Tear or Strain to Pec Major or Minor Insertion

[David Smith]

Hi Steve,
Just saw a physiotherapist who hurt his left “shoulder” while doing a bench press. As he brought the weight down to his chest, he felt “something happen”. Since then, he continues to have discomfort and shakiness when he does any similar weight work. A comprehensive US of his shoulder was negative. I didn’t pick up on anything wrong with his pecs, but I am less familiar with scanning these and I’ve never seen slides of any pathology. Do you by chance have any material on pec minor or major injuries and their sonopathology?
Thanks,
Dave

[Stephen Bird]

Yep,

Sure do.

I have a nice journal article I will email it to you.
The article says most tears happen at the insertion to the humerus and there are a few different described patterns of failure.
But in my clinical practice I see mainly failures occurring at the musculotendinous junction of the sternal head of pec major. I have attached a couple of images.
The clinical presentation sounds suggestive of a pec major tear.
They are often dramatic with obvious clinical deformity and massive bruising. I see them mainly in body builders who are trying to get massive rather than athletes trying to get fit and strong.

I have attached a Pec Major rhabdomyolysis case and a sternal head of pec which has failed at the sternal end.
I have other cases and are hunting them down.

Steve

Steve

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[Stephen Bird]

Here is a typical case of MTJ failure of the sternal head tendon.

Sorry about the video quality,

I couldn’t find the original video file but I think it gets the point across just fine.

Steve

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