A pectoralis major tendon tear (often called a pec tendon rupture) is a relatively rare but serious injury that affects the large chest muscle responsible for bringing the arm across the body and powering pressing movements such as the bench press, push-ups, and dips. These injuries usually occur in active individuals—particularly athletes or weightlifters—when the tendon tears away from its attachment on the upper arm bone (humerus) or within the muscle itself.
Clinical Presentation and Common Symptoms
The most common symptom of a pectoralis major tendon tear is a sudden sharp pain in the chest or upper arm during an activity such as weightlifting. Many patients describe feeling a “pop” or tearing sensation.
Other signs include:
- Bruising and swelling of the upper arm (often traveling down toward the elbow)
- Loss of strength when pushing or pressing
- Visible chest deformity, where one side of the chest appears sunken or asymmetrical
- Tenderness and weakness during shoulder adduction or internal rotation movements
If you notice bruising on the inside of your upper arm or a sudden loss of chest strength after a workout injury, it’s critical to seek evaluation as soon as possible.
Getting the Right MRI: Chest Wall, Not Shoulder
One of the most common mistakes in diagnosing a pec major tendon tear is ordering the wrong MRI. A shoulder MRI often misses the pectoralis tendon because it is focused too high on the joint.
The correct study is an MRI of the chest wall, which allows the radiologist to clearly visualize the pectoralis major muscle and its tendon attachment.
It’s also important to know that MRI reports often use the phrase “partial tear.” Don’t assume that a “partial tear” means the injury is minor. In the case of the pectoralis major, even a partial tear usually represents a significant structural disruption that can cause long-term weakness and deformity if left untreated.
Treatment Options: Why Surgical Repair Is the Gold Standard
While non-operative treatment may be suggested for low-demand patients or chronic injuries, surgical repair remains the gold-standard treatment for active individuals. Surgery involves reattaching the torn tendon to the bone using strong anchors or grafts.
When performed correctly, surgical repair of a pectoralis major tendon tear can restore up to 90% of pre-injury strength and correct the cosmetic deformity of the chest. Proper postoperative care and physical therapy are crucial for regaining motion, strength, and confidence.
Why Experience Matters
Because pectoralis major tendon ruptures are uncommon, many surgeons have limited experience treating them. As a result, some patients are told that surgery is unnecessary or that nothing can be done. Unfortunately, this misinformation often leads to chronic deformities and functional loss that could have been prevented with timely repair.
If you’ve been told to “just live with it,” it’s worth seeking a second opinion from a surgeon who specializes in pectoralis major tendon reconstruction.
Expert Care for Pectoralis Major Tendon Tears
Dr. Steve A. Mora, MD, is a board-certified, fellowship-trained orthopedic sports medicine surgeon recognized internationally for his expertise in pectoralis major tendon reconstruction and chronic tear repair. Patients from across the United States and around the world travel to see Dr. Mora for his advanced reconstructive techniques and successful outcomes in even the most complex cases.
If you’ve suffered a pectoralis major tendon tear or have been told that your injury is “too old” for repair, a virtual consultation with Dr. Mora can help determine your best treatment options and restore both form and function.
Request a Virtual Consultation Today!
Visit MyOrthoDoc.com or call 714-332-5498 to schedule a virtual or in-person evaluation with Dr. Steve A. Mora, MD. International Expert in Pectoralis Major Tendon Reconstruction.
Dr. Steve A. Mora, MD
Orthopedic Sports Medicine Surgeon
Restore Orthopedics & Spine Center
@SteveMoraMD | MyOrthoDoc.com