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View Full Version : Pectoralis Major Partial Tear - I want surgery, but doctor says its not required!



JLStorm
28-05-2007, 05:15 PM
I was bench pressing 145kg the other day, and without warning my arm just collapsed, the weight wasnt exceptionally heavy which is why the tear still doesnt make sense to me. The pain was unbearable and I went to the emergency room immediately. After an Xray and MRI I was told that I had a partial tear of the Pectoralis Major muscle only and no tendon damage (I still find this hard to believe).

I have read many articles and quite a few posts and everyone seems to agree that results after surgery are much better than results without surgery for complete tears, but not much data exists or partial tears. I am 28 and in the gym 5 days a week. I am very athletic and a former powerlifter and kickboxer, but I still try to push myself 110% in the gym everyday. I want to make sure that my muscle is able to recover as fully as possible and I plan to be as active as possible as soon as possible.

I realize that surgery may not be required, but shouldnt it be an option? The emergency room doctor said that I am not a candidate for surgery, which asbolutely shocked me. I live in the US and have good insurance, and I will be seeing a shoulder specialist on Tuesday for a second opinion. I want to do as much as I can to convince him that surgery is the best way to go.

What is your opinion, is surgery the best option for a full recovery? Any idea how I can make sure to convince him that it is?

Thanks!

P.S. here are some photos 72 hours after the time of injury.

kjwilkin
28-05-2007, 05:50 PM
Hi there,

I wouldn't rely on what the ER doctor said.

From past experience and doctors I've spoken to ER doctors don't often diagnose orthopaedic problems very well. I live in Melbourne, Australia and went to emergency when I badly rolled an ankle. They gave me the wrong advice and didn't give me any ice for 3 hours. As a result I ended up having to undergo reconstructive surgery as the damage had already been done. However, I did try conservative treatment for a couple of years.

I would strongly suggest you go and see a good sports physician rather than a surgeon to start with. They would be able to diagnose the problem accurately and advise on the appropriate treatment.

Good luck with it all !

Luke
28-05-2007, 07:39 PM
Do you still have the MRI's. Maybe you could post a few pics of the MRI and someone might be able to give you a bit more advice.
Looks impressive though, but the amount of bleeding isn't always a true indicator of the size of the tear.

JLStorm
28-05-2007, 10:48 PM
Here is an AVI video and a few jpegs of the MRI, they are small, sorry about that. There are around 50 jpegs, so I am posting photos 10 frames a part.

As a clarification the ER doc I saw was an orthopedic doctor, and the Dr. that I am seeing on tuesday is the head of shoulder reconstruction for a pretty good hospital. He has done shoulder surgery once before on me, so I trust him. I have just heard that so few of these cases come around, I want to make sure he understands that it is a quality of life issue for me and that healing on its own probably wont give me the results I want without surgery.

Hopefully all of you can see the attached files.

JLStorm
11-06-2007, 03:12 AM
My pec is recovering quickly, but it is growing back caved in where the outside of the pec used to be. I am not too concerned about how it looks (although that is troublesome) but I am VERY concerned that my days in the gym will be forever changed. I notice that when I do anything which would have required that part of the pec muscle my arm is picking up the slack because the pec muscle is not there to do the work. My doctor said I would be 100% in about 6 weeks, but I fail to see how that will be the case. I have a follow up appointment on friday and I want to know if anyone has any suggestions on what I can do or what questions to ask.

Because the MRI shows the tenodon is completely in tact, I am told surgery is not an option because apparently muscle cant be sewn back together. Does this sound about right, or should I get a second opinion? This doctor is the head of shoulder reconstruction for the University of Pennsylvania in the US and has done surgery for me in the past, I feel very comfortable with him if that matters.

ninaburrell
12-06-2007, 11:23 AM
My son recently tore his Pectoralis Major, only his apparently is torn from the bone, so his doctor recommends surgery. However, before we had the MRI results, his doctor said something very similar to what your doctor said: if it isn't torn from the bone, there is no surgical resolution because muscle cannot be sewn to muscle. Good luck. I only wish my son did not require the surgery, since the recovery will be long and he had to sit out his sports seasons last year for ACL surgery. If anyone out there has had the surgery for Pectoralis Major tears, can you tell me what the recovery process/timing was like?

JLStorm
12-06-2007, 11:34 AM
Thanks for the reply. My doctor said that if I needed surgery it would be similar to shoulder surgery I had last year. This would be very restrictive use for the first few weeks followed by a lot of physical therapy. I would be out of serious sports for 6 - 12 months. recovery would be slow, but steady. I am not sure how much that helps, its all the info I have right now.

Trackles
10-09-2007, 06:40 PM
My son recently tore his Pectoralis Major, only his apparently is torn from the bone, so his doctor recommends surgery. However, before we had the MRI results, his doctor said something very similar to what your doctor said: if it isn't torn from the bone, there is no surgical resolution because muscle cannot be sewn to muscle. Good luck. I only wish my son did not require the surgery, since the recovery will be long and he had to sit out his sports seasons last year for ACL surgery. If anyone out there has had the surgery for Pectoralis Major tears, can you tell me what the recovery process/timing was like?
My husband has been diagnosed with the same injury, tendon completely off the bone. The confusing part is, the next day, he has no pain and is very mobile (almost normal) except when he does certain things is it sore other than that his functional. He obviously has torn something as was alot of blood on the inside of his bicep area under the skin. Does this sound right? What symptons did your son experience after his injury?

Chester
11-09-2007, 10:57 AM
Thanks for the reply. My doctor said that if I needed surgery it would be similar to shoulder surgery I had last year. This would be very restrictive use for the first few weeks followed by a lot of physical therapy. I would be out of serious sports for 6 - 12 months. recovery would be slow, but steady. I am not sure how much that helps, its all the info I have right now.

Ultimately you have to be guided by the opinion of your doctor, assuming he is sufficiently experienced in sports injuries generally and shoulder injuries in particular. He's had the benefit of your history, radiology and of course physical examination.

You might want to reflect on how your injury happened. What was your training volume like at the time (even thought you say the 145kg wasn't a killer for you)? Maybe you should adjust your training program. Did you notice any pain, spasm or weakness in that muscle before the injury hit you? Maybe you should use that as a guide to avoid injury in the future.

Most of all, don't rush your return to training.

Shytiger
29-08-2008, 11:47 AM
The exact same injury happened to me in 2003, a day after my wedding at the Hotel gym in Maui. Only for me it was my left pectoral major. I was doing bench press, 180lbs no problem; on the 8th rep, I thought something from the ceiling or rack fell and hit me in the shoulder. I was able to get the weight back up onto the rack. I sat up and tried to figure out what the heck just happened. That is when I looked over and saw the area around my armpit turning red. There was also a "tingling" sensation by now. The hotel footed the doctors visit at the hotel and the diagnosis was just a rupture, no torn tendon. After a couple of hours passed, my arm looked exactly like yours...discoloration from bleeding.
It has been 5 years now and I have recovered 100% of my strength back. It will never look the same again, and I don't think the best surgeon on the planet could make it look like it did before. The muscle is still able to grow and develop....just at a slower pace now. I know how you feel. I was very concerned about my appearance of my injury for the longest time. Sooner or later you will except it. It's really no big deal though....it could have been worse. Here's a pic of my wrecked chest right before I wrote this.


You can draw a straight line from where the muscle ruptured, to where it used to be attached around my shoulder region.
http://farm4.static.flickr.com/3111/2806797099_25e0292692.jpg

Last year, I fell off my roof and messed up my quad and quad tendon...but that's a whole other story.