A pectoralis major strain refers to a tear in the large muscle which covers the chest. Its weak point is where the tendon attaches to the arm bone, and a strain or rupture can happen here when it is put under stress.

Symptoms

A sudden sharp pain at the front of the upper arm, near the shoulder.
Rapid swelling of the front of the shoulder and upper arm.
Weakness or inability to pull arm across chest against resistance
A visible gap or lump in the muscle may appear.

Causes

A pectoralis major strain typically occurs when the muscle is forcibly contracted whilst in a stretched position. This can occur during weight training when performing bench press exercises. In this position, overstretching of the muscle combined with the need to generate high muscle forces to lift and lower the bar may place too much stress on the muscle.

The muscle subsequently tears.

Tears can also occur in Collision sports where the muscle is forced beyond its limit

Anatomy

The pectoralis major muscle is a large powerful muscle at the front of the chest. It is the most superficial muscle in the pectoral region. It is large and fan shaped, and is composed of a sternal head and a clavicular head.

It used to rotate the arm inwards, pull a horizontal arm across the body, pull the arm from above the head down and pull the arm from the side upwards.

It is most likely to rupture at the point where it inserts into the arm (humerus).

Treatment

It is extremely important that the injury is graded properly.

A full rupture may need surgery and has an approximate 6 month rehab period whereas a minor tear can often have you return to play or your activity within a matter of weeks.

For minor tears you will need to initially rest and undertake a careful graded return to strength training and sporting activities.

For major tears a decision regarding surgical vs non-surgical management needs to be determined quickly. If delayed a retracted tear may be too difficult to repair leaving permanent weakness and deformity.

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