Background. Pectoralis major tendon ruptures have been reported in the literature as occupational injuries, accidental injuries, and sporting activities. Few cases have been reported with respect to rodeo activities. Purpose. To describe a series of PM tendon ruptures in professional steer wrestlers. Study Design. Case series, level of evidence, 4. Methods. A retrospective analysis of PM ruptures in a steer wrestling cohort was performed. Injury data between 1992 and 2008 were reviewed using medical records from the University of Calgary Sport Medicine Center. Results. Nine cases of pectoralis major ruptures in professional steer wrestlers were identified. Injuries occurred during the throwing phase of the steer or while breaking a fall. All athletes reported unexpected or abnormal behavior of the steer that contributed to the mechanism of injury. Seven cases were surgically repaired, while two cases opted for nonsurgical intervention. Eight cases reported successful return to competition following the injury. Conclusion. Steer wrestlers represent a unique cohort of PM rupture case studies. Steer wrestling is a demanding sport that involves throwing maneuvers that may predispose the muscle to rupture. All cases demonstrated good functional outcomes regardless of surgical or non-surgical treatment. 1. Introduction Pectoralis major (PM) tendon ruptures have been reported in the literature. These ruptures present as occupational injuries [1, 2], accidental injuries , and sporting activities [4–7] primarily in weight lifting. Ruptures have also been reported in elderly patients during procedures for transferring, positioning, and dressing the patients [8–10]. Ruptures of the muscle belly typically present as the result of direct trauma or traction injuries. Falls onto outstretched arms often result in ruptures at the musculotendinous junction, whereas excessive tension on a maximally contracted muscle often results in ruptures of the tendinous insertion from the humerus [6, 8]. Sport-related PM ruptures usually result from activities requiring a large amount of upper body strength. Two articles have reported PM ruptures resulting from a rodeo event: one reported a professional bull rider who tore his left PM during a bull riding ; the other reported three cases of PM ruptures during steer wrestling but failed to describe the events surrounding the injuries . These three cases are included in this study and reported in further detail. The purpose of this paper is to describe a series of PM ruptures in professional rodeo steer wrestlers in order to
B. K. Potter, R. A. Lehman Jr., and W. C. Doukas, “Simultaneous bilateral rupture of the pectoralis major tendon: a case report,” Journal of Bone and Joint Surgery A, vol. 86, no. 7, pp. 1519–1521, 2004.
N. R. Dunkelman, F. Collier, J. L. Rook, W. Nagler, and M. J. Brennan, “Pectoralis major muscle rupture in windsurfing,” Archives of Physical Medicine and Rehabilitation, vol. 75, no. 7, pp. 819–821, 1994.
Y. Beloosesky, J. Grinblat, A. Weiss, P. H. Rosenberg, M. Weisbort, and D. Hendel, “Pectoralis major rupture in elderly patients: a clinical study of 13 patients,” Clinical Orthopaedics and Related Research, no. 413, pp. 164–169, 2003.
S. W. Wolfe, T. L. Wickiewicz, J. T. Cavanaugh, and P. Shirley, “Ruptures of the pectoralis major muscle. An anatomic and clinical analysis,” American Journal of Sports Medicine, vol. 20, no. 5, pp. 587–593, 1992.
R. G. Kakwani, J. J. Matthews, K. M. Kumar, A. Pimpalnerkar, and N. Mohtadi, “Rupture of the pectoralis major muscle: surgical treatment in athletes,” International Orthopaedics, vol. 31, no. 2, pp. 159–163, 2007.
D. J. Butterwick, B. Hagel, D. S. Nelson, M. R. LeFave, and W. H. Meeuwisse, “Epidemiologic analysis of injury in five years of Canadian Professional Rodeo,” American Journal of Sports Medicine, vol. 30, no. 2, pp. 193–198, 2002.
B. H. Lau, D. J. Butterwick, N. G. Mohtadi, and J. R. McAllister, “Pectoralis major ruptures in Canadian professional rodeo steer wrestlers,” Clinical Journal of Sport Medicine, vol. 19, no. 3, article 260, 2009.
L. A. Hiemstra, D. Butterwick, M. Cooke, and R. E. A. Walker, “Surgical management of latissimus dorsi rupture in a steer wrestler,” Clinical Journal of Sport Medicine, vol. 17, no. 4, pp. 316–318, 2007.
M. T. Provencher, K. Handfield, N. T. Boniquit, S. N. Reiff, J. K. Sekiya, and A. A. Romeo, “Injuries to the pectoralis major muscle: diagnosis and management,” American Journal of Sports Medicine, vol. 38, no. 8, pp. 1693–1705, 2010.