This pathology seen here is an uncommon event and happens almost exclusively in young, athletic males. In the majority of reported cases, patients were performing weightlifting activities, specifically the bench press.
The pectoralis major is a powerful shoulder adductor that also functions to assist with internal rotation and forward flexion of the shoulder. In order to perform all of these functions adequately, it spans a large portion of the anterior chest wall and has several laminae (heads), including one that inserts into the humerus.
Patients with a ruptured pectoralis major typically present in the acute stages of the injury, with pain, extensive swelling, and ecchymosis of the anterior chest wall, axilla, and medial aspect of the affected arm. If the swelling is excessive, it may mask the loss of the anterior axillary fold that is characteristic of this condition. However, the ecchymotic patterns are definitive and typical of this injury. In the absence of ecchymosis, determining the correct diagnosis may be difficult, especially in the presence of persistent chest wall swelling.
Surgical repair should be complemented with a well-supervised rehabilitation program, which in most cases brings the postoperative strength back to normal or near normal capabilities.
