Pectoralis major injuries: evaluation and treatment.

PM tears most commonly occur in the young athletic male while performing weight-lifting exercises, but can result from any activity whereby the arm is maximally contracted in an extended and externally rotated position. Patients typically present with acute pain, swelling, ecchymosis, deformity, and weakness with adduction and internal rotation. Diagnosis of PM tears can usually be made by history and physical examination, but MRI can be helpful in identifying the extent and location of injury. Most tears occur near the tendon insertion. Nonoperative treatment is generally reserved for proximal tears, low-grade partial tears, and tears in sedentary patients. In most cases these patients will resume full activities of daily living. For all other tears, especially in the young, active athlete, acute (<6 weeks) repair is recommended to return the patient to full strength and function.