon or muscle. After surgery, patients are usually immobilized in a sling for 4-6 weeks and gradual exercises are introduced over several months.
To manage pain and swelling, it is recommended to apply ice to the affected area and rest the muscle. It is important to cease the activity that caused the injury and consult a sports medicine professional as soon as possible.
