Pectorals Major Repair

Pectoralis Major Repair

Please check amount of time muscle/tendon was ruptured before repair and quality of tendon. Also NB Does the patient have a h/o heavy weight training or steroid intake


  • On Ward

Shoulder Sling for 4-6 weeks dependant on repair size.

Teach scapula neutral position with upward shrugs of scapula.

Hand,wrist and elbow with fist clenches/ball squeezes.

Active assisted exercises with weight of arm supported, 0-90 degrees in flexion with MR initially and LR to neutral. Keep in pain free zone. DO NOT FORCE OR STRETCH


  • Week one - three

Active assisted exercises in protected ‘box’ zone – keeping hands in line of vision.

Closed chain exercises with weight of arm supported – ball on table.


  • Week three to six

Progress Closed chain to Open chain exercises in safe pain free zone, Avoid over stress in extension, abduction and LR.

Commence isometric post deltoid and LR initially then add MR and ant deltoid.

Wean off sling.

Do not force or stretch.


  • Week six to twelve

Progress to open chain exercises in all ranges as tolerated.

Progress isometric thro range to light resistance training with free weights and light bands.

Observe good RC activation and reduced pec major fixation.

Start controlled weight bearing with 10% body weight – ball on plinth.

May do light gym work starting in sagittal plane and progress into rotational plane of movement. Always high reps with low weights and ensure upward regulation of RC. May need looped band with commencing heavier weights.

AVOID hyperextending in bench press or flyes or pec-deck. Always warm up RC before gym.


  • Week twelve onwards

Functional specific programme. Gradual loading.

Unsure efficient use of kinetic chain.



Andrew Cole