Thursday, October 6, 2011

My Pectoral Tear - 15 Years Later: What I've Learned (Part 2)

If you missed Part 1 of this blog post, you can check it out here.

The pectoral major muscle is a fan-shaped muscle that insert into the top portion of the humerus. It originates from the clavicle and sternum. As a whole, the pectorals adduct and medially rotate the humerus, as well as drawing the scapula to the front and down. A nice set of pecs really define the male as a active individual--or a weight-lifter, athlete, or alpha male. As men are attracted to women's breasts, females are attracted to a nice strong, thick chest on a male. Well, at least most. 
 
The chest is one of the body parts that are repeatedly trained in the gym. Like me in my early years, it was a body part that I had to enhance through benching because it served as my calling card that I had put my time in the gym. However, after my injury, I felt that I had no more calling card. If I wasn't able to bench press, what else was there?

As I mentioned earlier that was back in 1996, there were not many incidents on pectoral ruptures in medical literature. Most cases were seen in sports such as tennis, football, rugby, and professions like construction, carpentry, and tree service. However, there has been an abundance in the last 10 years--especially in young body-builders or aspiring weight-lifters. The incidence rate has increased to the point where more and more findings are being recorded and surgeries are performed for those that need upperbody strength to perform in sport or professionally. 

I did not elect to get surgery. At the time, I was fearful of the rehab and simply going under the knife. I was young and wanted to continue lifting. Weeks after my injury I did return to the gym and was able to perform some machine-based chest pressing. Looking back, I can say that I should have examined my workouts and habits a little bit better. Its been 15 years since my injury and I have returned to bench pressing--albeit, wiser and more educated. Most people cannot even distinguish my injury because the area has developed rather evenly--and although I am not as strong as I used to be, I am as strong as I need to be today.


Here are some things that I was guilty of 15 years ago and how I have learned from them:

1.) Over-training with high volume.
At the time, my thought rationale was if I can bench press 275 or 315, I need to continue to do every workout--just to reassure my body that it can be accomplished. This emphasis on high volume constantly put stress on the pectoral tendons and shoulder joint. At the time, it was about getting bigger and stronger. So I accompanied the bench pressing with incline pressing, decline work, cable crossovers, flyes, peck-deck, pull-overs, and tons and tons of other upper body exercises. I included tons of shoulder work: military press, behind the neck presses, upright rows, front raises, lateral raises, and shrugs. Over time, the repetitive stress on these joints caused an enormous imbalance in my anterior musculature versus the rear antagonists which simply tore muscle fibers without letting them heal fully. Back then, stretch marks were "battle scars" and you were proud to wear them.

What I Know Today: My bench press technique was awful. There was no shoulder packing and my elbows were not tucked in. I laid my back flat and flared my elbows out. Why? Because that is what I was taught. The concept of de-loading was non-existent back in those days. De-loading and continuously changing the volume amount is critical to keeping tissue healthy and muscles fully recovered. Today, I change up muscle groups, have light days/heavy days and follow up with more compounded movements to take stress away from muscles that participate in single joint actions. As I have gotten older, my goals have obviously changed. I am able to shorten my workouts and concentrate on my diet and rest. It also helps as I am able to spend time doing things outside of fitness which contribute to my life's fulfillment

2.) Imbalance. With the amount of shoulder work I did with my chest work, I exhibited a terribly protracted shoulder girdle that portrayed me as a walking ape, and also spelled disaster for my upper-body. At the time, I was not overly concerned with my posterior chain muscles.  The amount of "mirror" muscle work always out-weighed and out-did the amount of back exercises in my programs.

What I Know Today: I understand the repercussions of a tight anterior shoulder capsule and how the movement pattern is affected by the condition of the surrounding joint structure. Today, I make it a point to give equal attention to antagonist muscle groups, and concentrate on eccentric actions during lifts. I tend to pay close attention to the rotator cuff and scapular muscles; as well as the core. Remember how I mention3ed I never used to pack my shoulders when benching? Reason being...I didn't know how and didn't know how it was supposed to feel. Now, I include Scap Clock Drills into my programs and all my clients know what the scapular muscles "feel" like.



3.) Fixed Joint Angles. Yes, back then I only used machines. If I wasn't up to bench pressing, then you would find me on a Cybex Chest Press machine or a plate loaded Hammer Strength. The following machines were staples in my upper body workouts: peck-deck, incline or seated chest press, Nautilus pullover, side raise machine, and shoulder press machine. I thought these pieces were god-sends at the gym and for years, I always looked for these dinosaurs whenever I joined a facility. It was obvious that the loading pattern had taken its toll on the joint structure and the pattern overloaded the tendinous fibers.I focused too much on teh pectoral major,  that many of the small key-players were ignored, including the pectoralis minor and serratus.

What I Know Today: I understand that joints must be able to work in the range of motion that is allowed. I understand that injuries cause scar tissue and that will affect range of motion in my muscles and/or that of my clients. Therefore, it is imperative that I utilize movements that allow my joints to move in the strongest plane and make corrections where needed. No need to apply tons of balance boards and other tools, but simple free weights and bodyweight exercises will satisfy this. Today, I include many drills that will work the pec minor and serratus including Standing Band Pulls:



4.) No Stretching and No Mobility Work. Today, mobility work is essential to staying pain free and keeping movements smooth. After a full week of bench pressing, I never stretched the chest or shoulders. My range of motion was limited, and it was impeding on my development--without me even knowing it!

What I Know Today: Injuries develop scar tissue. I know that because my left pectoral is filled with scar tissue. Scar tissue does not carry the same tensile properties that muscle fibers do and therefore is inherently weaker and less pliable. Therefore, mobility work--especially for the shoulder-- is important; and stretching (both static and dynamic) are key to overall tissue quality.Today, all my programs include some sort of mobility work targeting the shoulder joint--including the TRX Shoulder Mobility Drill: 



Today, it is recklessly assumed that we can "prevent" injuries from occurring in athletes and active individuals, but I truly believe (as this is recently), that injuries will occur. Injures occur in top level professional athletes who pay big bucks for great strength coaches to devise great programs, but in the end, we can only hope to REDUCE the risks of injuries and still benefit from lifting strong and hard.

5 comments:

  1. John, thanks for this excellent article. It's a must-read for serious lifters.

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  2. John,
    I just strained/tor my left pec benching as well. After 5 days the bruising is still on my arm but most of the pain is gone and I have full ROM. I'll see an ortho in a few days and hopefully its just a slight tear and not a full rupture. If it was a full rupture, wouldn't I still be in a lot of pain?

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  3. Eric - did you figure out what happened to your pec? I did something similar this weekend. Went to see an ortho, he's setting me up with an MRI later this week. Thinks is just a partial tear/strain, but not certain. I only have mild brusing on my left bicep after, but it seems to be slowly getting worse.

    I can't do a pushup but can hold my own body weight in the plank position. Scared to do anything that might damage it further. Very worried it's a complete rupture and may require surgery (or not fully heal).

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  4. Thanks so much for the info. I tore both my right pec first (2003) and the left pec three years later....both not weight training related. Had surgery in 2008. Still training and love it.

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