Pectoralis Major Tendon Repair
How is Pectoralis Major Tendon Repair Performed?
Pectoralis major tendon repair is a surgical procedure performed to reattach the torn pectoralis major muscle to its normal attachment site on the humerus (upper arm bone). The injury typically occurs during activities that involve heavy lifting or bench pressing. The surgery is performed under general anaesthesia. An incision is made in the front of the shoulder and chest to identify the torn tendon. The tendon is then mobilised and securely reattached to the bone using strong sutures and anchors or cortical buttons. The goal of the procedure is to restore the muscle’s strength, cosmetic contour, and function.
What is the Recovery in the Immediate Postoperative Period?
Hospital stay: Most patients stay overnight for observation.
Sling: You will wear a sling for comfort and protection for approximately 6–8 weeks.
Range of motion: Gentle passive shoulder movement is started at 2–4 weeks. Restricted active shoulder motion begins at 6 weeks to protect the repair.
Ice: Used frequently to control pain and swelling. You should ice for 20 minutes, 3–4 times per day right after surgery. An ice/compression machine can be hired from a third party.
Sleep: You may find it more comfortable to sleep in a reclined or semi-upright position with the sling on for the first few weeks.
How is the Wound Managed?
A waterproof underlay dressing should be left on for 2 weeks.
Incisions typically heal within 2 weeks.
Showers are permitted while wounds are covered with waterproof dressings during the first 2 weeks.
Do not submerge incisions in water (baths, pools, or ocean) for 4 weeks.
A wound check with your GP, allied health provider, or our clinic is recommended at 2 weeks.
Absorbable sutures are usually used and do not require removal, though small remnants may surface naturally during healing.
How Do I Manage My Pain After a Pectoralis Major Tendon Repair Procedure?
Your anaesthetist may use a regional nerve block to help control pain immediately after surgery.
Local anaesthetic will also be injected around the surgical site during the procedure.
Use ice regularly (20 minutes, 3–4 times per day). An ice machine may be hired from a third party.
Take prescribed pain medication as directed. Opioids may be used short-term but have known side effects (nausea, constipation, dependence). Non-opioid medications such as paracetamol or anti-inflammatories are preferred when tolerated.
Keep the arm supported in the sling to reduce tension on the repair and improve comfort.
What Issues Should I Call the Clinic Regarding?
You should contact your surgeon or clinic immediately if you notice:
Increasing redness, swelling, or foul-smelling drainage from the wound.
Persistent or worsening pain not controlled by medication.
Fever, chills, or night sweats.
Numbness, tingling, or weakness that does not improve after the nerve block wears off.
Any sudden injury or fall resulting in new pain or deformity at the chest or shoulder.
Prompt review allows early management of potential complications.
When Can I Return to Normal Activities After Pectoralis Major Tendon Repair?
Recovery varies depending on the severity of the injury and your progress in rehabilitation. As a general guide:
Light daily activities: Immediately, using your non-operated arm.
Desk or computer work: 1–2 weeks, if comfortable.
Shoulder movement: Gentle passive motion begins after 2–3 weeks. Active range of motion starts at 6 weeks.
Strengthening: Begins at 8–10 weeks with progressive resistance exercises.
Sport or gym activities: Return to non-contact gym work typically at 3–5 months, and contact sports at 6–9 months, depending on recovery and surgeon clearance.
When Can I Drive?
You can usually drive once you can safely control the steering wheel and perform emergency manoeuvres comfortably. This is typically around 6–8 weeks after surgery. You must not drive while taking strong pain medication (e.g., opioids).
When Can I Return to Work?
Return to work depends on your occupation:
Office or sedentary work: 1–2 weeks, once you can commute safely.
Light manual work: 6–8 weeks.
Heavy manual labour or overhead work: 3–4 months, depending on recovery and tendon healing.
Should I See a Physiotherapist?
Physiotherapy is recommended for a successful outcome after pectoralis major tendon repair. Your physiotherapist will:
Guide you through a structured rehabilitation program focused on restoring shoulder motion and muscle strength.
Protect the repair early on and prevent overstretching of the tendon.
Gradually progress exercises to restore strength, power, and function for sport or manual labour.
Most patients continue physiotherapy for 4–6 months for optimal recovery.
What Are the Complications After a Pectoralis Major Tendon Repair Procedure?
Potential complications include:
Re-rupture or partial failure of the repair.
Infection or wound healing problems.
Shoulder stiffness or reduced range of motion.
Weakness or loss of muscle bulk.
Cosmetic deformity of the chest if the repair does not fully heal.
Numbness around the incision from minor nerve irritation.
Deep vein thrombosis or pulmonary embolism (rare).
Complications related to the anaesthetic block (persistent numbness, nerve toxicity, shortness of breath, or rarely pneumothorax).
