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Updated: May 11 2021

Latissimus Dorsi Rupture

Images tear.jpg
  • Summary
    • Latissimus dorsi rupture is a very rare condition that has been reported as a cause of pain in the thrower’s shoulder.
    • Diagnosis is suspected with pain over the latissimus dorsi made worse with shoulder adduction/internal rotation and confirmed with an MRI.
    • Treatment is nonoperative for the majority of patients. Surgery is indicated in competitive athletes with completed tears. 
  • Epidemiology
    • Incidence
      • very rare condition
  • Etiology
    • Mechanism
      • felt to be eccentric overload during the follow-through of the throwing motion
  • Anatomy
    • Latissimus dorsi muscle
  • Presentation
    • Physical exam
      • local tenderness and deformity over latissimus dorsi muscles
      • pain with shoulder adduction and internal rotation
  • Imaging
    • MRI
      • shows increased T2 signal and retraction of latissimus dorsi muscle
  • Treatment
    • Nonoperative
      • short period of rest followed by PT
        • indications
          • allow resumption of activities in low demand patients
        • technique
          • physical therapy goals are to restore shoulder motion and strength
          • throwing can be allowed
            • after full, pain-free motion and good strength
            • balance of the rotator cuff and scapular rotator muscles
    • Operative
      • primary repair vs reconstruction
        • indications
          • for high demand athletes (currently there are no defined indications for surgical repair)
        • technique
          • early primary repair is favored to prevent retraction and scarring
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