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Recovering from a pec tear requires time and patience, but pec rehab exercises can help you get there faster. Your physical therapist can assess your condition and offer the right strategies and treatments to help you fully recover.
This article looks at how physical therapy (PT) can help you recover from a torn or ruptured pectoralis muscle.
Initial care for a pec tear may include surgery to restore the proper position of your pectoralis muscle. Surgery involves sewing your pec tear back into place on your upper arm.
Three to four weeks after surgery, you should be able to do some passive or active assisted range of motion (ROM) exercises, depending on the surgery. It will most likely take around six weeks for you to do active motion without help.
Your pectoralis major muscle may tear if it becomes overloaded, typically during activities where you are pushing or lifting something, such as during weight training. Other forceful encounters, such as a fall onto an outstretched arm or a sudden and violent pull on your arm may also cause this injury.
A torn or ruptured pectoralis muscle can limit your ability to engage in normal work and recreational activities. It can limit arm use and may cause significant pain.
If you do not require surgery, your healthcare provider may still require that you wear a sling. The sling helps to keep your upper arm and shoulder still to allow your pec tendon to heal. Typically, a sling is worn for four to eight weeks.
During this initial time of immobilization, you may use ice to help control the pain and to decrease swelling around your shoulder and chest. Ice should be applied for 10 to 15 minutes several times each day. Be careful not to suffer a frost burn on your skin. Placing the ice pack in a towel wrap is recommended.
You may be wondering how soon you can start PT after a pectoralis injury. This usually depends on the severity of your injury.
Everyone's injury is different, so be sure to talk with your healthcare provider to understand when the best time for you to start PT.
Your first session with a physical therapist is called an initial evaluation. During this session, your PT will interview you about your injury. They will ask how your injury occurred, how it is affecting your work and recreational activities, and if you have had surgery or not. Your PT will also ask about your past medical history.
During the PT evaluation for a pectoralis major tear, your therapist will perform specific tests. These help determine your functional baseline and guide your treatment. Tests commonly performed during an evaluation for a pectoralis tear include:
After your physical therapist has completed the evaluation, they will work with you to develop a plan of care and set goals for your rehab. Goals should be challenging, but attainable. Your PT can also tell you what to expect from therapy and what your overall prognosis is likely to be.
Various treatments may be used by your physical therapist during your pec major tear rehab. These may include physical modalities, exercise, or manual techniques. All treatments are designed to help you move better, decrease pain, and improve overall functional use of your arm.
Exercise for your pec tear should be your main treatment in physical therapy. Why? Because exercise helps you regain range of motion, strength, and functional use of your arm. Your physical therapist may also have you perform a daily home exercise program to augment the things you are doing in the PT clinic. Various types of exercises may be done, including:
Keep in mind that your exercises may cause slight discomfort. Your exercises should not cause severe or lasting pain in your chest, shoulder, or upper arm. If any exercise causes pain, check in with your physical therapist.
If you have had surgery, your PT may perform scar tissue massage over the surgical scar. The massage and mobilization helps to create a mobile scar in the skin and fascia surrounding your surgical incision. Keep in mind that scar tissue massage has not been proven to improve functional use of your arm after a pectoralis major tear.
Your physical therapist may apply heat to your upper arm and shoulder during your pectoralis major rehab. Heat is used to increase local circulation, decrease pain, and improve tissue mobility. Care should be taken when using hot packs, as they can burn your skin. Be sure to tell your PT if the heat application is too hot.
Ice is often used at the end of physical therapy to help decrease pain and inflammation around your shoulder and pec. Ice decreases local blood flow to the tissues where it is applied. Care should be used when applying ice, as it may cause a frost burn to your skin. Inform your PT if the ice application is painful or uncomfortable.
Ultrasound is a therapeutic modality used in physical therapy. The goal of ultrasound application is to improve circulation to the tissues deep in the body.
Application of ultrasound is done by your physical therapist, who uses an ultrasound wand and a coupling gel over your injured arm and shoulder. Ultrasonic waves are passed into your body, heating the tissues and increasing circulation.
Typically, ultrasound is painless, but if it is not applied properly, it may cause a deep burning sensation. Tell your therapist if you feel any discomfort during ultrasound for your pectoralis major tear.
A word of caution: scientific studies have not proven that ultrasound adds anything of value to a physical therapy program. The use of ultrasound after a pec tear does not offer superior functional improvement when compared to rehab programs that do not include ultrasound.
Still, some physical therapists use it, so you should have a basic understanding of it and how it is used during rehab for your pectoralis tear.
Your physical therapist may use electrical stimulation as part of your pectoralis major rehab. Electrical stimulation, or e-stim, is used to help decrease pain, improve circulation, or improve the way your muscles contract around your chest and shoulder.
Care should be taken when using e-stim near your pectoralis major as it is near the heart. Applying e-stim over your heart has the potential to interfere with cardiac function.
A recent advancement in injury rehab is the use of kinesiology taping. Kinesiology tape, or K-tape is applied by your physical therapist to help decrease pain, decrease muscle spasm, or facilitate muscle function.
Kinesiology tape may also be used to decrease bruising during the initial phases of your recovery. Keep in mind that K-tape is a newer treatment and has not passed rigorous scientific testing. Therefore, it may not add much to your overall functional improvement with your pectoralis major.
You can expect to attend physical therapy for four to eight weeks after a pectoralis major tear. If you have had surgery or have a grade III tear, you can expect to attend physical therapy a bit longer than if you have a grade I pec tear.
Everyone heals at different rates and everyone's injury is unique, so keep in mind that your specific situation may take longer to heal, or your rehab may be done quite quickly. Working closely with your physical therapist and healthcare provider can help you understand what to expect with your specific situation.
Physical therapy can help you recover from a pec tear or strain. How long you should wait before starting physical therapy depends on the extent of the injury. Typically, you can begin PT in about a week if you have a grade I tear, but if your tear is grade III you will need to wait until about six weeks after the injury.
Physical therapy for a pec tear can include a combination of strengthening, endurance, and range of motion exercises. Your physical therapist may also incorporate techniques like scar tissue massage, heat, ice, ultrasound therapy, electrical stimulation, or kinesiology taping into your recovery plan.
A pectoralis major tear is a rare occurrence, but if it happens, you may experience significant pain and functional mobility loss. Your normal work and recreational activities may be affected as well. Working with a physical therapist after a pectoralis tear can help you regain range of motion, strength, and functional use of your arm. That way, you can quickly and safely get back to your normal activity.
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By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.
