Koji Uehara's Strained Pectoral Muscle

Koji Uehara Injury

On July 19, seven pitches into a non-save situation, Red Sox reliever Koji Uehara left a game against the San Francisco Giants clutching his right arm and grimacing. It’s easy to imagine Red Sox fans grimacing too. After all, the team has seen its fair share of bullpen injuries this summer — including trips to the DL by closer Craig Kimbrel and reliever Junichi Tazawa. But even after an MRI revealed that Uehara had suffered a right pectoral strain, Kevin Samaha, PA-C, Physician Assistant in the Division of Sports Medicine and Shoulder Surgery at Beth Israel Deaconess Medical Center, suggests there’s reason for hope.

“A large majority of muscle strains can be managed non-operatively and will go on to heal with very little lasting effects,” says Samaha. “Of course, muscle strains need to be assessed on a case-by-case basis, and it’s important for each individual to take enough time to heal properly.”

Your pectoral muscles help with movements of the arm and shoulder. They’re what help you rotate the arm, pick up objects, and throw a baseball. So it’s never good when a pitcher has a pectoral injury. But even with all the strength and conditioning that goes into preparing for a major league season, muscle strains can still happen.

“It’s a common misconception that strength alone can prevent muscle strains,” says Samaha. “Muscle tissue will start to tear when it cannot tolerate a stretch in the process of contracting. Therefore, muscle flexibility is just as important as, if not more important than, strength alone. When it comes to muscles, remember this: longer is stronger.”

Samaha explains that pectoral strains are categorized as grades one through three. Grade 1 is the tearing of a small amount of muscle fibers, resulting in some pain but allowing full function. Grade 2 is the tearing of a significant amount of muscle fibers, resulting in moderate loss of function. Grade 3 is when all muscle fibers are ruptured, resulting in major loss of function. Symptoms of a torn pectoral muscle can include a sharp pain near your shoulder, soreness, a burning sensation, and swelling of the shoulder and arm.

“Depending on the grade, muscle strains can generally take somewhere between four and six weeks to heal. Athletes, both professional and recreational, should only resume physical activities once they’ve achieved full strength, full range of motion and have no pain. Doing too much too soon can lead to a higher risk of re-injury.”

So how can you help lower that risk of re-injury? Samaha notes that the R.I.C.E. method of treatment — rest, ice, compression, elevation — can be helpful for grades one and two strains. A sports massage is another option to help with healing and recovery. And it’s also important to remember that resting a torn muscle decreases its flexibility, which means athletes need to stretch their pectorals to restore range of motion before participating in strenuous activity again.

But as for Koji? Patience is key to a successful return to the Red Sox bullpen. The Fenway faithful will just have to be patient, too.