Pectoralis Major Tears

The Increase of Torn Pec Muscles and More About Treatment

Ty Johnson, the back-up running back for the last 3 years, was cut this week by the NY Jets after tearing his pectoralis major tendon while training.  He was told by the team physician that the injury required surgery but was then released the day after the surgery.  He was rightfully upset by this turn of events as he had recently just resigned with the NY Jets. That said, as the 3^rd or 4^th running back on the roster with a one year contract he was expendable given the average time missed after a pectoralis major tendon repair is about 6 months and return to play is not a guarantee.

Pectoralis major ruptures are uncommon injuries but have been more prevalent over the last several decades due to the increased incidence of weight lifting.  This increase has also been seen in the NFL.  In a study from 2000 to 2010 there were only 10 documented pectoralis major (PM) tendon tears documented in the league.  In a more recent study from 2010 to 2018 there were 63 PM ruptures.  And while weight lifting is thought to be the major reason for PM tears 76.2% of these injuries in the more recent study occurred during games.  79.3% were defensive players and the most common position was linebacker.  It is thought that the increase may be attributed to changes in tackling techniques as mandated by the league.  The average time for return to sport is 6 months in the NFL which would have put his return at mid-November at the earliest.  Patients with PM tears often present with swelling and bruising, a deformity of their pectoralis muscle, loss of the definition of the front of the axilla (the arm pit) and weakness with pushing or pressing.  MRI of the chest (not the shoulder) is the key to diagnosis.  Operative intervention is the treatment of choice for improved functional outcomes and restoration of strength. For those with a tear of the tendon from the bone the tendon can be repaired directly back to the bone.  For those with tears in the mid tendon or in the muscle tendon junction a reconstruction can be performed to restore anatomy and function.  Dr. Ruotolo has described a technique of reconstructing the tendon using a hamstring tendon (either from the patient or donated from a tissue bank) which has shown success to restore strength and function in multiple patients.  His technique is the largest series published in the medical literature on pectoralis major tendon reconstructions in the Journal of Shoulder and Elbow Surgery in 2019. Dr. Ruotolo and the team at Total Orthopedics and Sports Medicine also published a review of the treatment of all pectoralis major injuries in Orthopedic Reviews in 2022.  This paper highlights the spectrum of injuries of the pectoralis major tendon and the different treatment options for optimal outcomes of pectoralis major tears.  The key to success is finding a surgeon with experience in diagnosis and surgical treatment of this uncommon but increasing injury.

Total Orthopedics & Sports Medicine are the leaders in Long Island based orthopedic surgery and treatment. If you are suffering from an orthopedic injury, contact us today to learn more about what treatment options we may offer you.