Quick Starr rehab question about pec tears

[elVarouza]

Rip,

I tore my pec while benching Monday night and am planning to begin the rehab tomorrow (Friday). I tried some sets of 25 with the empty bar yesterday but I was getting some sharp pains still near the end of each set and decided to give it another day's rest.

My question is: at lockout of a bench press rep the pec is still stretched relative to, say, if I were standing up straight or if I had my arms together, kind of like at the top of a dumbbell fly. Is doing the rehab with the bench press itself sufficient work through the pec's ROM to heal an injury fully, or would it be useful to add another exercise that takes the pec through the entire ROM, such as a fly type movement?

If it matters, the tear is near the outside of the pec closer to the shoulder than the bottom of the sternum, maybe a couple inches up and out from where you would place your hand over your heart. Oh, and it's about the 3rd or 4th time this has happened. The first times I didn't think it was torn so I never did the rehab, which in hindsight was dumb.

[Mark Rippetoe]

I think that if the ROM was sufficient to tear the pec belly, it's probably sufficient to stress it enough to heal it

[elVarouza]

Thanks, I appreciate the reply.

[elVarouza]

I'm hoping you won't mind if I ask a follow-up question. I've searched but can't really find many specific examples of people having done the rehab. My question basically pertains to how quickly to increase the weight and how much pain is okay during rehab sets.

I'm on day 6 of the rehab, injury was 9 days ago. The muscle is still swollen at the injury site, but it's feeling better every day and the swelling is steadily decreasing. Day 1 I did 45x25x3 bench and each set had some sharp twinges in the pec. I've added 10lbs each day and today I did 45x25, 70x25, and 95x25. 45 and 70 both felt great -- no pain at all -- but at 95lbs after 15 reps each subsequent rep felt a little worse, with some twinges in the injured area. It's definitely not reinjured and felt alright after I left the gym, but I'm wondering: is this normal/okay? Should I back off the weight a little bit? If I can do 15 reps with no issues, should I drop the top set reps to 15 instead of 25?

Sorry if it's a silly question, but I'm pretty much alone in trying to figure this out. For reference my bench 1RM prior to the injury was around 340-350, so 95 is still really, really light.

[Mark Rippetoe]

I think you're trying to progress too fast.

[elVarouza]

I think you're trying to progress too fast.

Thanks for the reply. That's too bad to hear but it feels like you're right.

Hopefully final question: is it not uncommon for these things to remain swollen for a few weeks? The swelling has decreased but it seems like it'll remain swollen for at least another week or two.

[Will Morris]

with some twinges in the injured area.

The quality of the twinges of pain is probably more important than simply their presence. Sharp, stabbing or tearing type pain would indicate tissue is being damaged...dull, aching, throbbing, or fatigue type pain is okay.

I had a quad rupture this past summer and I had a lot of pain during my rehab with squatting, but I only stopped my progression if it was progressing to sharp, well localized pain.

[Mark Rippetoe]

Hopefully final question: is it not uncommon for these things to remain swollen for a few weeks? The swelling has decreased but it seems like it'll remain swollen for at least another week or two.

How swollen is it? 10% over normal, or 40% over normal?

[elVarouza]

How swollen is it? 10% over normal, or 40% over normal?

I'd say about 10-15%. If I measure with a string from my sternum along the injured area of the pec, then compare to the non-injured pec, I get about a 12% increase in length. It's hard to notice by eye; I'd say you'd have to be looking for it, but I can definitely feel it with my hand. There's no visible deformation. It feels like it tore over a line about 2-3" long from the middle of the pec belly to the outside. It never really bruised, which is why I haven't been too worried yet. It was a little red the night it happened but that's been the extent of it.

The quality of the twinges of pain is probably more important than simply their presence. Sharp, stabbing or tearing type pain would indicate tissue is being damaged...dull, aching, throbbing, or fatigue type pain is okay.

I had a quad rupture this past summer and I had a lot of pain during my rehab with squatting, but I only stopped my progression if it was progressing to sharp, well localized pain.

Thanks for the reply. I agree about the quality of the twinges. I also rehabbed a quad tear last fall but it was not as severe as this pec tear. Within about 4 weeks the quad had healed fully.

When you experienced sharper pain during the rehab did you drop the weight a little and then make smaller jumps, or did you do something like repeat the previous day?

If you wouldn't mind answering a few more questions, I'm curious about: how bad was the initial injury? How much pain, swelling, bruising, and/or loss of ROM occurred? How long did the rehab process take you? Have you written about it somewhere, in a training log maybe?

[Will Morris]

Thanks for the reply. I agree about the quality of the twinges. I also rehabbed a quad tear last fall but it was not as severe as this pec tear. Within about 4 weeks the quad had healed fully.

When you experienced sharper pain during the rehab did you drop the weight a little and then make smaller jumps, or did you do something like repeat the previous day?

If you wouldn't mind answering a few more questions, I'm curious about: how bad was the initial injury? How much pain, swelling, bruising, and/or loss of ROM occurred? How long did the rehab process take you? Have you written about it somewhere, in a training log maybe?

I had a bit of a different experience because the vast majority of the vastus medialis was torn. It was ruptured to the point that I could not palpate any tension on the distal insertion with contracting the quadriceps. I had a palpable deformity on both ends of the muscle. There was a wad of muscle tissue on the medial aspect of the thigh right above the knee, and I had a golf ball or slightly larger lump at the top of my thigh (near the inguinal ligament). The initial pain was pretty bad. I had a very hard time with weight bearing the first 48 hours. The entire medial aspect of my thigh looked like the Joe Pesci scene in Casino. But, within three months I was back to squatting 405.