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At which of the following points during a bench press is the pectoralis major insertion at greatest risk of rupture?
Middle portion of upward motion
Point of maximum elevation
During downward deceleration
When bar is touching chest
No difference in rupture rate is seen
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A 24-year-old bodybuilder reports shoulder pain after an injury while bench pressing. Physical exam reveals ecchymosis and swelling in his right upper arm as shown in Figure A. He has weakness in internal rotation but has good strength in external rotation and abduction; his apprehension test is negative. When he puts his hands on his hips, his upper chest is asymmetrical. When is surgery indicated for this injury?
Surgery is not indicated; conservative management including ice, rest and NSAIDs are recommended
After a period of immobilization, followed by physical therapy, has failed
When the pectoralis major has avulsed from its humeral insertion
Asymmetry of the upper chest wall without functional deficits
If swelling and ecchymosis are primarily located on the chest wall rather than the upper arm
A weightlifter feels a pop in his anterior left shoulder while doing a bench press exercise. Which nerve innervates the muscle that is disrupted as seen on the MRI shown in Figure A?
Upper and lower subscapularis
Lateral and medial pectoral nerves
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