York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement


The pectoralis major muscle is located on the front of the chest. The pectoralis major originates from two heads: the clavicular (collarbone) and the sternal (breastbone) heads. The two heads unite to form a tendon, and the tendon inserts on the humerus bone below the shoulder joint. The pectoralis plays an important role in internal rotation (rotating the shoulder toward the body) and adduction (bringing the arm toward the body). A tear of the pectoralis major usually occurs during weight-lifting with the shoulder in an externally rotated or extended position. A common exercise associated with pectoralis major tears is the bench press. A tear of the pectoralis major leads to swelling, bruising, pain, and weakness. A tear of the pectoralis major can cause significant weakness and cosmetic deformity, and Dr. Welch may recommend surgery for some patients

During surgery, Dr.Welch makes an incision on the front of the shoulder and then identifies the torn tendon. Dr. Welch then locates the area on the humerus bone where the tendon tore. Dr. Welch then inserts two or three suture anchors (medical screws with sutures) or a “cortical button” into the humerus bone and passes the sutures through the torn tendon. Dr. Welch then tensions the torn pectoralis tendon back down to the humerus and ties strong knots.

Post-Operative Rehabilitation

Following surgery, patients are placed in a sling for comfort. The arm is positioned in a neutral or internally-rotated position. This position keeps tension off of the repaired tissue. Dr. Welch recommends intermittent icing and gentle range of motion following surgery. Dr. Welch also recommends starting physical therapy 2-4 weeks after surgery. Physical therapy focuses on reducing swelling in the shoulder, restoring range of motion, and eventually, restoring strength to the shoulder. It is very important to follow the rehabilitation process carefully to achieve the best outcome.