Increasing Incidence of Pectoralis Major Ruptures in NFL Players

Abstract

Objectives: Pectoralis major ruptures are considered an uncommon injury in football. A previous study showing that only 10 compete ruptures occurred in the NFL between the years 2000-2010. The purpose of the study is to report the incidence of pectoralis ruptures in National Football League (NFL) players from 2010-2017 and identify any characteristics that could have contributed. We hypothesized that incidence of pectoralis major ruptures would increase over the past eight years. Methods: Using publicly available reports from websites such as ESPN.com and NFL.com, pectoralis major injuries in professional football players were identified during the years 2010-2017. Details about age, position played, injury setting, performance enhancing drug (PED) suspensions, and combine performance were obtained from NFL Combine and compared to peers at the same workout. Results: During the eight years analyzed 51 separate NFL players suffered a total of 55 pectoralis major ruptures. Defensive players accounted for 82% (42 of 51) of the injured players. The ruptures happened at the average age of 26±1 years, and 76.4% (42 of 55) of them occurred during games. After the rupture, 87.3% (48 of 55) required surgery, while definitive treatment could not be determined for the remaining seven injuries. For athletes that received playing time before injury and had their rupture occur prior to the most recent 2017 season, 85.4% (41 of 48) returned to play in a game. When comparing athletes at the combine who later ruptured their pectoralis major to peers at their position, those who tore their pectoralis major tendon on-average ranked in the 63 rd percentile for bench press (N=40), 50th percentile for arm length (N=14), and 52nd percentile for 20-yard shuttle (N=20). When the NFL suspension records were examined, only 5.9% (3 of 51) of players with a pectoralis major rupture had been suspended for (performance-enhancing drug) PED use before or after the injury. Conclusion: The total number of pectoralis major ruptures has drastically risen from 10 cases between 2000-2010 to 55 cases from 2010-2017. The reason behind this increase remain uncertain but appears to be independent of relative strength, agility, and arm length, and suspension for PED use.