From the Guidelines
The most effective treatment for a pectoral strain is rest and limiting the use of the injured extremity, combined with cold application to decrease pain and swelling. This approach is supported by the 2024 American Heart Association and American Red Cross guidelines for first aid, which recommend rest and cold application as the mainstay of treatment for strains and sprains 1. The guidelines suggest that cold application can acutely decrease pain and swelling in joint sprains and muscle strains, and recommend limiting the duration of cold application to 20 to 30 minutes for 3 to 4 times daily.
Some key considerations for treating a pectoral strain include:
- Resting the affected area by avoiding activities that cause pain, particularly pushing or lifting movements
- Applying cold packs for 20 to 30 minutes, 3 to 4 times daily, to reduce inflammation and pain
- Avoiding direct contact between ice and skin to prevent cold injury
- Using a bag filled with ice and water surrounded by a damp cloth for the most effective tissue cooling
It's also important to note that while cold application can improve pain scores and reduce swelling, it has not been demonstrated to improve function or time to recovery 1. Therefore, a gradual return to normal activities and gentle stretching and strengthening exercises should be introduced as pain allows, typically starting 3-7 days after injury. If symptoms are severe or do not improve within a week, medical attention should be sought.
From the Research
Treatment for Pectoral Strain
The treatment for a pectoral strain typically involves a combination of conservative management and, in some cases, surgical intervention.
- The initial treatment consists of rest, ice, compression, and elevation (RICE principle) to reduce pain and inflammation 2, 3, 4, 5.
- Immobilization of the affected muscle is necessary for a short period to allow the formation of a scar and to prevent further injury 2, 5.
- Early mobilization is crucial to promote healing, restore flexibility and strength, and prevent atrophy and loss of function 2, 4, 5.
- Physical therapy, including stretching and strengthening exercises, can help improve range of motion and reduce the risk of further injury 4, 5.
- In cases of complete rupture or severe injury, surgical intervention may be necessary to repair the damaged muscle or tendon 3, 6.
- The treatment approach may vary depending on the severity and location of the injury, as well as the individual's overall health and activity level 6.
Specific Considerations for Pectoralis Major Muscle Injuries
- Pectoralis major muscle tears are relatively rare and often occur during weightlifting activities 6.
- Complete ruptures are most commonly avulsions at or near the humeral insertion, while ruptures at the musculo-tendinous junction and intramuscular tears are usually caused by a direct blow 6.
- Surgical treatment is often recommended for pectoralis major muscle injuries, especially for younger, active individuals, as it yields superior results compared to nonsurgical management 6.
- Prompt diagnosis and timely intervention are critical to achieving optimal outcomes and minimizing the risk of complications 6.