Acute Traumatic Tear of Iatissimus Dorsi Muscle in an Elite Track Athlete

Abstract

Soft tissue injuries constitute 30-50% of all sports related injuries; however, injury to the latissimus dorsi muscle is quite rare with only a few cases reported in the literature. Herein, we describe an acute traumatic tear of the latissimus dorsi muscle in an elite track athlete, which has not been reported in the track and field sports before. The injury was caused by forceful resisted arm adduction that took place at hurdling and starting from the block. A pseudotumor appearance in the axillary region was misdiagnosed as a mass. The diagnosis was made by ultrasound alone and the patient was managed conservatively.

Traumatic Tear of the Latissimus Dorsi Myotendinous Junction

“… 1 , 7 Recent advances have shown both MRI and ultrasonography as imaging modality options that provide useful information, allowing characterization of these injuries into 4 basic categories: (1) isolated tendon injury/avulsion 1 , 5 , 7 - 9 , 11 , 13 , 14 , 17 , 19 ; (2) combination injuries with LD tendon injury associated with trauma to the adjacent pectoralis major, teres major, or rotator cuff 3 , 12 , 14 , 17 , 18 ; (3) isolated myotendinous strain 10 , 15 , 16 ; and (4) intramuscular strain. 2 , 4 …”

“…An MRI scan provides important presurgical information of the nature of the injury, specifically, distinguishing between tendinous and myotendinous etiologies, as well as evaluating the extent of tendon retraction or tendinopathy. The majority of reported myotendinous and muscular injuries of the LD have been treated conservatively, 2 - 4 , 10 , 16 with only 1 patient reporting development of a mild functional deficit. 3 …”

Sports Injuries to the Latissimus Dorsi and Teres Major

“…A review of citing and cited articles produced 25 case reports and 2 case series detailing 55 sports injuries to these 2 muscles. While the majority of the athletes studied (32/ 55) were baseball pitchers, 12,14,29,34,37,44 these injuries have also been reported in athletes participating in water skiing, 12,20,[30][31][32]35 tennis, 38,46 rock climbing, 33 track, 10 hockey, 18 golf, 45 body building, 7 volleyball, 1 basketball, 1 handball, 2 wrestling, 19 rodeo steer riding, 9,21 cricket, 47 a police athletic competition, 8 and military training 47 (Table 1).…”

“…The first, found in nonpitchers, is forceful resisted shoulder adduction and flexion, causing eccentric contraction of the muscles. 10,32,33 This may be precipitated by sudden forced extension 2 or hyperabduction 7,19,21 of the shoulder. The other mechanism, seen in pitchers, is part of the throwing motion.…”

“…Some patients describe a burning sensation. 10 If able to pinpoint the timing of the pain, pitchers describe the pain as being worst at release and follow-through. 44…”