Active Duty Soldiers & Bench Press Injuries | News | Loyola Medicine
Wednesday, March 28, 2018

Military Surgeons Report "Alarming Frequency" of Bench Press Injuries

bench press

MAYWOOD, IL – While deployed in combat zones, U.S. armed forces prepare for the rigors of combat and stay in peak condition by lifting weights during intense and demanding workouts.

However a new study has found that serious chest muscle injuries are occurring with "alarming frequency" among deployed service members who lift weights. The injuries – tears of the pectoralis major tendon – occurred while doing bench press weight training. The injuries then required surgical repair and six months recovery.

Loyola Medicine orthopaedic surgeon Dane Salazar, MD, a former Air Force orthopaedic surgeon, is lead author of the study, published in the Journal of Orthopedics and Rheumatology.

Dr. Salazar and fellow Air Force orthopaedic surgeon W. Steven Choate, MD, treated nine active duty soldiers and airmen for pectoralis tears during just four months at a hospital in a forward deployed location. The injury is relatively rare among civilians. In fact, a shoulder-and-elbow surgeon may see an average of less than one pectoralis tear a year.

Deployed active duty personnel "likely represent a high-risk population for this injury," Dr. Salazar and colleagues wrote. "Future studies designed to identify the true incidence, report long-term outcomes and investigate modifiable patient risk factors in this population are warranted."

Before joining Loyola, Dr. Salazar spent 14 years in the U.S. Air Force Medical Corps. From the fall of 2013 through the summer of 2014, he was deployed at an expeditionary medical treatment facility (field hospital).

During a four month span in that deployment, Drs. Salazar and Choate treated nine male patients (four Army, five Air Force) for pectoralis major tears. All were injured while doing bench press weight training. At the time of injury, the weight on the bench press bar ranged from 135 pounds to 415 pounds, with an average of 258 pounds. The servicemen ranged in age from 23 to 52, with an average age of 32. Three were officers and six were enlisted.

The pectoralis major muscle has two distinct heads. One originates at the collar bone. The other extends from the chest bone to the upper arm bone via a tendon. The muscle-and-tendon unit often is referred to as "the Pec" or "pec muscle."

The surgeons hypothesize that the pectoralis major tears "can be attributed to the increase in both intensity and frequency of physical training that occurs during deployments to the war zone."

The field hospital lacked all of the equipment and technology of a civilian hospital. For example, the surgeons had to send pectoralis tear patients to foreign local hospitals for MRIs. Nevertheless, Drs. Salazar and Choate were able to successfully repair the pectoralis tears without serious complications. They used a technique called bone trough and transosseous repair.

Following surgery, the patients wore slings for six weeks. From six weeks to four months, the patients did physical therapy, but could not lift anything heavier than five pounds. From four months to six months, patients continued therapy and began light strengthening exercises. They were allowed to resume full activity at six months. All were able to return to duty.

To reduce the risk of pectoralis injuries, the surgeons urged the military to ban maximum-weight bench press competitions. They also recommend weightlifters lift lighter weights with more repetitions.

Dr. Salazar is an assistant professor in the department of orthopaedic surgery and rehabilitation of Loyola University Chicago Stritch School of Medicine. (During the time the study was conducted, Dr. Salazar was affiliated with St. Louis University School of Medicine.)

The study is titled "Acute Pectoralis Major Tears in Forward Deployed Active Duty U.S. Military Personnel: A Population at Risk?"

In addition to Drs. Salazar and Choate, other co-authors are Irshad Shakir, MD, Heidi Israel, PhD, Kara Van de Kieft, MD and the late Keith Joe, MD. 

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 129,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.