Teres major and latissimus dorsi myotendinous injury in a professional boxer

Abstract

Introduction.-Shoulder injuries are common sports pathologies. We describe the diagnosis and management of a rare injury: a teres major tendon tear. Case report.- A 28-year-old man who was a professional boxer, was admitted for left axillary pain after an uppercut. On examination, he had no apparent abnormalities but had painful limitation of active range ofmotion (ROM) with no limitation of passive ROM. There were no signs of neurovascular deficit, rotator cuff injuries or gleno-humeral instability. During manual strength testing, isometric teres major and latissimus dorsi contractions were painful. Ultrasound and MRI showed teres major and latissimus dorsi tear at the myotendinous junction. He was treated conservatively with rehabilitation (specific and global muscular strengthening). He returned to competition 4 weeks later. Discussion.- There are only few (21) reported cases of teres major tears, and most occurred in competitive athletes. None had been reported on boxers. These injuries are underdiagnosed as the functional deficit is of minimal consequence in daily life but may be unacceptable in an athlete. The low prevalence of these tears may be explained by the lack of visualization on conventional shoulder MRI due to the narrow field of view. We thus insist on the need for a thorough clinical examination followed by echography and MRI with adapted windows. Our case shows conservative treatment was successful, with good outcomes and return to the competition level.