Pectoralis Major Tendon Tears
The pectoralis major tendon plays a crucial role in upper body strength, power, and aesthetics. It’s the muscle that drives your ability to push, lift, and stabilize your arm during pressing movements like the bench press. When this tendon tears often during heavy lifting or athletic activity the results can be both painful and visually alarming.
Unfortunately, pectoralis major tendon tears are commonly misdiagnosed or underdiagnosed, especially in the early stages. Many patients are initially told they’ve sustained a simple muscle strain or shoulder injury, and others are reassured that they can “live with the tear.” These delays often cause the injury to progress from acute to chronic, making surgical repair far more complex.
Why Early Treatment Matters
Timely surgical repair is critical. In the first few weeks after injury, the tendon and muscle remain mobile and easier to reattach to the bone. However, as time passes, the muscle retracts, scars down, and shortens, while fatty degeneration begins to set in. This makes later reconstruction more technically demanding and can impact both cosmetic and functional outcomes.
Delaying treatment can also lead to:
- Worse chest wall deformity
- Loss of shoulder strength and endurance
- Increased surgical complexity, sometimes requiring graft tissue to bridge the gap
- Longer rehabilitation and recovery times
Why So Many Pectoralis Tears Become Chronic
There are several reasons these injuries are frequently missed or left untreated:
- Initial Misdiagnosis: Early swelling and bruising can mask the deformity, leading to confusion with shoulder or biceps injuries.
- Underdiagnosis: Many providers rarely see this injury and may not be familiar with its subtle presentation.
- Dismissal of Symptoms: Patients are sometimes told that surgery isn’t necessary, especially if they’re not professional athletes despite clear functional deficits and deformity.
- Delay in Imaging: MRI, the key diagnostic tool, is often not ordered early enough.
The Best Advice for Patients
If you’ve been told that you have a pectoralis major tendon tear or suspect one seek prompt evaluation by a surgeon who specializes in these injuries. Do not accept the advice that it “doesn’t need to be repaired” without consulting an experienced sports medicine or shoulder specialist familiar with pectoralis major tendon repair and reconstruction techniques.
With expert care, even chronic tears can often be improved or reconstructed. But the earlier the diagnosis and treatment, the greater the chance for a full recovery of both strength and appearance.
Dr. Steve A. Mora, MD
Orthopedic Sports Medicine Surgeon
Restore Orthopedics & Spine Center
@SteveMoraMD | MyOrthoDoc.com