Dealing with a Torn Pectoral Tendon
August 15, 2008
by Nate
Almost two weeks ago, in a late-night workout at home with HB spotting, I reached a new max on the bench press of 325 pounds. I'd been making rapid strides on the bench recently, partially by working out much closer to my max and partially, I suspect, because of creatine supplements. I warmed up, but not a whole lot: I remember wanting to preserve as much energy as possible for hitting a new max. I'd set my new goal on the bench at 400 pounds. I did 325 and, honestly, it felt easy. I wanted to do more: 330, or 335? Hell, I said: you only live once. We put 335 on. I brought the weight down and stalled. As I tended to do, I shifted the bar a bit higher to get a burst of strength from the shoulders. I started to push up and felt a moment of triumph--I thought I had it. Suddenly, something snapped in my right pectoral. The weight crashed down on my right side. HB grabbed the bar and I slid out from under it and fell to the floor, cradling my right side.
The next day, it looked like my right pec was swollen, which was only to be expected. The injury didn't hurt that much; there was a constant dull ache, but not the kind of burning pain I thought would accompany a tendon injury. I was pretty sure I'd just pulled a muscle. But after two days, Bek asked me for the fifth time or so if I was sure I didn't want to have her take me to a doctor. I was pretty sure it wasn't serious, but it was probably better to be safe than sorry, and if she'd help with the arrangements, I thought I might as well do it, if only as a precaution. I went to urgent care, and the doctor didn't even examine me, but put me in a sling and sent me to an orthopaedist.
I had developed a rather ugly black and blue strip on my right bicep, but my bicep didn't hurt and wasn't that close to my pec, so I figured I'd dropped the bar on it.
At the orthopaedist, he took one look at me with my shirt off, laughed, and said, "Yeah, I can tell you exactly what you've done." He explained that the pectoralis major tendon was a long, broad tendon, connected to the entire side of each tendon. "You see how it creates kind of a web across the side of your left pec and draws it out? See how that's missing on your right side?" My right side wasn't swollen, it had dramatically changed shape because most of it wasn't connected anymore.
You can see a good example of what this looks like, if you wish.
Monday, I got an MRI. Now I'm waiting with a sheaf of magnetic images of my insides to present to the doctor on this coming Monday. On the first visit, he indicated a strong preference for treating the injury "non-surgically" and just living with the "defect". I don't know if this will change based on the MRI, but I'm going to ask about the possibility of surgery anyway. With surgery, I'd have the possibility of returning to full strength, not to mention a more normal appearance. The problem is that the surgery sucks. 3-6 weeks in a sling, at least a week of sleeping in a chair, many months of painful physical therapy afterward. (Well, I get that even without surgery.)
It's amazing how impossibly self-absorbed I feel right now: it's hard to think about much beyond my injury and the possibility of surgery. I'm angry about the seeming arbitrariness of the injury (all my speculation about the causes of the injury may add up to nothing... descriptions of the injury online are all different), angry about losing my best lift, and generally quite filled with self-pity. It's nice, on the one hand, to have an injury so widely acknowledged to be hell, and to have a horrible black and blue mark on my arm as proof that something serious has happened to me. On the other hand, I feel like it's coming very close to the time that I need to get over myself and focus on living again.
I keep thinking about Amanda and Tania, both of whom (to different degrees) have had to come to terms with a constant life of difficulties like these. How hard it is to care about anything outside the psychologically consuming experience of one's own pain! It reminds me of something I have often said, but not perhaps felt so dramatically as I do now: the primary problem with pain is that it makes one so tremendously particular, it drags one into being just me, just now.
At any rate: weight-lifters, beware. It looks like there are things one can do to reduce one's risk of this type of injury. Use a narrower grip, don't bring the bar down all the way to the chest, warm up extensively. Doing the press with dumbbells is apparently even better, as it strains the tendons less. Maybe someday I'll have the chance to do it again, and take my own advice. I hope so.
Comments
On August 15 at 1'01 PM
, Adrian Turner wrote:
WOW! Well I’m glad you are ok.
God Bless you on a speedy recovery.
On August 15 at 1'21 PM
, Amanda wrote:
Nate, I know how often others can sound like belittling or patronizing assholes when trying to console, sympathize, or encourage. I know there are times when I sound exactly this way too, despite disliking it in others so much. For someone who has dealt with so much illness and injury, I’m not good at responding appropriately when other people go through these things, so I’m sorry if any of my twitter responses to you have come across as insensitive. Know that above all I have been thinking about you and wishing the best for you through this or the emotional fortitude if the best doesn’t come, whatever different daft things I might wind up saying.
On August 15 at 1'31 PM
, Nate wrote:
Adrian: Thank you!
Amanda: Not at all! Sorry: it looks like I actually missed a couple of your twitters. I need to check the replies thing more often. Or, actually… I bet I could get a feed of just those, couldn’t I? No, your well-wishes are welcome and appreciated.
On August 15 at 2'20 PM
, Tania wrote:
Hope there are good options for your recovery, Nate.
Also, for the future… there’s a difference between enjoying your body and, well, trying to conquer it. I hope that’s become clear to you and you won’t make the same mistake twice. Living with my body keeps trying to drill that into my head. It’s a hard lesson. (Even yesterday, I “re-organized” in the bathroom and over-used my brand spanking new, not-yet-fully-recovered wrist.)
(Also, 335 pounds? Holy shit!)
On August 15 at 7'20 PM
, Amanda wrote:
I want to respond a little more thoroughly now that I have time to do so.
How hard it is to care about anything outside the psychologically consuming experience of one’s own pain! It reminds me of something I have often said, but not perhaps felt so dramatically as I do now: the primary problem with pain is that it makes one so tremendously particular, it drags one into being just me, just now.
This reminds me of some passages from Elaine Scarry’s The Body in Pain that I feel like you might appreciate:
“As the body breaks down, it becomes increasingly the object of attention, usurping the place of all other objects, so that finally, in very very old and sick people, the world may exist only in a circle two feet out from themselves; the exclusive content of perception and speech may become what was eaten, the problems of excreting, the progress of pains, the comfort or discomfort of a particular chair or bed.”
“As in dying and death, so in serious pain the claims of the body utterly nullify the claims of the world.”
You’ve described the way you feel as self-absorbed, but to me this isn’t an adequate description. Self-absorbed has the connotation of choosing to be utterly involved in your own thoughts. When you’re in so much pain there’s often not that level of choice involved. I wish I knew a better way to describe this because it’s something I often try to explain to people. In any case, I wouldn’t worry much about being too self-pitying. It can help a lot to give in to those feelings at times. You needn’t “get over yourself” since focusing on living doesn’t involve the exclusion of self-pity or other “negative” feelings, but the willingness to permit yourself to experience whatever breadth of feeling this injury and the situations arising entail. Of course, I’m terrible at permitting myself to feel anything, so consider that advice as coming from someone who is usually incapable of following it herself.
On August 15 at 7'41 PM
, Martin G wrote:
This topic of conversation deals in why I am entering medicine. When a very good friend recently asked me why I was enlivened by medicine this is what I had to say:
“If I have a thesis it consists of two parts: 1) there is a best life to be lived and 2) humanity is eminently distractable from living the best life. One of the chief sources of distraction to people are their bodies and disease is one of the large reasons for it. If I can alleviate disease then there is the chance that I free someone of one of the chief encumbrances toward living the best life.”
I hope it works out. I should also say that many folk have seen their pain as an orientation to something beyond their body and in that way are blessed to turn their suffering into something truly enlightening. That said, I admit myself to think that charism a rarity but a very noble rarity.
On August 16 at 6'00 PM
, Rachel Sullivan wrote:
I completely agree with your instinct to go for the surgery. With laprascopic tendon repair these days, it’s not even very risky at all, though I’m by no means an expert. If the surgeon says you’re a good candidate, which I think he will, then you should go for it.
Also, be careful with the creatine, we see a lot of sport supplement related injuries in the Active Duty population, especially in the kidneys. You need to drink a LOT of water to make sure that you don’t go into kidney failure one of these days. Just the other month I treated someone taking “N.O. EXPLODE” which is creatine and caffeine, and after a particularly intense workout he went into rhabdomyolysis and is now on the list for transplant, with no hope of his kidneys ever returning. I’m a big fan of Whey protein, but anything else makes me really nervous.
And I agree with Martin: much of the things you express are why I decided medicine was such a noble profession: my job is to help people get back to living, and it’s an amazing feeling when I actually do something that helps to do just that.
On August 21 at 3'32 PM
, Joann Walling wrote:
Hello there, I worked with you at Safeway. I asked youre Mother about you and she gave me this websight. I havent had alot of chance to read much, but I will be back when more time is at hand. I hope all is well for you and all youre doing… graham sends a cheery greeting