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New Study Shows Surgery Beneficial in Treating Certain Chest Muscle Ruptures
January 24, 2000--Rosemont, IL- In an attempt to build a "buff" physique with "cut" muscles, many men turn to weight lifting. Specific exercises like the bench press, which targets the pectoral muscles, may come with certain hazards. Trying to lift too much or doing too many repetitions of the exercise can lead to rupture of the pectoralis major muscle.
When the muscle is ruptured, surgery may be beneficial, according to a new study, "Rupture of the Pectoralis Major Muscle: Outcome After Repair of Acute and Chronic Injuries", published in the January/February 2000 issue of the American Journal of Sports Medicine, the peer-reviewed journal of the American Orthopaedic Society for Sports Medicine (AOSSM).
In the last two decades, there has been a significant increase in the number of reported ruptures of the pectoralis major muscle. The pectorals, also known as pecs, are the main chest muscles that consist of two pairs of muscles working together - the pectoralis major and the pectoralis minor. The pectoralis major covers most of the upper chest and stretches from the top of the arm to the collarbone, breastbone and upper six ribs on each side. The pectoralis minor is a smaller muscle underneath that runs from the middle of the chest to the shoulder blade.
"All patients who were treated operatively -- in the acute or chronic stage of injury -- fared significantly better than those subjects who didn't have surgery," said Anthony Schepsis, MD, an author of the study, who serves as Director of Sports Medicine and Arthroscopy at Boston Medical Center. "If a diagnosis is not made within a few days, patients with delayed surgery still do well. The final results of the chronic repairs seem to be just as good as the acute repairs."
Following surgery, patients in the acute and chronic groups reported similar results when evaluated for pain, strength, and overall satisfaction.
This study included 17 cases of distal pectoralis major muscle rupture as treated by one surgeon. The subjects ranged from 19 to 37 years old, and they all reported injury as a result of trauma or participation in an athletic activity. Ten of the 17 injuries were a result of weight lifting -- with eight of those cases related to the bench press. Four of the patients in the study reported use of anabolic steroids.
Thirteen patients underwent surgery, including six patients with acute injuries (surgery performed less than two weeks after injury) and seven with chronic injuries (surgery performed 10 weeks to 14 months after injury). Four patients had nonoperative management. As part of the study, each patient was evaluated with a subjective questionnaire and an objective examination.
Subjective findings showed that patients treated operatively for acute ruptures reported that their strength returned to 85 to 100 percent of pre-injury levels and patients who had surgery for chronic ruptures reported their strength returned to 80 to 100 percent of pre-injury levels. Participants treated nonoperatively reported their strength returned to 55 to 85 percent of pre-injury levels.
Following surgery, the acute group had an average level of pain relief of 95 percent and the chronic group ranked an average level of pain relief of 89 percent. The nonoperative group reported an average level of pain relief of 65 percent.
When there is a rupture, the tendon and muscle retract back to the chest wall. Surgery is performed to pull the tendon and muscle into position -- using heavy sutures to attach the tendon directly to the bone. Patients are immobilized in a sling for four to six weeks, and are sidelined from sports for four to six months.
Dr. Schepsis recommended that any athlete who experiences a sharp pain in the lateral chest area or "popping sound" while weight lifting should seek immediate medical treatment from an orthopaedic specialist. He explained that athletes who have a tear often experience swelling and bruising in the lateral chest wall and upper arm area.
The American Orthopaedic Society for Sports Medicine (AOSSM) - a world leader in sports medicine education, research, communication and fellowship -- is a national organization of orthopaedic sports medicine specialists, including national and international sports medicine leaders. The AOSSM works closely with many other sports medicine specialists and clinicians, including family physicians, emergency physicians, pediatricians, athletic trainers and physical therapists, to improve the identification, prevention, treatment and rehabilitation of sports injuries.
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