Isolated rupture of teres major in a goalkeeper

Abstract

A complete rupture of the teres major is an extremely rare injury and rarely described in the literature. We report the first case of an isolated rupture of the teres major in a professional football goalkeeper. The diagnosis requires a high degree of suspicion and complementation by image examinations. Conservative treatment has a high success rate with early return to sport.

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“…In a sporting context, the existing literature typically pertains to throwing or overhead athletes, notably baseball pitchers (Ellman et al, 2013;Nagda et al, 2011;Park, Lhee, & Keum, 2008;Schickendantz et al, 2009). Whilst uncommon, the true incidence of injury may not be fully appreciated given the moderate functional limitations encountered in this and other reported cases (Fysentzou, 2016;Maciel et al 2015). In the absence of imaging to confirm diagnosis, such limitations may be attributed to less significant pathology.…”

“…Fibres of latissimus dorsi traverse the axilla to insert into the proximal humerus at the lesser tuberosity and medial aspect of the bicipital groove (Fysentzou, 2016;Henry & Scerpella, 2000;Schickendantz et al, 2009). Teres major performs similar functions and can have confluent fibres with latissimus dorsi at the humeral aspect (Maciel et al, 2015;Malcolm, Reinus, & London, 1999).…”

“…Fysentzou (2016) described a complete latissimus dorsi myotendinous junction rupture caused by falling on an outstretched arm, with return to play at five weeks post-injury. Maciel et al (2015) reported a case of isolated teres major tendon rupture caused by overarm throwing; this athlete was able to complete the match in which the injury occurred, before subsequent return to play after 18 days. In both cases, athletes were conservatively managed with rehabilitation programmes consisting of progressive strengthening exercises and graded return to play (Fysentzou, 2016;Maciel et al, 2015).…”

“…Maciel et al (2015) reported a case of isolated teres major tendon rupture caused by overarm throwing; this athlete was able to complete the match in which the injury occurred, before subsequent return to play after 18 days. In both cases, athletes were conservatively managed with rehabilitation programmes consisting of progressive strengthening exercises and graded return to play (Fysentzou, 2016;Maciel et al, 2015). Both authors rate their outcomes as excellent, with no injury recurrence or functional limitation at 12-month follow-up (Fysentzou, 2016;Maciel et al, 2015).…”

“…Due to signs of rapid clinical improvement and reported comparable outcomes of surgical and conservative management, recommendation was made to manage the player non-operatively (Schickendantz, Kaar, Meister, Lund, & Beverley, 2009). A return to play timeframe of 4-6 weeks was estimated based on previous case reports (Fysentzou, 2016;Maciel, Zogaib, de Castro Porchini, & Ejnisman, 2015) and rate of clinical improvement thus far.…”