Mount Sinai

Pectoral Muscle Injury

June 18, 2018

The tennis world was delighted by the appearance of Serena Williams at the French Open following her return from maternity leave in March. But the 23-time Grand Slam champion was forced to withdraw before her fourth-round singles match.


In announcing her withdrawal, Williams cited a right pectoral muscle injury that prevented her from blasting her trademark serves, among the fastest in the women’s game. Tennis fans wondered whether this injury could delay her return to the top of the game. Fortunately, the injury was not a season-ender, and it can be treated by taking time off to rest.


For many fans, this may have been the first time they heard about this type of injury. Indeed, Williams herself said she had never experienced this problem.


In this Q&A, Alexis Colvin, MD, an orthopedic sports medicine surgeon at The Mount Sinai Hospital in New York and the U.S. ADVERTISEMENT Fed Cup team physician, explains the injury and how you can guard against it. Dr. Colvin will be in her tenth year treating players at the US Open this year and leads a team of Mount Sinai doctors and sports medicine experts responsible for caring for players throughout the event.


What are common signs of a pectoral muscle injury?


The pectoral muscles are large, fan-shaped muscles that extend from each shoulder to your breastbone. You probably know them as your “pecs.” They are primarily used to control arm movement. Signs of injury to the area include arm or shoulder pain and weakness. Swelling and bruising may also occur if there is a muscle tear.


How does this injury happen?


When playing tennis, you are activating the “kinetic chain.” When you hit a ball, you transfer energy from your legs to your torso, through your shoulder, down the arm, and through to the racquet. Any disruption or weakness along this chain can overload another part of the chain and potentially lead to injury.


Is this an injury you can play through?


With any injury, it is never wise to play through pain. The pain may be severe enough that your body will force you to stop. Alternatively, sometimes you are still able to play through the pain, but other body parts will compensate for the injured part and you could cause further injury.


If you think you have an injury, when should you see a doctor?


You should see a doctor sooner rather than later if there was trauma or an injury, or if you experience swelling, weakness, loss of motion, and/or numbness or tingling.


Otherwise, whether you need to see a doctor depends on the progression of the pain. If the pain diminishes within a day or so, then you probably don’t need to see a doctor right away. Normally, Rest, Ice, Compression, Elevation (RICE) will be enough. If not, and the pain has not diminished within 24 to 48 hours, you should see a doctor.


What is the treatment for this type of injury and what steps should a player take during recovery?


RICE will be important initially. Afterward, physical therapy will help to gradually get pain-free motion back to the area and to strengthen the muscles around the injury. Then you can begin work on getting back to the sport.


With a muscle injury, you should be able to continue using the body part within a pain-free range. There is no need to shut down all activity; instead, work around the injury. For example, when recovering from a shoulder issue, you can work on lower body exercises and vice versa.


What can a player do to prevent the reoccurrence of this type of injury?


The best form of prevention is cross-training. This type of training works by exercising alternating muscle groups. It also ensures that your body is balanced and complementary muscles are strong. There are plenty of activities to choose from, including running, swimming, or exercises in the gym. You can find some additional information on our sports medicine web site.


Alexis Colvin, MD, is an Associate Professor of Sports Medicine at the Icahn School of Medicine at Mount Sinai in the Leni and Peter W. May Department of Orthopedic Surgery. Dr. Colvin specializes in the surgical treatment of knee, shoulder, and hip disorders. She is the Chief Medical Officer of the US Open and the team physician for the US Fed Cup team. 


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