Pectoralis major injuries: evaluation and treatment

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Injuries

Background:

• Proximal muscle (PM) tears are common in young, athletic males, often associated with weightlifting.
• These injuries occur during maximal arm contraction in extension and external rotation.
• Clinical presentation includes acute pain, swelling, bruising, deformity, and rotational weakness.

Purpose of the Study:

• To summarize the clinical presentation, diagnosis, and treatment of proximal muscle tears.
• To provide guidance on management strategies based on tear severity and patient activity level.

Main Methods:

• Diagnosis relies on patient history and physical examination.
• Magnetic Resonance Imaging (MRI) aids in assessing tear extent and location.
• Treatment strategies are categorized into nonoperative and operative approaches.

Main Results:

• Most tears occur near the tendon insertion site.
• Nonoperative treatment is suitable for proximal, low-grade partial tears, or sedentary individuals.
• Surgical repair is recommended for most tears, particularly in young, active athletes, with acute repair (<6 weeks) yielding optimal outcomes.

Conclusions:

• Early diagnosis and appropriate management of proximal muscle tears are crucial for patient recovery.
• Surgical intervention is often necessary for active individuals to regain full strength and function.
• Timely repair (<6 weeks) is key for optimal results in athletic populations.