Frisella Shoulder Surgery

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January 19, 2012

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Bench press injury: It's a pec tendon tear!

The pectoralis major is the large muscle on the front of the chest wall, and attaches the arm to the rib cage. The pec major tendon can tear (or rupture), just like any other tendon in the body. However, the pec tendon almost always tears in young, muscular men, usually while doing the bench press. Using steroids can increase the risk of this muscle tear, because steroids allow the muscle to grow so large that the tendon can no longer handle the force that the muscle generates. A pec major tendon rupture often feels like being hit with a bat, and usually causes an obvious bruise and deformity. Someone with a pec tendon rupture needs surgery to repair the tendon for full function, especially the typical patient who is young, healthy, and active. The repair is done through a small incision near the armpit, and stitches (sutures) are used to pull the tendon back into its normal position. Pec tendon tear: Note bruising and dimple on the right side of the chest.

Did I tear my pec tendon?

In a previous post, I described a pec major tendon tear. The pectoralis major is the large muscle on the front of the chest. The tendon attaching the muscle to the test can tear, and this almost always happens in an athletic male performing bench press. A torn pec tendon is very obvious: the weight drops, there is severe pain and a feeling of something tearing, and a bruise usually develops. The pec muscle looks deformed or "caved in". A right pec tendon tear. A pec tendon tear is more common in someone who uses steroids, because the muscle grows so big that the tendon can no longer handle it's force. The presence and severity of a pec tendon tear is confirmed on MRI. MRI: Arrows show the separated tendon. A pec tendon tear can be partial and may not need surgery. If the tear is more serious, however, then surgery is necessary to repair the tendon in order to maintain strength and a normal appearance. Here I demonstrate the latest technique for repair o

I tore my biceps tendon! Now what?

The biceps muscle Everyone knows the biceps muscle, the large muscle on the front of the arm. The biceps has a tendon at the top of the arm that attaches in the shoulder and and another tendon that attaches at the elbow. The biceps can be torn in either location. Either type of tear can cause a "popeye" deformity in the arm, and means a loss of strength. Most people who tear their biceps tendon are male, in their 50's or 60's, and are lifting something or lowering something down. Most say something like "it felt like I got hit in the arm" or "it felt like somebody shot me in the arm." They will have pain and notice an extra bulge in the arm. The bulge occurs because one end of the tendon has broken free and pulled back, like a rubber band, and the muscle balls up, creating a bulge. Here's a picture of a torn biceps tendon. Can you see the bump in the arm? A torn biceps tendon causes a bump in the arm, or "popeye"

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W. Anthony Frisella MD

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