Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 18;7(7):2325967119860157.
doi: 10.1177/2325967119860157. eCollection 2019 Jul.

Pectoralis Major Rupture in Military Academy Athletes

Andrew G Chan  1 , George C Balazs  2 , Chad A Haley  3 , Matthew A Posner  3 , John-Paul H Rue  4 , Brett D Owens  5
Affiliations

Pectoralis Major Rupture in Military Academy Athletes

Andrew G Chan et al. Orthop J Sports Med. .

Abstract

Background: Pectoralis major ruptures are rare injuries that can occur at several parts of the muscle. Little is known of the pathoanatomic process and performance following pectoralis major ruptures in young athletes.

Purpose/hypothesis: The objective of this study was to describe a series of pectoralis major ruptures in military academy athletes at the US Military Academy and US Naval Academy. We hypothesized that military academy athletes will demonstrate a different rupture location than previously reported in older patients.

Study design: Case series; Level of evidence, 4.

Methods: A retrospective case series was performed by analyzing all electronic medical records and imaging software for consecutive pectoralis major ruptures undergoing surgical repair within the student population at 2 military academies. The primary outcome of interest was rupture pattern and location. We also assessed functional recovery following surgery by analyzing push-up performance on the biannual Army Physical Fitness Test and Navy Physical Readiness Test.

Results: From 2005 to 2017, a total of 19 cases of pectoralis major ruptures occurred in military academy cadets. Patients ranged in age from 19 to 23 years, with a mean age of 20 years. All injuries occurred during sports activity, with bench press as the most common mechanism of injury (n = 10; 53%). The most common rupture location was the musculotendinous junction (n = 10; 53%), followed by pectoralis major tendon insertion (n = 8; 42%), and only 1 bony avulsion was noted. Physical activity performance following the rupture was negatively affected. The mean ± SD number of push-ups preinjury was 73.20 ± 12.10, which decreased following injury and surgery (66.50 ± 11.98; P = .037).

Conclusion: Military academy athletes in our study cohort demonstrated a different type of rupture location than has been reported in older cohorts, with the majority experiencing tearing at a location other than the tendon itself. Performance was also negatively affected immediately following repair, but moderate improvement was observed as time from surgery increased.

Keywords: military academy; pectoralis major; push-ups; shoulder injury; tendon rupture.

PubMed Disclaimer

Conflict of interest statement

The views expressed in this article are those of the authors and do not reflect the official policy or position of the US government. One or more of the authors has declared the following potential conflict of interest or source of funding: G.C.B. has received educational support from Smith & Nephew. C.A.H. has received educational support from Arthrex. M.A.P. has received educational support from Arthrex and hospitality payments from Smith & Nephew. J.-P.H.R. has received educational support from Stryker. B.D.O. is a paid consultant for CONMED Linvatec, Depuy/Medical Device Business Systems, Mitek, and Musculoskeletal Transplant Foundation; has received research support from Histogenics; has received honoraria from Vericel; receives royalties from Saunders/Mosby-Elsevier, SLACK, and Springer; and is a paid associate editor for The American Journal of Sports Medicine. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
T1-weighted axial magnetic resonance imaging of pectoralis major rupture at musculotendinous junction (arrow).
Figure 2.
Figure 2.
T2-weighted axial magnetic resonance imaging of pectoralis major rupture at musculotendinous junction (arrow).
Figure 3.
Figure 3.
Axillary radiograph of pectoralis major rupture with bony avulsion (arrow).
Figure 4.
Figure 4.
Pearson correlation coefficient subgroup analysis of Army Physical Fitness Test push-up scores in cadets (R = 0.68, P = .04).
See this image and copyright information in PMC

References

    1. Äärimaa V, Rantanen J, Heikkilä J, Helttula I, Orava S. Rupture of the pectoralis major muscle. Am J Sports Med. 2004;32(5):1256–1262. - PubMed
    1. Antosh IJ, Grassbaugh JA, Parada SA, Arrington ED. Pectoralis major tendon repairs in the active-duty population. Am J Orthop. 2009;38(1):26–30. - PubMed
    1. Bak K, Cameron E, Henderson I. Rupture of the pectoralis major: a meta-analysis of 112 cases. Knee Surg Sports Traumatol Arthrosc. 2000;8(2):113–119. - PubMed
    1. de Castro Pochini A, Andreoli CV, Belangero PS, et al. Clinical considerations for the surgical treatment of pectoralis major muscle ruptures based on 60 cases. Am J Sports Med. 2013;42(1):95–102. - PubMed
    1. de Castro Pochini A, Ejnisman B, Andreoli CV, et al. Pectoralis major muscle rupture in athletes: a prospective study. Am J Sports Med. 2010;38(1):92–98. - PubMed

LinkOut - more resources