Pec major manual muscle test

The latter category is further subdivided by location as follows: A sternoclavicular origin; B muscle belly; C myotendinous junction; D insertion. The treatment of a pectoralis major tear depends on the severity of the injury and the anticipated use of the injured muscle based on the activity level of the patient e. The treatment of choice for complete tears is generally operative. Initial non-operative treatment involves rest, ice, analgesia, and immobilization in a sling with the arm adducted and internally rotated.

Progressive resistance exercises can begin at six to eight weeks from the date of injury, gradually increasing until full resistance training can resume at three to four months post-injury. The prognosis of pectoralis major tears is generally good, especially if a prompt diagnosis is made and appropriate treatment is administered. Several studies have compared operative and non-operative management and concluded that operative management generally results in better functional recovery, including peak torque and work performance.

Patients should be aware of diminished strength and worse outcomes with non-operative treatment. Presentation to a healthcare provider often gets delayed as patients treat the injury like a typical strain or sprain.

A pectoralis major tear can be more difficult to detect after the initial pain and swelling have subsided. Persistent weakness and asymmetry after the resolution of the initial symptoms usually suggest a more severe injury.

In contrast, an acute pectoralis major tear may be more challenging to detect due to swelling, an intact fascial covering, or the overlying and uninjured clavicular head obstructing a palpable or visible defect. Pectoralis major tears are rare injuries, and there may be a delay in the presentation to the emergency department or primary care provider.

To improve the morbidity of the disorder, an interprofessional team approach is a recommendation. Healthcare practitioners should order an MRI if a pectoralis major tear is suspected. The patient should obtain a referral to a sports physician, orthopedic surgeon, or rehabilitation specialist. Early diagnosis and treatment are important as chronic injuries may lead to more technically difficult surgery and suboptimal outcomes.

Patients need to be educated on the adverse effects of analgesics and should opt for non-pharmacological measures like ice, massage, and acupressure. For those who are young, active, and want a faster recovery, referral to an orthopedic surgeon is the proper course. The recovery after conservative treatment is often long; after surgery, the recovery is faster, but there is always the risk of complications.

Irrespective of the approach, the patient should be encouraged to seek physical therapy. The outcomes in most patients are good. Orthopedic specialty-trained nurses can assist with either surgical or conservative care, and act as a bridge between physical therapists and rehabilitation specialists and the surgeon.

All members of the interprofessional healthcare team must communicate and have access to the same level of information regarding the case to drive optimal patient outcomes. Clinical image showing a patient with a right Pectoralis major tear. Findings: Swelling and ecchymosis over the anterior arm. Asymmetric medial prominence of the muscle belly. Right nipple is lower. Contributed by Franco L. De Cicco, MD. This book is distributed under the terms of the Creative Commons Attribution 4. Turn recording back on.

National Center for Biotechnology Information , U. StatPearls [Internet]. Search term. Deltoids MMT. Latissimus Dorsi MMT. Latissimus Dorsi Length Test. Upper Trapezius MMT. Levator Scapulae Length Test. Rhomboid Major MMT. Pec Minor Length Test. Pec Minor MMT. Pec Major MMTs.

Pec Major Length Test. Coracoid Muscles Length Tests. Upper Extremity. Triceps MMT. Biceps and Brachioradialis MMTs. Palmaris Longus MMT. Lumbopelvic Hip Complex. Abdominals MMT. Quadratus Lumborum MMT. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.

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The shoulder will be in lateral rotation. Shortness: The extended arm does not drop down to table level. Limitation may be recorded as slight, moderate, or marked; measured in degrees using a goniometer, or measured in inches using a ruler to record the number of inches from the lateral epicondyle to the table.

Test Movement for Upper Clavicular Part: The examiner places the subject's arm in horizontal abduction, with the elbow extended and the shoulder in lateral rotation palm upward.

Normal Length: Full horizontal abduction, with lateral rotation, the arm flat on the table, and without trunk rotation. Shortness: The arm does not drop down to table level.