From the Research
Surgical intervention is recommended for complete pectoralis muscle tears, particularly in young, active individuals and athletes who require full strength and function of the chest muscles. This recommendation is based on the most recent and highest quality study available, which suggests that early surgical repair or reconstruction should be offered to younger, active patients with a complete pectoralis major tear, as it results in good-to-excellent outcomes 1.
Key Considerations for Surgical Intervention
- Complete rupture of the muscle from its insertion on the humerus (arm bone)
- Tear occurs at the tendon attachment site
- Significant muscle retraction is present
- Patients who experience substantial weakness, deformity of the chest wall, or inability to perform activities requiring chest strength
Non-Surgical Management
Non-surgical management may be appropriate for partial tears, elderly patients, sedentary individuals, or those with minimal functional demands. However, studies have shown that surgical repair results in greater recovery of peak torque and work performed compared to conservative management 2.
Timing of Surgery
The timing of surgery is important, with better outcomes typically seen when repair is performed within a reasonable timeframe of injury. While the exact timeframe is not universally agreed upon, early intervention is generally preferred to prevent chronic tears, which can lead to muscle atrophy, scarring, and retraction, making later repair more difficult and potentially less successful 1, 3.
Surgical Procedure and Rehabilitation
The surgical procedure involves reattaching the torn tendon to the bone using suture anchors or drilling holes through the bone. Post-surgical rehabilitation typically includes immobilization followed by progressive strengthening, with full return to activities usually possible within several months 1.