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A pectoralis major rupture is a tear of the large chest muscle where its tendon attaches to the upper arm bone (humerus). It most often happens during a heavy bench press or another forceful pushing or tackling movement, and is usually felt as a sudden pop and tearing pain in the chest, armpit or upper arm. Dr. Andrew Dold, a board-certified, fellowship-trained sports medicine surgeon in Frisco, Texas, evaluates and treats pectoralis major tears, including surgical repair of complete tendon tears.

On this page:Who gets it · Symptoms · Diagnosis · Treatment · Recovery · FAQs · Research
At a glance

  • Most common in young, active men, often during weight training
  • Most tears are at or near the tendon attachment on the arm
  • Complete tendon tears in active patients are usually treated with surgical repair
  • Early repair gives better results than delayed repair, so prompt evaluation matters
  • Muscle-belly tears and partial tears are often treated without surgery

Who gets a pectoralis major tear?

In a review of 365 published cases, 83% of injuries happened from indirect force (the muscle contracting against a heavy load), and 48% happened during weight training.1 Tears are seen mainly in young men, and bench pressing is the most common cause, followed by sports that load the muscle while it lengthens, such as wrestling, rugby and football.2

Symptoms

  • A sudden pop or tearing sensation in the chest or upper arm
  • Pain, swelling and bruising across the chest, armpit and upper arm
  • Weakness pushing, or bringing the arm across the body
  • A change in the shape of the chest or armpit fold, which may be more visible once swelling settles

Diagnosis

Dr. Dold examines the chest wall and the front fold of the armpit, compares strength with the other side and looks for loss of the normal tendon contour. An MRI confirms the tear, shows whether it is at the tendon, the muscle-tendon junction or the muscle belly, and shows how far the tendon has pulled back. Tears are described by timing (acute or chronic), location and how much of the tendon is torn, which guides treatment.1

Treatment

Without surgery: partial tears, tears within the muscle belly and tears in less active patients are often treated with a sling for comfort, ice, and then progressive physical therapy. Non-surgical treatment of a complete tendon tear is possible, but it usually leaves a visible deformity and some loss of strength, and results are less satisfactory than after surgical repair.2

Surgical repair: for complete tendon tears in younger, active patients, early surgical repair is generally recommended, and most patients have good to excellent results.2 Through an incision at the front of the shoulder, the torn tendon is reattached to the humerus with strong sutures secured by cortical buttons, suture anchors or bone tunnels. A meta-analysis of 384 injuries found that acute repair produced better function and cosmetic satisfaction than delayed (chronic) repair, with no difference among fixation methods.3 For chronic tears where the tendon has retracted too far, a tendon graft may be needed to bridge the gap.2

Recovery

After surgery, the arm is usually protected in a sling for several weeks, followed by gradual range-of-motion and strengthening exercises. Bench pressing and heavy upper-body lifting are typically delayed for several months. There is no single agreed rehabilitation protocol,2 so Dr. Dold will give you a specific plan.

What the research shows

  • Diagnosis: a pop during bench press or a tackle, bruising, and loss of the fold at the front of the armpit compared with the other side suggest a rupture. MRI confirms the location and extent of the tear, which guides treatment.
  • Repair restores strength: a meta-analysis and comparative studies found that early anatomic repair of complete tendon ruptures gives better strength, function and appearance than non-surgical care, which often leaves weakness and a visible deformity.
  • Timing matters: repair within about 6 weeks is associated with better outcomes. Chronic tears can still be reconstructed with a tendon graft, with good results.
  • Non-surgical care is reasonable for partial tears, tears within the muscle belly and lower-demand patients.
  • Return to sport: most athletes return after repair. In the NFL, about 86% of players returned to play, although higher-grade injuries took longer.
  • Prevention: many ruptures occur during heavy bench pressing; proper lifting technique helps lower the risk.

Why see Dr. Dold

  • Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
  • Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
  • Fellow of the American College of Surgeons (FACS), the American Academy of Orthopaedic Surgeons (FAAOS), the American Orthopaedic Association (FAOA) and the Royal College of Surgeons of Canada (FRCSC)
  • Author of a SLAP repair book chapter (Springer, 2017) and research on shoulder suture anchors (KSSTA, 2013)
  • Team physician and surgical consultant to Rugby Canada; has cared for professional athletes from the NFL, NBA, NHL, MLS, PGA Tour and Major League Rugby
  • D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google

Frequently asked questions

Does a torn pectoralis major need surgery?

Not always. Complete tendon tears in active patients are usually repaired, while partial and muscle-belly tears are often treated without surgery.2

How soon should it be repaired?

Sooner is better. A meta-analysis found better function and appearance with acute repair than with delayed repair.3 If you think you have torn your pec, see a doctor promptly.

Can I bench press again?

Many patients return to weight training after repair, but heavy pressing is usually delayed for several months and resumed gradually.

What if I do not have surgery?

Non-surgical treatment of a complete tear often leaves a visible change in the chest and some weakness pushing or bringing the arm across the body.2

Can an old tear still be repaired?

Often yes, although chronic tears may need a tendon graft, and results are generally better with early repair.3,2

Do you accept my insurance?

Dr. Dold accepts most major insurance plans, including Medicare and Tricare. Please call 469-850-0680 to confirm your coverage.

Related pages

Research cited on this page

  1. ElMaraghy AW, Devereaux MW. A systematic review and comprehensive classification of pectoralis major tears. J Shoulder Elbow Surg. 2012;21(3):412-422. PubMed
  2. Magone K, Ben-Ari E, Gyftopoulos S, et al. Pectoralis Major Tendon Tear: A Critical Analysis Review. JBJS Rev. 2021;9(8). PubMed
  3. Bodendorfer BM, Wang DX, McCormick BP, et al. Treatment of Pectoralis Major Tendon Tears: A Systematic Review and Meta-analysis of Repair Timing and Fixation Methods. Am J Sports Med. 2020;48(13):3376-3385. PubMed
  4. Aärimaa V, Rantanen J, Heikkilä J, et al. Rupture of the pectoralis major muscle. Am J Sports Med. 2004;32(5):1256-62. PubMed
    Meta-analysis: early anatomic repair gave the most favorable results for total and near-total ruptures.
  5. Hanna CM, Glenny AB, Stanley SN, et al. Pectoralis major tears: comparison of surgical and conservative treatment. Br J Sports Med. 2001;35(3):202-6. PubMed
    Study: surgical repair restored more peak torque and work than conservative management.
  6. Lipman A, Strauss E. Treatment of Pectoralis Major Muscle Ruptures. Bull Hosp Jt Dis (2013). 2016;74(1):63-72. PubMed
    Review: bench pressing is the most common cause; ruptures can cause pain, weakness, deformity and loss of function.
  7. Butt U, Mehta S, Funk L, et al. Pectoralis major ruptures: a review of current management. J Shoulder Elbow Surg. 2015;24(4):655-62. PubMed
    Review: history and exam usually suggest the diagnosis; MRI is the investigation of choice to define the tear.
  8. Connell DA, Potter HG, Sherman MF, et al. Injuries of the pectoralis major muscle: evaluation with MR imaging. Radiology. 1999;210(3):785-91. PubMed
    Imaging study: MRI accurately evaluates pectoralis injuries and identifies patients who benefit from repair.
  9. Lee YK, Skalski MR, White EA, et al. US and MR Imaging of Pectoralis Major Injuries. Radiographics. 2017;37(1):176-189. PubMed
    Imaging review: ultrasound and MRI classification of pectoralis major injuries.
  10. Kowalczuk M, Elmaraghy A. Pectoralis Major Rupture: Evaluation and Management. J Am Acad Orthop Surg. 2022;30(7):e617-e627. PubMed
    Review: comparing with the opposite side on exam (swelling, bruising, loss of the front armpit fold) is essential; surgery restores strength.
  11. Potter BK, Lehman RA, Doukas WC. Pectoralis major ruptures. Am J Orthop (Belle Mead NJ). 2006;35(4):189-95. PubMed
    Review: partial tears and some neglected complete tears may do well with rehabilitation.
  12. Thompson K, Kwon Y, Flatow E, et al. Everything pectoralis major: from repair to transfer. Phys Sportsmed. 2020;48(1):33-45. PubMed
    Review: repair within 6 weeks gave better outcomes than repair at 6–8 weeks; chronic tears more often need graft reconstruction.
  13. Shaw KA, Brown S, Moreland CM, et al. Parachute-Induced Pectoralis Major Tears in Military Servicemembers: What Is the Functional Recovery?. Orthop J Sports Med. 2021;9(6):23259671211014494. PubMed
    Study: repair within 6 weeks gave better strength and function than delayed repair in military parachutists.
  14. Mooers BR, Westermann RW, Wolf BR. Outcomes Following Suture-Anchor Repair of Pectoralis Major Tears: A Case Series and Review of the Literature. Iowa Orthop J. 2015;35:8-12. PubMed
    Systematic review: suture anchor repair provides high satisfaction and predictable return of strength and function.
  15. Schneider PR, Eckhoff MD, Koehler LR, et al. Pectoralis Major Tendon Reconstruction: A Systematic Review. J Surg Orthop Adv. 2022;31(2):123-126. PubMed
    Systematic review: chronic tears can be reconstructed with graft (most often hamstring), with good outcomes.
  16. Wise PM, Ptasinski AM, Gallo RA. Pectoralis Major Ruptures in the National Football League: Incidence, RTP, and Performance Analysis. Orthop J Sports Med. 2021;9(6):23259671211018707. PubMed
    Study: NFL players had an 85.7% return-to-play rate after pectoralis major rupture.
  17. Bodendorfer BM, DeFroda SF, Shu HT, et al. Performance and Survivorship of National Football League Players with Pectoralis Major Injuries. Arthrosc Sports Med Rehabil. 2021;3(4):e1097-e1104. PubMed
    Study: NFL players needing repair had lower and slower return to play, likely due to higher-grade injuries.
  18. Wurm M, Imhoff AB, Siebenlist S. Surgical repair of acute pectoralis major muscle ruptures. Oper Orthop Traumatol. 2018;30(6):390-397. PubMed
    Case series: acute repair outcomes in active patients injured mainly during bench press and sports.
  19. Chomič J, Vaněček V, Strnad T, et al. Pectoralis major ruptures. Rozhl Chir. 2022;101(5):211-226. PubMed
    Study: surgery is indicated for complete ruptures in young active patients with high functional demands.
  20. Golshani K, Cinque ME, O’Halloran P, et al. Upper extremity weightlifting injuries: Diagnosis and management. J Orthop. 2018;15(1):24-27. PubMed
    Review: weightlifting injuries of the upper extremity, including pectoralis ruptures, are preventable with proper technique.
Ready to get it checked? Request an appointment online or call 469-850-0680. Our staff will contact you by phone and text within an hour of your request (during business hours, Monday–Friday, 8 am–5 pm). Walk-in visits are welcome Monday, Wednesday and Friday, 8:30–10:30 am at 6700 Dallas Parkway, Suite 100, Frisco, TX 75034. We see patients from Frisco, Plano, McKinney, Prosper, Little Elm, The Colony, Allen, Dallas and across North Texas. Same-day appointments available.

Request an AppointmentCall 469-850-0680

Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice. Individual results vary.