Pectoralis Major Muscle Tear (Pec Tear) – Causes, Symptoms & Treatment

Pectoralis major muscle tear injuries most frequently occur when the arm is extended and rotated externally - like during a heavy bench press or if sudden impact occurs. When the arm is in this position, and the muscle contracts or tightens at a greater force than it can tolerate, a partial or full tear of the pectoralis major muscle (pec) can occur.

The pectoralis major muscle is located in the front chest wall and lies underneath the breast tissue. The sternum (breastbone) and the clavicle (collarbone) come together into the pectoralis major tendon, connecting the muscles to the upper arm (humerus) near the biceps tendon. While injuries can occur anywhere along the pectoralis muscle, the most common site of damage is where the muscle and tendon meet.

While generally a rare injury, pectoralis major muscle tears most commonly occur in men, particularly athletes or bodybuilders, between the ages of 20 and 40. Most pectoralis muscle tear injuries are associated with weightlifting; however, a tear can also happen from direct trauma during sports or an accident.

If you believe your pectoralis major muscle is partially or fully torn, treatment from a physiotherapist is crucial for recovering and then restoring full strength and mobility.

Causes of a pectoralis major muscle tear (pec tear)

Pectoralis major muscle tears occur from a sudden force put on the arm while it is stretched out and rotated outwards. Excessive stretching or direct trauma of the pectoralis muscle, like during heavy lifting or sudden deceleration, can cause the muscle to tear.

The most common cause of a pec tear is during weightlifting, particularly while performing a bench press. A bench press involves pressing a heavy barbell up and down at chest height, working the pectoralis muscles. When the weight on the barbell is too much, the pressure can cause a tear in the pectoralis muscle.

However, other activities can cause the pectoralis muscle to tear, including:

• Skiing

• Football

• Wrestling

• Rugby

• Gymnastics

How do you know if you’ve torn your pectoralis major muscle?

If you’ve torn your pectoralis major muscle, you will almost certainly know about it. While minor tears can feel like an over-stretched, sore muscle, large tears are obvious immediately. Some people hear a “pop” sound or a tearing sensation in the upper arm when the injury occurs. Other symptoms of a pec tear that can occur include:

• Sudden onset of pain in chest and upper arm

• Weakness when arms are pushed out or rotated inward

• Bruising in chest and arm

• Change in the contour of the upper arm and armpit (dimpling or pocket)

How are pectoralis major muscle tears treated?

To treat a pectoralis major muscle tear, your physiotherapist will first perform a physical exam to identify the extent of the injury. During the exam, your physio will examine the chest region, overall muscle mass, and site of injury. A physio may also order imaging tests, like an X-ray, MRI, or Ultrasound, to determine whether the muscle is partially or fully torn, influencing treatment.

Partial tear (non-surgical treatment) 

A partially torn pectoralis muscle injury may not require surgery. Instead, your physiotherapist may suggest using a sling for the affected arm and resting it completely, avoiding heavy lifting and overhead activities. Physio or GP may also recommend anti-inflammatory methods, like icing and compressing the injured area and taking medication to reduce pain and swelling.

Attending regular physiotherapist appointments throughout treatment for a partial pec tear is vital. By constantly assessing the injury, your physio can recommend rehabilitation exercises to strengthen surrounding muscles and restore mobility in your arm and chest area.

Full tear (surgical treatment) 

A fully torn pectoralis muscle injury will generally require surgery to reattach the tendons, and restore the muscle back to full strength and function. It’s crucial to work with a GP, physiotherapist, and appropriate surgeon to determine the best time to have surgery to prevent the tendon from tearing and achieve the best outcome – generally two to three weeks after the injury. 

What is the recovery time for a pectoralis major muscle tear?

The length of time needed to recover from a pectoralis major muscle tear will depend on the extent of the injury and the type of treatment required. 

Non-surgical treatment

Full restoration of strength from non-surgical treatment is often seen within six to twelve weeks. Two weeks after the injury, the physiotherapist will work to regain strength and motion in the shoulder and arm for a partial tear. If a sling is required, it should be worn for four to eight weeks in between physiotherapy appointments. 

Surgical treatment

Returning back to normal activity after surgical treatment for a pec tear often takes between four and six months. After surgery, a sling must be worn for four to six weeks before any small arm exercises can start. Six weeks after surgery, light and carefully instructed exercises by the physiotherapist are allowed, and light weightlifting is allowed from four months post-surgery.