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Large Partial-Thickness Tear of the Subscapularis Tendon
The Journal of Orthopaedic and Sports Physical Therapy
|February 1, 2019
Summary
A traumatic shoulder injury in a sailor resulted in a significant subscapularis tendon tear. Early physical therapy intervention and MRI were crucial for diagnosing this complex shoulder injury.
Area of Science:
- Orthopedics
- Sports Medicine
- Physical Therapy
Background:
- Direct access physical therapy allows for prompt evaluation of musculoskeletal injuries.
- Understanding injury mechanisms is vital for accurate diagnosis in athletes and active individuals.
Observation:
- A 27-year-old active-duty sailor presented with acute left anterior shoulder pain after a forceful throwing motion.
- The patient exhibited weakness in internal rotation, prompting further investigation.
Findings:
- Magnetic resonance imaging (MRI) revealed a large partial tear and retraction of the subscapularis tendon at the lesser tuberosity.
- Associated injuries included a labral tear and an intratendinous biceps tendon tear with subluxation.
Implications:
- This case highlights the potential for severe shoulder injuries from high-energy rotational forces.
- Prompt diagnosis through clinical examination and advanced imaging is essential for effective management of complex shoulder tears.
- Early physical therapy can guide appropriate diagnostic pathways for shoulder injuries.
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