Torn Left Pectoral Muscle - Surgery R...

Since: Jan 11

United States

#1680 Mar 31, 2011
Josh wrote:
<quoted text>Has anyone had surgery from Dr. Carlos Guanche? I've seen his name on a few message boards? I think he's in L.A. I want someone who's done this before. Seems like a very rare injury. Any feedback or suggestions would be appreciated. If anyone knows a Kaiser doctor that has performed this surgery it would be helpful. Thanks.
I can give you my orthopod in pasadena. He did a great job. Im 12 weeks out and was given the green light to start training again.
Danopp

Glenview, IL

#1681 Mar 31, 2011
Can anyone in this formum provide a referral for a good orthopedic surgeon in Illinois (Chicago area if possible)? I have a 3 week old pectoral tendon rupture and tear in the belly of the muscle that needs to be repaired soon. Thanks!
Josh

Livermore, CA

#1682 Apr 1, 2011
santsephai wrote:
I have a few recommendations for surgeons in the LA area if anyone is interested. Not Dr Guanche, although someone here used him I know.
Any recommendations would be appreciated. How does it look/feel at this point? Is there still a hole between the pec and the shoulder or was he able to reattach?
Kim

Livermore, CA

#1683 Apr 1, 2011
Josh wrote:
<quoted text>
I tried to post something earlier, but not sure if it worked. I live in San Fran and also have Kaiser insurance. I just tore it last week and want to get a good surgeon as soon as possible. It didn't sound like any Kaiser surgeons had experience with this injury. Please post if you hear of any. Thanks.
I spoke to a couple Kaiser surgeons. Dr. Costouros in San Jose has done quite a few pec repairs - 4 in the last couple of months. He is pretty conservative - feels if tear is at the muscle/tendon junction thier is only a 50/50 chance of it being repaired. That is where my tear is. Given those odds and the long recovery at this point I have decided not to have the surgery. I am now a little over 3 weeks since my injury and I have full ROM and no pain. I can do my normal work-out except for bench which is still very weak. I hope I am not shooting myself in the foot latter down the line. I would be interested to hear from others who decided to take the non-surgery route and how things went. From this forum it appears some that had surgery still have issues.
Matt

San Diego, CA

#1684 Apr 1, 2011
Josh,

I had my surgery done by Guanche at the beginning of Feb. I was in and out in about 3 hours (1 hour for the surgery).

It went smoothly and there wasn't much pain post op whatsoever. He did the incision by my deltoid, but also in my armpit, so my visible scar is a lot shorter than most people who get this surgery. He also doesn't use stitches, which means the scar is less thick than people who have stitches. He basically went in and got my torn pec and then reattached it to my bone with anchors.

As far as the actual surgery, I think he did a pretty good job. It's almost 2 months post op now, and I feel like I could start doing light weight benching, but of course I won't, it's too early.

I also went to the PT today, and I can raise my arm up to about 140 degrees, which is a big improvement over 2 weeks ago when I went to the PT and could only do about 100 degrees.

The one gripe I have is that their office is a little difficult to get answers from. My PT has called over there a couple of times, and hasn't gotten a return call. Basically the PT treatment plan that they gave me was geared towards shoulder surgery, so my PT wanted to know what modifications needed to be done, since I was doing PT for a pec tear.

However, two months out now, the only soreness I have is in the shoulder, so it almost feels like I had shoulder surgery.
Matt

San Diego, CA

#1685 Apr 1, 2011
Kim wrote:
<quoted text>
I spoke to a couple Kaiser surgeons. Dr. Costouros in San Jose has done quite a few pec repairs - 4 in the last couple of months. He is pretty conservative - feels if tear is at the muscle/tendon junction thier is only a 50/50 chance of it being repaired. That is where my tear is. Given those odds and the long recovery at this point I have decided not to have the surgery.
I'd get a second opinion. My tear was at the MT junction and I had surgery and am doing great. A bunch of other people on this board have also had the surgery done after a tear from the MT junction.

It's all about who you go see. If the doctor says 50/50 success on the repair, go to another doctor who has more experience.

Since: Jan 11

Los Angeles, CA

#1686 Apr 1, 2011
Josh wrote:
<quoted text>Any recommendations would be appreciated. How does it look/feel at this point? Is there still a hole between the pec and the shoulder or was he able to reattach?
It looks great. No gap, a scar obviously, and a slightly different visual appearance than before my injury. The pec itself feels great, my shoulder (which was frozen) is responding well to PT. Ive basically got all my ROM back and ready to start training. I had a full tendon avulsion from the bone.

My doc was great, spent a lot of time with me, was very patient and helpful with all my questions and concerns.

Www.congressmedical.com
Dr. Adamson

Good luck
Jeff Newbery

Los Gatos, CA

#1687 Apr 2, 2011
Josh wrote:
<quoted text>
I tried to post something earlier, but not sure if it worked. I live in San Fran and also have Kaiser insurance. I just tore it last week and want to get a good surgeon as soon as possible. It didn't sound like any Kaiser surgeons had experience with this injury. Please post if you hear of any. Thanks.
Dr. Costouros is the best shoulder surgeon that Kaiser has -- I would respect his opinion and experience.
Bill Kleinberg

Los Gatos, CA

#1688 Apr 2, 2011
Kim wrote:
I just joined the torn pec club this week. MRI is indicating a complete tear. I live in Northern CA and have Kaiser. Any recommendations for a good Kaiser Ortho surgeon that has experience with this procedure would be greatly appreciated. Thanks
DR. JOHN COSTOUROS. Based on my own experience and what I have heard from friends around the Bay, he is the best shoulder surgeon in Northern California
Frank

Woodland, CA

#1689 Apr 2, 2011
Danopp wrote:
Can anyone in this formum provide a referral for a good orthopedic surgeon in Illinois (Chicago area if possible)? I have a 3 week old pectoral tendon rupture and tear in the belly of the muscle that needs to be repaired soon. Thanks!
Danoop

USE DR. Corcoran he use to be the Chicago Bears Ortho, he can fix you
Josh

Livermore, CA

#1690 Apr 2, 2011
Kim wrote:
<quoted text>
I spoke to a couple Kaiser surgeons. Dr. Costouros in San Jose has done quite a few pec repairs - 4 in the last couple of months. He is pretty conservative - feels if tear is at the muscle/tendon junction thier is only a 50/50 chance of it being repaired. That is where my tear is. Given those odds and the long recovery at this point I have decided not to have the surgery. I am now a little over 3 weeks since my injury and I have full ROM and no pain. I can do my normal work-out except for bench which is still very weak. I hope I am not shooting myself in the foot latter down the line. I would be interested to hear from others who decided to take the non-surgery route and how things went. From this forum it appears some that had surgery still have issues.
Thanks for the response. Looks like he is the best Kaiser has to offer. Nice to hear that you got your full ROM back. Good luck with your recovery.
Matt

San Diego, CA

#1691 Apr 2, 2011
Another thing to keep in mind is that often the MRI doesn't show the full extent of the injury because of all the scar tissue. Almost 50% of MRIs for pec tears show an incorrect diagnosis. How do I know? The most respected pec tear doctor in the US told me this on the phone...Dr. Schepsis.

Ken

AOL

#1692 Apr 3, 2011
1 Year Post Op

I have been posting on this thread since before my surgery and I have come a long way since.

I had a complete tear of the clavicle and sternal head at musculotendinous junction. This is a compete tear of the Pec Major and Minor from the tendon. This is the worst possible tear you can have. To make matters worse I was 45 years old and waited a year to get it fixed. I tore it March 10, 2009 and had it repaired April 1, 2010. I did this while bench pressing 275LBS on the decline bench (Stupid). When I brought the weight down I felt the muscle go - it was like two ropes snapping inside my chest and shoulder. I knew immediately I fcked up bad and was going to need some type of surgery. Over the next several days my left bicep developed a big bruise that filled with blood and eventually moved down my arm before fading away over several weeks.

This is when the real journey began. I can't tell you how frustrating it is dealing with insurance companies and Dr's who just don't know what their talking about. The problems is most Dr's have not dealt with this injury and don't have any clue how to diagnose or treat this injury. It took me several weeks to get an MRI and into an Orthopedic Surgeons office. I went to a top Ortho office in Tampa who work with the Tampa Bay Lightening and local college sports team. The Dr I saw is a top rated shoulder Dr but he ended up misdiagnosing me with pec muscle belly tear and said that it will heal itself in about 6 weeks and then I should go through some physical therapy - what a big fkng waiste of time. There is no rehabbing a muscle that is not attached. I went through the PT and actually got back to swimming laps and could do 30 pushups but I new I was not working the pec. There was no muscle between the pec and shoulder (the wing). I basically wasted 6 months going down this dead end.

It was on this thread that I got the advice to contact Dr Schepsis. There were other people given the same diagnosis and said that I should mail a video and MRI to his office. I followed their advice and he got back with me with the correct diagnosis and said that he could fix me. I did a lot of research on Dr's after that point and decided that I would only let him do the surgery. I could have had the surgery done at no cost with my current insurance but it would require me to stay local. I am retired military and the insurance I have won't pay to go out of network if they can find someone in network to do the procedure. This was in Nov 2009 and I could of had the surgery in Decmber but I decided to buy additional insurance so I could go to Boston and have Dr Schepsis do the surgery. By the time I got the additional insurance in place I had to wait until 1 April, 2010 for his next opening. He was worth the wait because I knew he could fix me no matter what he found.

The surgery took about 3 hours and the pain was not to bad. They gave me a bottle of pain pills and I took them - made my stay in Boston go faster. I never needed a refill. The post surgery is a bitch. The sling and swath gets old quick. The biggest pain I has was in my shoulder do to the sling - frozen shoulder. I was out of work a couple of weeks but I have a desk job and was able to go back after that. Putting a shirt on with the sling and swath is the biggest pain but you figure out how to do it.
Ken

AOL

#1693 Apr 3, 2011
continued:

The final phase is rehab. Remember I went through PT after the injury so I knew what that was all about. The fact they were able to take one look at me and say rehab won't do anything ; I lost all faith in them. The biggest advice I would give anybody is don't push the ROM in rehab. It will come back on its own with everyday activity. I just worked it a little bit each day not pushing to hard and in 6 months my ROM was basically 100%. It is absolutely ridiculous to me to risk a re-tear trying to push something that will come back on its own. If after 6 months you are not where you want to be then go to PT. I don't think you will find anybody who had this surgery who has a problem with ROM a year after. People who go through PT give so much credit to the PT when they don't realize that most of that would have come back on its own. The only thing I will tell you is if you do go to PT get somebody who has experience with this injury and at no time should you let them push you beyond what you feel comfortable with. You need to stay in control. Risking a re-tear for early ROM is the dumbest thing you could do. I belong to the YMCA and local gym so I access to all the equipment I need. I started swimming laps at the 16 week mark and this was by far the best rehab exercise for me. My shoulder pain was 100% gone after a few weeks. I was up to swimming a mile each workout after a month. I started regaining a lot of confidence it the repair after I was able to work hard in the pool. At no time did I experience any swelling or real pain in the pec. When I got back into lifting I did experience some pain in the first few reps of the bench. It was like a pinching feeling and kind of went away with each set. I always stretched real good before lifting and the pinching feeling has since gone away.

I am currently back to full speed with sports and have been for some time. I have always been into playing sports and worked out to be at my best. I am not a power lifter so cutting out the heavy bench is not a problem. I am up to 3 sets of 10 with 165lbs and I do not plan on going any higher. I use a narrow grip when benching and I do not feel I am putting a big stretch on the muscle. In combination with dumbells I am getting a good workout. The look is not quite symmetrical but it looks good. There is a slight dent at the top of the peck but only someone who knows what to look for could tell. The scar is fading and I really have no problem with it. Before the surgery I looked at this as a deformity and now that it has been repaired I think of it as a battle scar and story to tell. The advice I would give anybody is to get it fixed. I lived with a complete tear for a year and I could not get if off my mind. The reason it his hard not to think about is every time you use your arm you can feel the muscle not working right. This really bothered me. My shirts did not fit right either do to the huge chunk of muscle that was no longer there. I also thought how bad was this going to look down the rode with the muscle just continuing to deteriorate. This pec is a major muscle and if it is not attached you body will have to compensate which is going to cause other problems.

The most important decision in this entire process once you decide on the surgery is the surgeon who does the repair. If it is not fixed right all the rehab in the world won't help. Once I had the surgery I could see and immediate difference. The huge dent was gone and I could grab a big chunk of muscle between the shoulder and pec that was ripped away.

Sorry for the novel but hope this info helps. Good luck to everybody, and don't give up hope.
Ken

AOL

#1694 Apr 3, 2011
I meant to say the fact that the my PT couldn't just look at me and realize PT would not help made me lose faith in them. After the surgery I fealt I knew a lot more about this injurt then the PT that was working with me. Looking back if he would have said at any point that your pec is torn I would have had a little more faith in them. Trust me - If I saw somebody in the gym with a complete pec tear I would tell them to get surgery - not to see if they can do 30 pushups.
Matt

San Diego, CA

#1695 Apr 3, 2011
Ultimately the best thing you can do for a pec tear after the surgery is to let it heal. It takes months for the muscle and bone to have a strong reattachment.

I've gone to a PT twice, and the only reason I really go is because she gives a really good massage to my deltoid/lat area, which are the two areas that are going to be sore post op. Surprisingly, my pec area was never sore post op, it's the shoulder that stiffens and the lat that gets sore because there's no abduction of the arm for 6 weeks.

I think Ken is 100% right. ROM will come back naturally with daily activity, it just takes time. I am 8 weeks out now and I feel great, though my shoulder is still stiff and my ROM is about 80%.

The biggest problem that I'm having is that I want to go to the gym and work out so bad, but I know I can't. Seeing my upper body get flabby and lose muscle is far worse than the surgery ever was.
john

Broomall, PA

#1696 Apr 4, 2011
possible torn pec muscle going into the shoulder...probably not a full tear seeing how its been a week and i have been getting better....was wondering how late is to late for surgery if needed...also no insurance any ideas on what i should do? thanks guys

Since: Jan 11

Los Angeles, CA

#1697 Apr 4, 2011
For me, PT has been great. I really think it depends on the experience level of the person you find. I personally cant imagine just letting my pec/shoulder 'heal' on its own. Just my opinion and experience obviously, but everyone here who is saying DONT go to PT, is presenting only an opinion. So take this all with some salt.

There have been studies done that show the faster you move your injured area through specific ranges of motion, the better and faster it heals. I'll see if I can find the papers. My 2 cents.
Kevin

Remsen, NY

#1698 Apr 4, 2011
Ken, you are basically confirming what I keep asking everyone. If you don't have the "wing" or "sweep" then you still have a pec tear. Right?
I'm 8 weeks post opp and it still looks like I have a pec tear, muscle is NOT fanned out when I do a double biceps or iron cross pose. It does not LOOK connected at all. I can feel the repaired tendon however, and when I stretch I believe I can feel that its connected.
Surgeon doesn't have a good answer as to why the muscle hasn't fanned/stretched out. Some guys have told me that it comes back when you start working out the chest muscle again.
I don't understand how that's possible but I can't imagine them just lying about it, so who knows?
I just dont know wtf to do.
Ken wrote:
I meant to say the fact that the my PT couldn't just look at me and realize PT would not help made me lose faith in them. After the surgery I fealt I knew a lot more about this injurt then the PT that was working with me. Looking back if he would have said at any point that your pec is torn I would have had a little more faith in them. Trust me - If I saw somebody in the gym with a complete pec tear I would tell them to get surgery - not to see if they can do 30 pushups.
Ken

AOL

#1699 Apr 4, 2011
Santsephai,

I am not saying don't go to PT - just don't push the ROM to hard and be in control of the session. I was swimming over a mile non stop after 20 weeks, not to bad. I was back playing sports in 5 months. I was dealing with a complete tear of the Pec major and minor at 46 yrs old. I am saying it will come back on its own and there is no need to risk a re-tear by pushing it to hard. A re-tear would have been devastating to me. The body needs time to heal. It is like scraping your knee. Your body has its own way of healing it. You develop a scab and eventually it goes away. There is no rehab exercises you could do to make the cut heal any faster. This is what is going on inside the body it just takes a little bit of time. At the end of the day if you were repaired correctly ROM will not be an issue down the road with or without PT.

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