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This post is from 2012 and is in need of an update regarding icing, muscle balance, and concepts of tissue quality
I can remember it like it was yesterday. It was the second rep of a heavy set, not my working weight, but a heavy set on the bench press nonetheless. Lowering the bar to my chest, I started to feel a searing pain across the upper portion of my chest, like someone had jabbed something hot into the muscle. My ears were filled with what could only be described as the sound of the world’s largest velcro shoe tearing apart. I yelled for my spotter to take the bar, and he quickly helped me get the bar back to the rack, falling in just above the bottom pin of the bench. As I rose from the bench, not fully realizing what happened, I asked if he heard the same noise. He looked at me strangely; obviously he hadn’t.
Looking down, I could see an immediate shift in the colour of my skin, which was switching from a strangely orange hue (yes, I had a self tanning phase in high school) to a sickly purple. It eventually sunk in. It wasn’t someone slapping on a pair of the loudest velcro sneakers ever made, it was my pec tearing.
Being 18 at the time, I wasn’t prepared for the gravity of the situation. Despite delaying medical treatment, I did eventually learn, thanks to a lengthy late Friday night MRI, that I had partial muscultendinous tears in both pecs that could not be repaired surgically. Certainly not the worst outcome, but still something I’d rather do without. To compound the injury, my teenaged understanding of exercise physiology and strength training lead me astray in my recovery efforts. Over the course of the year I suffered many setbacks, mainly due to my inability to put my ego aside and create an effective rehabilitation program. Ten years later, my understanding of muscle function and tissue regeneration have improved quite a bit, and if I could go back in time, here are 11 things I would have done differently:
1. Iced more
By the time most of us have reached adulthood, we’ve had enough first aid courses ingrain RICE (Rest, Ice, Compression, Elevation) into our heads that it is second nature whenever a musculoskeletal injury occurs. Despite the steadfast belief that ice is the be all and end all for musculoskeletal injuries, the scientific literature suggests that while it may be effective in pain reduction, the purported effects on tissue swelling and inflammation are not as consistent (1,2). Science aside, since ice is one of the least expensive treatments around, extending the icing could have potentially reduced the initial swelling and inflammation of the injury, or at least provided a degree of pain relief that would have been much appreciated. While I chose to put the ice pack on until it warmed up only once, a more aggressive icing strategy could have reduced my pain at the time. You won’t find consistent, scientifically based recommendations on how to ice tissue, but I’d favour aggressive protocols with at least 10-20 minutes every two hours on the first day, and similar durations two to four times the following day (3).
2. Rested more
Sure I was familiar with the RICE protocol, but that first ‘R’, or rest, didn’t seem to sink in. I’m sure I’m not the only one who has the compulsive need to constantly test an injured area to see if it’s improved over the last five minutes. If it’s only been a day or two, and you’ve sustained a pretty serious injury like I did, a few days of rest won’t hurt you. That’s not to say you need to spend those days at home crying into your pillow, there’s nothing to stop you from training around the injury. You can certainly address other uninjured areas of the body, identifying exercises that don’t exacerbate the injury while still protecting the injured area.
Mainly, you just need to resist the urge to test the injured area during the initial few days following the injury, a mistake I made too many times. The early stages of muscle injury are associated with the formation of a collagen matrix which serves as a scaffold for muscle repair (4). Stress these fragile collagen structures too soon when they are improperly formed and you’ll damage them, ultimately increasing collagen proliferation from the injury site (larger scar tissue) (5) , and decreasing the likelihood of efficient muscle repair (6,7).
3. Increased the frequency of training (after I rested)
Much to my detriment, my main training influence at the time was the popular bodybuilding mags, and as such, I followed the standard body part per day split. This meant that my pec rehab (if you could call it that), happened once per week, on chest day and not a day more. With the inverse relationship of volume and intensity, given the limits the injury put on training intensity, it’s sufficient to reason I could have tolerated a greater volume that would be easily achieved by increasing the frequency of my training. There’s a reason some of the original strength training rehabilitation protocols had the word ‘daily’ right in the title (8,9). While frequent loading can be contraindicated immediately following the injury (5), in the subsequent repair and regenerative phases this frequent loading is essential to the formation of new tissue (6,7).
4. Used isometrics at varying angles
After the initial few days, with the swelling and my purple bruising subsiding (shifting to a rather sickly looking yellowish brown), I found myself tempted to start bench pressing. I started with the bar and even that was painful, but I continued despite the pain. What this should have told me was that I wasn’t ready for dynamic exercise through a full range of motion, and had I thought that, I would have saved myself some pain in the process.
Isometric contractions, where a muscle contracts without changing length, are essential to recovery from a muscle strain. In my case, a full range of motion was painful, but I could’ve tried isometric contractions, holding static contractions at various joint angles that were pain free. This may not be an ideal strategy to increase overall strength as strength gains can be position specific (10), but under these conditions any pain-free loading of the tissue would have been advantageous, at least until dynamic exercise could have been added back.
5. Performed more pushups
I don’t want to make this a debate about the superiority of the bench press or push-ups, they’re different exercises (despite exercising similar muscles) and both have their places in effective training programs. Unfortunately, my teenaged self didn’t share the same belief. If you can lift weight on a bar, why would you bother with just bodyweight? Thankfully I’ve come around to the benefits of not fixing your scapula in place by squishing it between a barbell, your body, and a padded bench. With the ability to create various progressions by altering hand position, foot contact points and height, and suspended versions with the TRX (or Blast Straps), pushups would have been an excellent component of the rehabilitation program once loaded, full range of motion contractions were possible.
6. Incorporated board presses
In the bottom position of the bench press, the pectoral muscles are at their longest, and this degree of stretch can be a dangerous position, especially on recovering tissue. Board presses would have allowed me to achieve heavier loading earlier into my recovery, and allow me to do so while avoiding the painful regions of the bench press range of motion. As an added bonus, this increased loading would have benefitted my deltoids and triceps that weren’t quite receiving the loading they once were when I was fully capable of benching. Watch the EliteFTS definitive guide to board pressing here
7. Increased my volume of rowing and rotator cuff work
Muscle strains are a perplexing problem with a variety of potential causes, including strength imbalances across joints coupled with dysfunctional activation patterns of stabilizing muscles. Or we’re over-thinking, and it’s usually just mechanical; momentary poor technique coupled with a weight too heavy often spells disaster. Either way, given that the average person spends hours a day slumped at a desk over a keyboard, it wouldn’t be surprising that in addition to poor tissue quality and muscle length in the pectoral region, we might also have some issues on the other side. Couple this chronic slumped posture with a training program that overemphasized the large internal rotators (Pec Major, Lattisimus Dorsi) and you have a recipe for some serious weakness of the upper back and external rotators. Balancing strength across a joint is a complex issue, not simply equating the number of sets one for one like you often see on the net. Despite this, had I increased my upper back work, including specific external rotator work both pre and post injury, I may have had a significant impact on my return to pressing and may not have ended up in my torn pec predicament in the first place.
8. Addressed tissue quality
This one speaks to the point above. Over time, increased loading of the internal rotators along with poor posture results in poor tissue quality and tightness in the pectoral region. This could have easily been addressed with regular massage of the area, coupled with a mobilization program to address tissue length. Not everyone has the cash or the extended health benefits to get regular massages, but the quick and dirty treatment in the video below, from the guys at Cressey Performance, will get you on the right track.
9. Avoided overhead pressing (temporarily)
In the early stages, I could overhead press, not as heavy as pre-injury, but heavier than I could bench after the injury and enough to satisfy my need for heavy training (read: 18-year old ego). But just like in the bench press, there were signs of my injury, namely pain that increased into the depths of the range of motion and with increased load. Sure enough, after a few weeks, I felt the sign of re-injury during a particularly heavy overhead press, and yet another setback. While the overhead press is largely considered a shoulder and tricep exercise, the pectorals are active and contribute to the movement (11,12). You may need to find alternate ways to load your shoulders, even using ‘blasphemous’ isolation based exercises, until heavier compound exercises are possible.
10. Swallowed my pride
At the time, nothing was more painful than the injury itself than the simple fact that I couldn’t bench press what I had in the past, and this blow to my fragile teenage ego was a setback. Instead of focusing on the signs my injury was giving me, namely the pain, I focused more on the weight on the bar, desperate to return to my pre-injury strength. This constant drive lead to many physical setbacks, minor tears of the already damaged tissue, and ultimately a much longer recovery. Next time around, my focus will be on maintaining a pain free, complete range of motion while GRADUALLY adding weight back to the bar.
11. Actually listened to the warning
As I mentioned above, it’s possible that my pec tear could have been the consequence of a momentary slip in technique, where a disadvantageous mechanical position with a loaded barbell overcame the strength of the soft tissue. Or, more likely, it was a combination of poor program design, too much loading, and piss poor periodization (or lack thereof). It’s unfortunate that I didn’t see this as a warning sign, and my program design lagged until quite a while later. Fortunately, thanks to a growing interest in strength and conditioning and the teachings and writings of many great professors and strength coaches along the way, my programming gradually improved, albeit at a slower rate than it should have. My training now includes sufficient balance between pressing and rowing movements, periodization of loading and training volume, and a healthy selection of variations for all the basic exercises.
If I only knew then what I know now…
Obviously my knowledge on the rehabilitation of musculoskeletal injuries has increased since I was an 18 year old meathead. Ten years ago the internet was a different place, and the sheer amount of training information was significantly less than what gets posted on a daily basis today. These 11 changes would have made a substantial difference to my lifting then, and hopefully, if someone finds themselves in the same position I was in, these will help them avoid the same mistakes that I made.
I’d love to hear what mistakes you’ve made or what you’d do differently following any injuries you have sustained while training. Let me know in the comments.
Thanks for this Site, i had torn my pectorial last year too, i was 18 as well.. slowly i feel better i think Meditation and practicing breathing methods help alot! I guess these are the conseqeunces for eating meat for 17 years!!!
Sorry to hear about your injury, not sure I get the connection to eating meat though.
For starters, I am 5'9 and roughly 160 now. I am 28 years old and the time frame I am about to speak of is when I was 19 years old and around 145 pounds.
I have found your blog here very interesting. I have a clavicular tear of my right pec tendon, which was torn July 19th 2006.
How it started was actually backing 2005, I was warming up on the bench with 135, doing reps and felt a tug in my chest, right side, towards the clavicle. It didn't hurt but it was a strong tug and made me stop what I was doing.
I sort of got scared as I knew of tears so I immediately started doing push ups to "rewarm up" but didn't feel anything. I stopped for that day and kept a weight free summer.
Fast forward a number of months in the fall, I decided to move on to seated chest pressing; the machines, which I strayed away from for a long time under the disposition they wouldn't do as much.
I felt just as sore so I kept at it and it got to the point where I was pressing close to 200 pounds; I was repping 185 for about 6. (I flat benched 205 for 3 reps in my prime, at around 150 pounds, 5'9, I always found this admirable).
Then one day, 7/19/06, I was seated benching in the gym and after awhile felt a strange sensation in the same spot I felt back in '05 (May 11th, to be exact). I decided to do some push ups after I finished my benching and BAM! Felt the most sharpest pain I've ever felt in my life. I went to the bathroom and looked at my chest and the whole area around where my right clavicle is was redder than a mofo.
Yet, I could still do push ups? As after I checked on my chest, I went back out to the gym and continued to do push ups. I was in shock I guess. I couldn't figure it out.
I told my parents that night and after I got home the redness subsided, I had this strange gap in my chest by my collar bone that I HAD NOT had a day, even a few hours prior yet I could still do and have done chest exercises.
Fast forward some more, In October 2006 I saw a OrthoPod about my shoulder and still have never got an MRI done because of being able to do mountain climber push ups and all sort of resistant tests in his office.
There is clearly a deformity in my chest when I flex, yet why am I able to do quite a bit?
The Ortho I went to see said "you'll probably just get fatigued from now on in that area". He has never been more right as that what is what I've experienced. Yet, with the deformity? I can't understand it.
This is my story and I hope it helps someone.
Thanks for sharing your experience Dennis. I also have a permanent deformity, definitely lacking in the clavicular head of pec major ever since. Many lifters have come back from tears to successful lifting careers, and there can be a pretty remarkable restoration of function. My bench press hasn't ever returned to pre-tear levels, but I'm getting closer day by day.
did you have surgery? just had a tear off the bone and considering surgery. thanks!
Nope, both were grade two strains, musculotendinous. I suspect my prognosis would have been better at the osteotendinous junction, with the appropriate repair. I’m left with two gapping holes where my clavicular head of pec major should be towards my sternum, and a smaller bench press.
I'm sorry about you tearing you pecs. It's a very confusing time and because it's an unusual injury – not many people can truly understand the pain as it is an uncommon injury in the general populous.
Weight lifting was a big part of my aura and personality in my early twenties as I'm sure it was and still is to you.
Great article and thanks. Really helped me get through this, as my insurance company put it, uncommon injury. I'll definitely heed your shared learnings during my recovery.
Thanks Ryan glad it helped. I'm starting to wonder how uncommon it really is, I think this is the most popular article on the site!
Hey Dan i'm 18 and recently had a partial pec tear (3 months ago) and i am just now getting back in the swing of things. I've been lifting for chest once a week and doing body weight rehab twice a week. My max was 425 pre tear and im now at 215 for my sets of 10 slow and controlled for bench (100 lbs less than before) I was just wondering if ill ever gain back the strength i had before and if so how long could it take? Also what are my chances of tearing my pec again if i lift as heavy as i used to.
Hey Dan, thankyou for your article. I am 18 years old, and unfortunately pulled a muscle WHILE LIFTING 200 LBS ON THE INCLINE BP about a month ago. I got so scared i went to evry doctor that is involved with the chest area and all the organs there. A few days ago i found out from an orthopedist and he told me its a grade 1 muscle strain, and with around 10 physical therapy sessions i should be back on track. I know what you went through when you were 18, i just keep thinking about the gym and i just can not wait to get back in there, iam just working around my injury. For example, Legs, abbs, arms…..
Thanks for the blog. After 30 years of lifting it finally happened to me. I had a muscle belly tear at 50% and the only thing holding the weight was the Tendon which ripped from the bone and subsequently fractured the bone too. I lost about a pint of blood which could be seen by the purplish arm, chest, and right side of my body. The Doctor said I had very strong tendons but since the muscle ruptured and the only thing holding the weight was the tendon it just ripped off and avulsed the bone. There were three loud popping tearing sounds in my chest.
The first Doctor I went to with a MRI (sports Ortho) said he disagreed with the radiologist. The radiologist said the tendon was torn and the muscle belly was ripped open. The Ortho said because I passed his entire strength test I was fine and he could not sew back the muscle belly back together. I had a deformity in my chest and it did not look normal nor did I feel normal. I was dissatisfied with his diagnosis so I went to get a second opinion by the HEAD ORTHO of the Seattle Seahawks and the Mariners baseball team. After running me through a battery of tests by his physician assistant and looking at the MRI the doc said I needed immediate surgery. The doctor fixed everything. He sewed the belly back together and reattached the tendon and fixed the fractured bone too. It’s only been 6 weeks but I feel great.
I am still terrified of benching though. The experience was horrific. Some back ground. I am 48 yrs. old. I am a drug free USAPL power lifter with 3 state records and have held 2 American records. I was benching only 75% of what I can do (max lift 535) and out of know where the 425 lbs. weight came crashing down. My three spotters saved my life. Still though it’s hard to catch a falling weight.
My future unknown.
I made some of the same mistakes in your 11 lessons article but I am unable to blame youth as an excuse. In January of 2011 (at age 40) I apparently tore my (R) pec belly muscle. I suspect the cause was a seated bench press machine or pec cable flyes. I say "suspect" because I never really felt much at the time but surely did at my next workout. The first orthopedist I saw was sniffing his golf game 30 seconds into my appt and gave me crappy advice. Do light weights but avoid anything where the pecs are primary muscles involved. He recommended physical therapy which helped some. As a result of not stopping lifting my condition worsened and pain was felt nearly daily once I finally stopped weight training all together about 6 months later. I couldn't lift anything with my right arm without re-aggravating it or feeling significant pain. My 2nd orthopedist was great but told me there was nothing he could do for me. He said I would likely be better in 2-3 years but how much better he didn't want to say. I feel I did irreparable harm to my pec as 2.5 years later I still seem to re-aggravate it on occasion. My rehab over the past 2.5 years included: deep tissue massage, rolfing massage, soft tissue release massage, acupuncture, physical therapy etc. I am in a better place than my worst place during this lengthy rehab process. Setbacks occur less often and are much shorter than they were in the first 1.5 years. One massage therapist said breaking down the scar tissue would make a big difference. I ran out of dollars and medical pay for that so I will have to do massage on myself and will buy a book on soft tissue release massage. At this point I hope it isn't too late to keep improving my condition. Any insight based on the above is much appreciated.
Hi David,
Muscle tears are somewhat of a medical mystery. It's really a difficult area to study, as we must rely on animal studies as it would be be too difficult to amass freshly injured people and perform biopsy studies to understand the restorative process and how different treatments affect it. Until that time, we have only clinical functional measures, and invasive animal studies to guide us. I do plan to write more about this, and have a few posts planned but just need to get around to writing them.
It may seem simplistic, but really the best advice I used was let pain be your guide. If something hurt, I either didn't perform that movement, adapted to a pain-free ROM, or reduced load so that it wasn't painful. From there I progressed minimally, opting to add a rep here or there in a systematic fashion, or use small microloading increments (!.25 and 2.5lb plates). If lifting is an important part of your life, I encourage you to seek out medical professionals and physios that <strong>actually</strong> train, and can assess your case in person. It'll make a world of difference.
My early (18yr old) attempts at rehab were too aggressive, and I'm paying the price for it now. From animal studies there is some data to suggest that loading too early may alter the collagen isoforms expressed at the injury site, and may actually increase the size of the scar tissue in the end, and also affect its integrity. Unfortunately, it's hard to move from these basic animal studies into hard guidelines that we can use in the gym, therefore the simplest recommendation (pain) is likely the best.
All the best in your recovery.
Hi, thanks for making a site dedicated to this type of injury. I suffered a complete rupture of my right pec tendon about five years ago and wish I had some of this information handy when it happened. I had surgery for my injury but after 2 MRIs and a lot of debate a month had already passed by. Hopefully some people that have similar injurys will come across this information sooner rather than later. Also I was wondering if you have any good work out routines. I find it very difficult to maintain strength all around my shoulder. I seem to be developing a lot of internal rotation in my injured shoulder and am worried this will lead to another injury. Thanks
I just tore my right pectoral at the sternum, rather than the shoulder insertion, although I get pain from both points while performing chest rehab. If I do everything right, like you have described above, how long until you think I can start getting back into the shape I was prior to injury? It was a partial tear, like yourself.
As I sat here reading this blog, I was holding an ice pack on my upper right pec; just in the corner of my pit area. Today is Friday, it happened Wed night – 7pm to be exact. By 8:30pm I was being seen by a massage therapist. My right bicep began to bulge. My upper corner pec ached. After an hour, she was able to get me to "comfortable" place. By 11:00pm, I was doing ice packs cycles and loaded up an Advil. Thursday morning, saw the Dr. She said that the anterior bicep snapped and I'll end up having "popeye" arm. The deep purple color in my inner bicep is gravity pulling toward the injury. In respect to my pec, I have a slight, very slight, bruise. I had an xray, scheduled to see an Ortho for this coming Tues. My range of motion is o.k. Can wash hair, shave, type, drive, etc. However, there is no way in hell that I can raise my right arm skyhigh. And hey, thanks to all of you for writing. I am 38 and have always been on my game. Stitches, bumps, bruises – but never has anything in my life been to mind bending. Yeah, loosing sleep "thinking" about the road to recovery. Trying to be real opptomistic here. I eat right, take vitamins, drink a lot of water. Wish me luck. A lesson learned for all of us; right? Peace.
Dan, you can be fixed. You just need to see a better, more experienced doctor. Personally, I ruptured my right pec back in Feb of 2012 benching 405. My best max is 525, so how and why this happened with 405 is beyond me. I can totally relate to Lloyd on this issue. Anyway, I had a local surgeon operate on me in April of 2012, and that repair was unsuccessful. August of 2013, I had Dr. Matthew Stiebel operate on me, and the repair was a complete success. Matthew Stiebel and his former teacher Anthony Schepsis are widely regarded as the best pec specialists in the world. They’ve each done about 100 pec repairs, whereas the average orthopod will be lucky to see 1 or 2 in their entire career. I didn’t just rupture my tendon from the bone; I also completely ruptured my muscle from my tendon. Stiebel used an allograft tendon to repair me. I would highly recommend these two, as they have repaired partial and complete MT junction pec tears years after the fact. Matthew Stiebel is with Palm Beach Sports Medicine in West Palm Beach, FL and Schepsis is in Boston, where he works at a clinic and is a professor at Boston University.
Thanks for the info Don, I’ll definitely check these two out. I suspect the overly aggressive rehab promoted excessive scar formation (collagen proliferation) that years later is still causing me problems but never hurts to revisit the issue with a fresh set of eyes.
Hi don how long did it take you to get back to benching after your ok as tore my 9ec tondon of my left arm and had ok about 6 weeks ago desperate to get back to benching.
Return to bench press is highly variable across individuals and can vary depending the type/extent of tearing and surgical tears. Long story short, it’d be hard to extrapolate timelines from one individual to another.
Never had a pec year but did tear my calf recently. I did ice immediately and tried voodoo flossing the area on/off several times and to my surprise it looked and felt better. 24 hours later I continued the protocol and was surprised at the recovery. No science here but I’ll use that protocol again along with some of your tips Dan. Thanks!
Great read, sitting at work with ice on my right pec wedged in between my arm-pit. Just 2 hours ago on was on my final set of bench at 275 on the rack first rep nothing, but upon raising the second rep from my chest i heard the most awful almost crunch. I knew right away what happen as this has happened multiple times to me. It just so happens that this time i feels a bit worse. I had strain my right peck in 2005 with this same weight and just 4 months ago with this same weight so i have experienced it before. Im trying to determine if it is something i should visit the doctor about. I work for a private company and insurance is way to high priced here so i at this point am with ins. Initially i thought i was back but i think maybe i was just scared out of my mind bc it felt and sounded worse then the previous times. my right pec is swollen at the moment but no change in color yet. What im wondering is what getting the best treatment for something like this is going to cost out of pocket? I love lifting and at this point its one of the only things i enjoy about my day.
I can’t speak to the cost (thanks to the Canadian medical system), however I would recommend you seek medical advice ASAP.
Im 18 and two days ago I went to the gym and….I was trying to find my max on the bench press and I didn’t hear anything but it felt like a bee stung me in the chest and it didn’t really hurt that bad it just felt like a bad crap ….but after that I checked it out and the right upper part was really red and it looked like it was brused but not purple …an it didn’t hurt at all so..I quickly went to my school doc and she did a couple test and nothing really hurt I had full range of motion….but the muscle is still like stiff and I iced it and now I’m starting to apply heat to it ….,.,But I’m Freaking Out I Don’t know what to do??…..I play almost every sport and my basket ball season is about to start….and plus I just don’t know what to do from here
Never hurts to get a second opinion, preferably from a Sports Med doc.
Great article,man.Really informative.I tore my left pec about 9 months ago on the incline.Strange thing is,i don’t remember feeling the tear.The first visible sign that something was wrong was when i felt was when i felt pain in my delts.At first i attributed it to overloading on the overhead which i did on occassion on that last set,but then i started noticing a deformity in the middle of my chest.It got worse and i was really confused for a while till i realised what it was.Apparently,it also caused some nerve strain cause there was atrophy along my entire left side.I’ve been rehabilitating now for close to 7 months and its a really slow process.The deformity is still there; when i open up my arms in a cable crossover-like motion,there’s a clearly visible bundle of muscle in the middle part of my pecs thats just stiff.I listened to a Dorian Yates interview where he said the muscle would have lost its elasticity so its important to do excercises that help stretch it out.Thankfully,i didn’t experience any long lasting decrease in strength and right now i’m just working to get the deformity looking as normal as possible.In that regard,pushups with as many variations as possible are a big help.Combining them with a narrower grip and lighter weight on my bench press seems to be helping.
Again,thanks for sharing the info,man.God bless.
ok im 19 years of age, I tore my pec about march of 2013 and did not see a doctor or anything! I was on my second set of flat bench press only doing 245 and 325 was my max at the time. I went down for my third rep and all the sudden I feel a tearing sensation near my upper pec close to my shoulder. also it sorta sounded like Velcro like some people mentioned on here but the weird thing was I still racked the weight and after had no bruising. I could of possibly had bruising but im brown and nothing stood out lol! I did have quite a bit of pain for a while after and it took probably two months before I could lift any weights. now I regularly lift and do pretty heavy chest, my inclines stronger than before the tear and my flat with dumbells is probably stronger to. my flat barbell bench is weaker but ive been scared to really push it since I tore my pec! the tear left a deformity in my pec nothing too extreme but it bothers me because I want to do fitness modeling in the future but it only looks different when I flex. the deformity is sorta towards the bottom of my pec and what it looks like is that there was scar tissue that makes the bottom of my chest look bigger than the top. it also looked in the beginning like it tore the muscle slightly away from the tendon but ive been able to build muscle to basically cover it. I guess my question is will the muscle eventually get big enough to cover the deformity? Also if I was to pursue getting a surgery, is it too late or even worth it at this point? Its really eatin me up since it happened I get over it then all the sudden I start thinking about it again. any info would be greatly appreciated! im stronger than ive ever been now and I want to become a certified personal trainer so I would really like a solution to this problem also if I did end up having surgery what would be the estimated recovery time?
At this stage of the game, the best thing you could do is book an appointment with your doc, give him a detailed history of what has happened, and see if you can get imaging done of the injury and referral to a specialist if needed. The internet is great for many things but not for assessing injuries and establishing a prognosis. All the best in your recovery!
thanks, my biggest fear is the surgeons in my area lol. lets just say this area in tennessee has very few good and reliable doctors. sorta nervous about even trusting any of them. especially with such a rare injury and complicated surgery. would you possibly know of any doctors in Tennessee that do pec tear surgeries?
Unfortunately I don’t have any contacts in Tennessee to give you. Stay optimistic though and seek more info before judging the situation, there are great health professionals scattered all over the place.
Dan,
Thanks for sharing your experience. I have a 6 year old tear of my sternal head at the MT junction that I could never find a surgeon to fix. I later found out I had a lot of the outer tissue remain untorn, holding the bulk my torn muscle in place. I think this made it look not as serious as it actually is at the time. Now it is extremely obvious with all the atrophy that has taken place over the years. I do not have hardly any strength in my shoulder, have extreme muscle imbalances, and my scapula always feels out of place. It is very uncomfortable, and there is a lot of pain and discomfort when I do any shoulder exercises still. Shit, it feels uncomfortable just sitting here typing this.
I have put down the weights for the last six years and am trying to get back into it, but am seriously struggling. I’m still looking to get it repaired, but expect nothing this late in the game. It is time I came to terms with this. This is hard when your left arm will not move in front of your body with any force and without pain. It is so bad that I have even considered just working out the right side of my upper body and only doing core exercises and bi’s and tri’s with my left.
Do you have any advice on how to work around this?
Thanks.
This is a great article. I resently strained my pec muscle while performing bench press exercises(4 weeks ago). While lowering the bar(Bench Press) to my chest, I realized that my grip on the bar was to wide. As a result, i felt a sharp pain start at the top of the outside of my chest( Kind of near the armpit area) and end at the bottom of the outside of my chest area. I was able to place the bar back on the rack. I experienced no discoloration of any sort. Consistent pain for the first 3 days. After icing consistent inflammation went down and i was able to regain movement in that arm / pec area.
My question is, how long would you say the healing process takes before you can get back to doing some sort of bench press exercises/movements? When should i start rehabilitating my injured area? What exercises should i start of with?
I am going about my 5th week of resting the injured area. I iced the injured area for the first 2 to 3 weeks consistently. I feel slight(Very mild pain) if i move it into “That degree of motion” in which the injury occurred. I can perform normal movements without any pain. I have attempted to test the injured area with 5 pound dumbbell weights( Dumbbell Press) and had no signs of pain.
I am afraid of going full out in order to really test where i am. Should I rest a little while longer? after every rehab attempt should I ice the once injured area as a percussion?
Thank you in advance for the advise.
Hi Sean,
It wouldn’t be a good idea for me to offer up a timeline on your recovery without being able to assess your injury. The best thing you could do is get in to see a trained professional (Sports Med Doc) to assess and physiotherapist for rehab and to assess your function.
All the best in your recovery!
For some reason my computer tapped me out of completing my post. I would like to pick back up with my previous posting in saying that it was a long road to recovery over five years with my torn pec. It took really about three years to get back 100%. I say 100%, but I really have been reluctant to go all out to max with this tear. I am back this day (five years later) working out with the 80 85 lb dumbells. I stay away from straight bar flat bench. I’ve put up 225 on the smith machine with reps of five on incline. This in all is not too bad with the extreme tear I sustained. But I took off completely at least four months and then I slowly started back with 5 then 10 then 15 lb flat bench movements and very slowly worked my way back up. I also did stretching movements alot through the process. I also did cable flys and very light pec deck movements as well. The doctor told me I would never be able to do fly’s again. But my slow personal therapy prooved this theory wrong. I took the time and did not let my pride stand in the way of my recovery with everyone else working out around me heavy. And that was hard! I think I could get up the 90 95’s just fine to this day. But I dont push it. Suffering another tear would be horrible. But I still enjoy strength training with pec movements and make minor gains. I have an indention in my right upper pit to this day, but luckily I had descent pec development when my tear occured, so it does not look too bad to this day. Gentlemen, just take it easy and be patient with your recovery and go very slow and light for at least a year. It sucks, and the waiting sucks, but worth it in the long run if you still want to be able to lift and have good strength in the future even into your older years as a bodybuilder.
Pain is most definitely your teacher through the whole recovery process. Some pain will be involved in recovery. But you need to listen to your body with what is the right pain and pain that is damaging your body. Torn pec therapy is “painful” but overtraining and going to heavy pain too soon can be warning sign pains to prevent you from going heavy from the get go to prevent reinjury or permenant damage. Listen to your body, take a good year or two to fully recover, and stretch alot. I personally would lay off for at least four to five months from any type of lifting with this muscle area all together for adequate recovery. It worked for me.
Dan, great read! I am a 27 year old male. As I write, I am icing a left pectoral muscle in which I sustained a slight tear in just hours ago while doing a muscle up. After reading your article, I am committing myself to rest, icing and not starting rehab until the time is right. I don’t want to go through this again so I am going to do it one time, the right way while not pushing to hard after I have returned to training. Would appreciate any comments or advice as I am still in the early stages of experiencing the tear.
Sorry to hear about your injury Luke. The best advice I can give is early assessment and intervention from a trained medical professional. Best of luck in your recovery.
Dan thanks for your post. It’s given me a lot of hope for the future. I have a small tear at the sternum that I got about 7 months ago and it still plagues me. I’ve stopped working out all together to let it rest but it seems like it gets worse when I do. I’ve been to a PT and an ortho, they don’t seem to think it’s a huge deal but the pain persists. I’m wondering how long it’s taken other people to recover from an injury like mine. There is NOTHING on the internet that addresses a torn pec from the sternum (inner chest) I can do push-ups bench, but anything that puts pressure on the sternum area (dips) or even laying on my chest hurts. It’s really caused a lot of anxiety. The MRI showed a bright spot on the sternum so they did a bone scan. They finnaly said it was just inflammation from an injury. I’m just hoping someone will tell me that I’ll feel normal again!!!!
Hey Dan, I’m in the same boat as pretty much everyone here. 41 years old doing my third working set of bench not even a lot of weight compared to what I normally do and boom the Velcro tear felt in my chest and shoulder. Got an MRI and the doctor said it’s a chronic tear at the muscle tendon Junction that they cannot even replace with surgery. I guess it’s too torn up to even suture them together. Two days later I still have full range of motion and decent strength as for as performing every day tasks. I’m getting a second opinion next week but in the meantime would like to know should I keep stretching my arm to keep my range of motion? I don’t want it to stiffen up where I lose range of motion. The last two mornings it’s been a little tighter so I stretch it in the shower and it feels better. Will this hurt anything being that I can never get surgery or replace the tendon? Also should I start doing light weights bands and some type of TRX program to keep my current size which I would be more than happy with. I don’t see the point of going to physical therapy because the tendon will never heal and I can do the stretching on my own. Also what can I expect as far as keeping size and strength without the tendon? Doing light weights and Bands, can you still maintain decent size. I’m 6 foot six 250 pounds and would be happy just staying this size. Thanks and I would appreciate any information you can provide. Thanks -Scott
Sorry for the delayed response, my site isn’t notifying my of comments. I can’t give you specific recommendations without completing the appropriate assessment. As you’ve pointed out though, my process usually focuses on maintenance of ROM initially with a graduated return to loaded movements in the gym.
Dan, my left pec major is completely torn through the tendon at the myotendonous junction of the sternal head and retracted into my chest. Is it true there is no existing surgery for this type of tear. Doctors will not give me a straight answer
Yes and no. your best bet would be a referral to sports MD, then to an ortho in your area for their opinion.
This article is almost a decade old, but am just finding it now.I read through all the prior comments asking you questions about recovery when you are not a doctor nor know anything about there individual injury.I agree with everyone when it comes to pec tendon major tears being a unusual injury to many professionals and almost inexistent to most physical therapist.I am curious to how you got past the mental bridge of benching post injury.Also any suggestions on building the strength of the tendons and surrounding area besides the most obvious lifts.Thank you for the tips above as well and as a short 20 year old I can relate to the “need” to lift heavy.However, I learned quickly that heavy weight just leads to more cons than pro.I would love to hear more you that you learned after this article was posted.
Has it really been 10 years!?! This post sorely needs an update as some of my opinions have changed, especially regarding the use of cryotherapy.
There’s nothing wrong with asking me questions about prognosis, physical therapists can cover that as well as MDs. I will not indulge this with incomplete info though, as my common recommendation to attend with an MD or PT in person attests to.
For connective tissue integrity, I would look up the work of Keith Baar, and my more recent post on connective tissue growth. Complement that with a progressive strength training program, including multiple angles for pressing and flyes to address the anatomical complexities of the pec and you’ll be well on your way.
And yes, with the new data we have on muscle growth at various training intensities (both heavy and light) you have many options available to you.
Definitely think an update is in order – specifically for points 1,2 and 8. Not necessarily bad or detrimental advice, but perhaps has not stood the test of time.
thank you for the quick response time and all your articles are very informal especially since they are very scientific.I will most certainly be purchasing one of ur training packages when this pec is a bit more stable for intense training.I love the scientist perspective on bodybuilding.You are a unique breed and should feel incredible.I would love to see an article regarding cross education of muscles with unilateral workouts of the uninjured side.Thank you for your time !
Thanks John, I appreciate the kind words!
Also just checked out this website and notice you are a doctor…Apologies
I am not a medical doctor (MD), I’m a PhD in Medical Sciences. As it pertains to this post, I am also a physical therapist.
Hi Dan! I have came across your article whilst 8 weeks into a suspected double pec tear, both left and right side. It happened whilst training chest and shoulders one day, but I didn’t feel anything at the time but it worsened as the week went on.
I have been fobbed off by UK gp’s as having a possible grade 1/ grade 2 pec tear And referred to an NHS physio who has given me a 12 week rehab training plan but I still struggle to lift anything. I have been unable to work, or drive for the entire 8 weeks now. I have tried driving a few times but I find it aggravates it the most. The pain has lessened in the armpit/chest area but is more prominent in the inner arm and bicep region between the armpit and first 4 inches down my inner arm on both sides.
I have not even had an X-ray or MRI of any sort and I am beginning to fear that I am actually severely injured and left to let time heal it on its own.
Doctors are claiming an MRI is an 8 month wait due to Covid restrictions.
Can you suggest anything to help!
Thanks, Ryan
Hey Dan! I’m so glad to have found this site. I can totally relate to the sound-like Velcro/, ripping and/or popping like a rubber band. In the beginning g of October, I tore the upper part of my left pec while DEAD LIFTING. I was out of the gym for a month resting, then started up slowly in November. I was making progress and getting stronger, and tried to test the muscles too soon (I also tore some muscles along my ribs and clavicle). Needless to say, I had to start over again this week. Ego is a harsh thing to deal with, especially at the gym. But in order to get better and back to lifting again, I have to listen to my body (for a change!) and do what it says (again, for a change!) I can’t do push ups or pulls up yet, but I’m hoping my ROM will get better. Glad to find someone who can relate.
This was a great read! Dealing with a Grade 2 strain, 8 days post injury at this point. Suffered bench pressing. This article and reply’s have been the most helpful everything else is just clinical diagnoses stuff. I am thankful for the real world stores and experiences here.
My question to you and anyone who’s dealing with this is what kind of pain were you feeling in the muscle and tendon areas? Were they different? My muscle area feels sore and exhausted and the tendon area feels like sharp needle like pains.
I feel like i have a defect towards my armpit area not large but i can feel it. Will this stay or go away? I’m really okay with it there as long as the function is normal or somewhat normal.
How long was everyone’s recovery or expected recovery to being back to “normal” life. I understand the lifting will be a longer road but I’m okay with that.
Thanks In advance!!
Hello Travis,
The tendons in my shoulder start getting tight when I’ve done too much. My muscle doesn’t complain until night time, so I have to stop when my tendon’s tighten. I have a spot high up under my armpit that I will never be able to “stretch”, but never had a defect per se. I had to break down a lot of scar tissue with LOTS of stretching to get there, but that’s ok with me. I lost a lot of my strength, and it took me a year and a half to bench 135 (ie lift and carry anything heavy), more time to deadlift that amount. It took a LONG time, but I’m ok with where I am now. I’ve put this body through a lot, and its held up. That’s what I’m grateful for.