What is the treatment for pectoralis muscle strain?

Treatment for Pectoralis Muscle Strain

The most effective treatment for pectoralis muscle strain includes relative rest, ice therapy, NSAIDs for pain control, and progressive rehabilitation with eccentric strengthening exercises. 1

Initial Management

• Relative Rest: Reduce activities that cause pain while avoiding complete immobilization to prevent muscle atrophy 1

  • Limit use of the injured area for 3-6 weeks depending on severity
  • Avoid activities that reproduce pain, particularly those involving chest/shoulder movements

• Cryotherapy: Apply ice for acute pain relief 1

  • Use melting ice water through a wet towel for 10-minute periods
  • Apply 3-4 times daily for the first 48-72 hours
  • Do not place ice directly on skin to prevent cold injury

• Pain Management:

  • NSAIDs for short-term pain relief (first 7-14 days) 1
  • Topical NSAIDs may provide pain relief with fewer systemic side effects 1
  • Avoid corticosteroid injections directly into the tendon as they may inhibit healing 2

Rehabilitation Phase

Early Phase (1-2 weeks)

• Gentle range of motion exercises to prevent stiffness
• Isometric exercises without pain
• Maintain cardiovascular fitness with activities that don't stress the pectoralis muscle

Middle Phase (2-4 weeks)

• Eccentric Strengthening: Begin progressive eccentric exercises 1

  • Start with light resistance and gradually increase
  • Focus on controlled lengthening of the muscle
  • These exercises stimulate collagen production and promote healing

• Stretching: Gentle stretching of the chest and anterior shoulder 2

  • Hold stretches for 30 seconds, 3-5 repetitions
  • Avoid bouncing or forcing the stretch

Late Phase (4-6+ weeks)

• Progressive resistance training
• Sport-specific or activity-specific exercises
• Gradual return to normal activities based on functional improvement

Special Considerations

• Complete Ruptures: Surgical intervention may be necessary for complete tears of the pectoralis major, especially in athletes 3

  • Early surgical repair shows superior outcomes compared to conservative treatment for complete ruptures
  • Better functional results and return to sports capabilities

• Monitoring Progress: Regular assessment of pain and function to guide progression 2

  • Pain should decrease progressively
  • Range of motion and strength should improve steadily

Common Pitfalls to Avoid

• Returning to activities too quickly before adequate healing
• Prolonged immobilization leading to muscle atrophy 2
• Overaggressive early rehabilitation
• Using overhead pulley exercises (contraindicated as they may worsen the injury) 1
• Misdiagnosis as simple shoulder strain or other pathology 2

Expected Outcomes

Most patients with pectoralis muscle strains have excellent long-term outcomes with appropriate conservative management 4. Complete recovery typically occurs within 3-6 months depending on severity, with proper rehabilitation being the key factor in successful recovery and prevention of recurrence.

For severe or complete tears, especially in athletes or those with high physical demands, early surgical consultation should be considered to evaluate the need for operative repair 3.