Pectoralis Major Repair

The pectoralis major is the main muscle at the front of your chest. It originates as a large sheet from multiple locations including the ribs, sternum and clavicle. The muscle divides into two heads, a clavicular head and a sternal head, which then converge into a singular attachment at the upper arm or humerus.

A pectoralis major tendon rupture is most commonly seen in weight lifters performing bench press, but can occur in sporting activities such as football, rugby, boxing and wrestling.

A rupture occurs when the force on the muscle is too great, usually when attempting a maximal lift or effort. Often this will occur towards the end of a set or training session, when fatigue becomes a factor. A snap or pop may be felt or heard at this point and there may be a change in the appearance of the muscle due to tendon retraction.

Surgical repair is usually required to restore normal strength, and allow you to return to sporting activity or significant weight training. Older or sedentary individuals may elect not to have surgical repair. These patients can expect to lose up to 26% of peak torque and 40% of overall strength in shoulder adduction.

After surgical repair, increased recovery of strength has been demonstrated when compared with non-operative treatment in numerous scientific studies.

shoulder - pectoralis major tendon repair


The surgery is performed under a general anaesthetic and often a nerve block is used to make the procedure as comfortable as possible for you. An incision is made at the upper arm, near the chest wall, and the ruptured end of the tendon is identified.

Strong tapes are sewn into the end of the tendon and attached to metallic buttons. These are then inserted into the upper arm, through small holes in the bone, holding the tendon in place while it heals. Two or three buttons are usually necessary to hold such a strong muscle in place.

After Surgery

Following pectoralis major repair surgery, most patients will stay in hospital overnight. Your arm will be immobilized in a sling for the first two weeks, before range of motion exercises are commenced and a rehabilitation program is commenced. It can take four to six months before a return to sport and resumption of activities such as bench press.

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