Waiting can cost you the repair. A complete pec tear does not heal back to the bone on its own, and the best surgical window closes in weeks, not months.
Dr. Reza Jazayeri is a double board-certified orthopedic surgeon and sports medicine physician, faculty for the UFC Combat Sports Medicine Course, and a Kerlan-Jobe fellowship-trained surgeon. He repairs acute and chronic pectoralis major tears for lifters, fighters and active adults, using strong fixation, graft augmentation when the tissue needs it, and a recovery plan built around your metabolism and nutrition.
Why Pec Tears Are Hard to Fix
The pectoralis major is a big muscle with a surprisingly short tendon. That short tendon is the whole problem. Surgeons repair tendons by passing strong sutures through them. Tendon is dense and holds a stitch well. Muscle is soft, and sutures tend to cut through it under load.
Many pec tears happen at or near the point where tendon turns into muscle. That leaves little healthy tendon to grab, especially in chronic tears where the end has scarred and shrunk. For years this was why many pec tears were simply left alone, and patients lived with weakness and a visibly uneven chest.
Today that problem has an answer. When the tissue is thin or short, Dr. Jazayeri reinforces the repair with a graft that holds sutures securely and bridges the gap to the bone. In laboratory testing, adding an acellular dermal matrix to a pec repair raised its failure load from about 921 N to about 1,450 N, matching intact native tendon (about 1,289 N).¹
Why Timing Matters
The sooner a torn pec is evaluated, the simpler the surgery and the better the result.
- Acute tears (within 6 weeks): The tendon end is still mobile and healthy. It can usually be pulled back and fixed directly to the bone.
- Chronic tears (past roughly 8–12 weeks): The tendon pulls back, scars down and stiffens. Direct repair often is not possible, so the tear needs reconstruction with a graft.
Already past the window? It is usually not too late. Dr. Jazayeri regularly treats chronic tears, including tears 6–12 months old or more, using graft augmentation, collagen scaffolds and orthobiologics. In a published series of chronic and subacute pec tears reconstructed with dermal allograft, patients reported significant improvement in function and pain.²
If someone told you to rest and see what happens, get your MRI reviewed now. Every week counts.
Who Tears a Pec, and How
Most common in: weightlifters and powerlifters, bodybuilders, MMA fighters and wrestlers, football and rugby players, and master athletes who keep training hard into their 40s and beyond.
How it happens: Usually a forceful eccentric load, where the muscle is stretched while contracting:
- Lowering a heavy bench press, especially the bottom of the rep
- Defending a takedown or an armbar with the arm extended and pulled away from the body
- A fall or tackle onto an outstretched arm
Signs you may have torn it:
- A pop or tearing feeling in the chest or front of the shoulder
- Bruising across the chest and upper arm, often in the following days
- A change in chest shape, a dimple or loss of the fold at the front of the armpit
- Weakness pushing or bringing the arm across the body
Diagnosis: Get the Right MRI
An exam can suggest a pec tear. An MRI confirms it and shows what matters for surgery: partial or complete, where it tore, how far it retracted, and the quality of the tissue.
Ask for a chest wall (pectoralis) MRI, not a shoulder MRI. A standard shoulder MRI often cuts off the area where pec tears occur, so the tear can be missed or underestimated.
Dr. Jazayeri also checks what affects healing: metabolic and hormonal labs, muscle health and nutritional status. This is part of his Metabolic Report Card, used to prepare patients for surgery like athletes prepare for competition.
Already had an MRI? Send it to us. Dr. Jazayeri will personally review your images and tell you whether you need surgery, how urgent it is, and what kind of repair fits your tear, in person or by video.
Treatment Options
- Non-surgical care: Reasonable for small partial tears or lower-demand patients: structured physical therapy, ultrasound-guided PRP or BMAC injections, and nutritional optimization. Complete tears do not reattach on their own; untreated, they commonly leave a lasting strength deficit and chest asymmetry.
- Surgical repair: Recommended for complete tears, athletes, and anyone who wants their strength and chest shape back.
The Surgical Athlete Pec Repair Protocol
Dr. Jazayeri treats surgery like competition: prepare, perform, recover. Every repair is built on four parts.
- Prepare. Metabolic Report Card labs, muscle and nutrition screening, and a pre-surgery protein and amino acid plan through XR Xcelerated Recovery®.
- Fix it strong. A small incision at the front of the shoulder. The tendon is reattached to its footprint on the humerus with cortical buttons and high-strength suture tape, a construct that is strong, low-profile and avoids large bone tunnels.⁴ In a pooled analysis of laboratory studies, suture tape added about 207 N to repair strength, and button fixation was as strong as traditional bone-tunnel repair.⁷ A suture-tape internal brace can be added to take tension off the repair during early rehab.
- Reinforce when needed. For thin tissue, musculotendinous tears or chronic tears, an acellular dermal matrix or collagen scaffold reinforces the repair so sutures hold and the gap is bridged.
- Boost the biology. PRP or bone marrow aspirate concentrate (BMAC) can be added at the repair site to support healing, especially in chronic or complex tears.³ This is the Bio-Fertilization™ approach used across Dr. Jazayeri’s practice.
What Surgery Day Looks Like
- Outpatient: You go home the same day.
- Anesthesia: General anesthesia, with a nerve block for pain control.
- Operating time: About 60–90 minutes.
- Incision: A small incision at the front of the shoulder, placed to sit in a natural skin line.
- Going home: In a sling, with a pain plan, your nutrition protocol and your first PT appointment already scheduled.
- Locations: Surgery is scheduled through Dr. Jazayeri’s Southern California practice. Out-of-town patients usually stay in town 3–4 days.
Recovery Timeline
Most patients return to full lifting and sport at 4–6 months, depending on tear severity, timing of surgery and how rehab progresses.
| When | What happens |
|---|---|
| Week 1–2 | Physical therapy starts with gentle, protected motion |
| Weeks 0–6 | Sling for 4–6 weeks, depending on tear type and chronicity; high-protein diet and targeted amino acids (2–6 weeks by tear severity) |
| Months 2–4 | Motion restored; progressive activation |
| About 4 months | Light resistance training |
| 4–6 months | Return to full lifting, heavy pressing, grappling and contact sport |
Possible complications
Complications are uncommon. They include re-tear or incomplete healing (more likely in chronic or musculotendinous tears), infection, stiffness, scar sensitivity, and residual weakness if the tendon heals poorly. Careful technique, graft reinforcement when needed, and a structured rehab plan reduce these risks.
Outcomes
Most patients get back to sport after pec repair. In a series of 44 patients, 97.7% returned to sport, and about half returned at their full pre-injury intensity.⁵ In a series of 40 athletes with acute repairs, all returned to their pre-injury level of function at about 5.5 months, and adduction strength averaged within about 10% of normal.⁶ Early repair and a structured rehab plan give you the best chance of a full return.
Traveling for Care and Using Your Insurance
Your surgeon matters more than your zip code. Dr. Jazayeri sees patients from across Southern California, other states and abroad, with offices in Beverly Hills, Westlake Village and Orange.
How it works for out-of-town patients:
- Send your MRI and records.
- Get a clear plan and a cost estimate before you book travel.
- Have surgery, then follow up by video once you are home.
Insurance: Many commercial plans, including Blue Cross Blue Shield PPO, Aetna, Cigna, UnitedHealthcare and self-funded employer plans, include out-of-network benefits that can cover much of the cost of surgery. Our office verifies your benefits before your visit, so you know what to expect before you commit.
Patients from Nevada
Many of Dr. Jazayeri’s pec patients fly in from Las Vegas, Henderson and across Nevada for repair or reconstruction. Send your MRI first, meet by video, and arrive with your surgery date, plan and recovery protocol already set.
Watch: Pectoralis repair animation
Pec Tear FAQ
-
Small partial tears can improve with rehab. A complete tear, where the tendon comes off the bone, does not reattach on its own and usually leaves permanent weakness and an uneven chest.
-
Usually not. Chronic tears need a more involved reconstruction, often with a graft, but they can still be repaired well. Dr. Jazayeri treats tears that are 6–12 months old or older. The sooner you are seen, the more options you have.
-
That is the goal of surgery. Most patients return to full lifting, including heavy pressing, at 4–6 months. Your timeline depends on the tear, the timing of surgery and your rehab.
-
Yes, most athletes return to contact and combat sports after a full rehab progression, typically around 4–6 months. As UFC Combat Sports Medicine faculty, Dr. Jazayeri builds the return plan around the demands of your sport.
-
An MRI tells you. Ask for a chest wall (pectoralis) MRI, not a shoulder MRI. Send it to us and Dr. Jazayeri will review it personally.
-
An outpatient procedure under general anesthesia, about 60–90 minutes, through a small incision at the front of the shoulder. You go home the same day in a sling.
-
Yes. Many patients fly in from Nevada and other states for repair or reconstruction. Send your MRI, meet Dr. Jazayeri by video, and get a plan before you travel.
-
Not necessarily. Many PPO and self-funded employer plans have strong out-of-network benefits. Our office checks your coverage before your visit.
-
Tendon healing depends on protein, amino acids and overall metabolic health. Dr. Jazayeri’s Surgical Athlete approach screens and optimizes these before and after surgery to support a stronger recovery.
Why Patients Choose Dr. Jaz
A surgeon who works where pec tears happen. Dr. Jazayeri is faculty for the UFC Combat Sports Medicine Course and a member of the Association of Ringside Physicians. He understands what fighters, lifters and grapplers need to get back to.
- Double board-certified in orthopedic surgery and sports medicine
- Trained at the top: residency at NYU–Hospital for Joint Diseases; sports medicine fellowship at Kerlan-Jobe Orthopaedic Clinic
- 17+ years of experience, including over 15 years with Southern California Permanente Medical Group and over 10 years training orthopedic residents
- Recovery science leader: presented on perioperative nutritional optimization at AAOS three years in a row; founder of XR Xcelerated Recovery®; collaborative research and presentations with NYU
- Director of Longevity & Optimization at DOCS Health
Meet Dr. Reza Jazayeri
Dr. Reza Jazayeri specializes in sports medicine with expertise in shoulder, knee, and elbow injuries. A Southern California native, Dr. Jazayeri combines an engineering background with elite surgical training, completing his orthopedic surgery residency at the nationally ranked NYU Hospital for Joint Diseases and a sports medicine fellowship at the renowned Kerlan-Jobe Orthopaedic Clinic.
After more than 15 years caring for patients within the Southern California Permanente Medical Group, Dr. Jazayeri joined DOCS Health to expand a practice focused on personalized orthopedic and sports medicine care and surgical excellence. As Director of Longevity at DOCS Health, he leads the development and implementation of optimization protocols and regenerative medicine strategies designed to improve long-term musculoskeletal health and extend healthspan.
His published work includes a 2026 coauthored review of nutritional optimization in spine surgery in the Journal of the American Academy of Orthopaedic Surgeons. View Dr. Jazayeri’s research publications and training.
I’m a physician in the LA area… I tore my right pec muscle in the gym… Dr. Jaz came highly recommended and I was not disappointed. His urgency and communication was excellent, got me scheduled right away and was checking on me the whole way… 9 months out and strength and mobility are great.
Don’t wait on a torn pec.
The best repair options are time-sensitive. Book an in-person or virtual consultation with Dr. Jazayeri in Beverly Hills, Westlake Village or Orange.
References
- Mirzayan R, et al. Acellular dermal matrix augmentation significantly increases ultimate load to failure of pectoralis major tendon repair: a biomechanical study. J Shoulder Elbow Surg. 2020;29(4):728–735. doi:10.1016/j.jse.2019.09.020
- Neumann JA, et al. Outcomes after dermal allograft reconstruction of chronic or subacute pectoralis major tendon ruptures. Orthop J Sports Med. 2018;6(1):2325967117745834. doi:10.1177/2325967117745834
- Gianakos AL, Sun L, Patel JN, et al. Clinical application of concentrated bone marrow aspirate in orthopaedics: a systematic review. World J Orthop. 2017;8(6):491–506. World J Orthop, PMC5478493
- Sanchez A, Ferrari MB, Frangiamore SJ, et al. Pectoralis major repair with unicortical button fixation and suture tape. Arthrosc Tech. 2017;6(3):e729–e735. doi:10.1016/j.eats.2017.02.002
- Liu JN, Gowd AK, Garcia GH, et al. Analysis of return to sport and weight training after repair of the pectoralis major tendon. Am J Sports Med. 2019;47(9):2151–2157. doi:10.1177/0363546519851506
- Cordasco FA, Mahony GT, Tsouris N, Degen RM. Pectoralis major tendon tears: functional outcomes and return to sport in a consecutive series of 40 athletes. J Shoulder Elbow Surg. 2017;26(3):458–463. doi:10.1016/j.jse.2016.07.018
- Saito RR, Panwar KS, Huish EG. Biomechanical comparison of pectoralis major repair techniques: a systematic review and meta-regression. Shoulder Elbow. 2024;16(2):145–151. doi:10.1177/17585732231152251
Medically reviewed by Reza Jazayeri, M.D. on
