Pectoralis Major Tear and Extensive Capsulolabral Injury After Military Combatives Class

Area of Science:

• Orthopaedic Surgery
• Sports Medicine
• Diagnostic Imaging

Background:

• Direct-access physical therapy allows patients to seek care without physician referral.
• Shoulder pain can arise from various traumatic or overuse injuries.
• Accurate diagnosis is crucial for effective management of shoulder injuries.

Observation:

• A 26-year-old male presented with acute right shoulder pain after forceful abduction and external rotation during combatives training.
• Initial radiographs were inconclusive.
• Magnetic resonance imaging (MRI) and MR arthrogram were performed.

Findings:

• MRI confirmed a complete pectoralis major tendon detachment from the humerus.
• MR arthrogram revealed an extensive, near-circumferential labral tear.
• A reverse Bankart fracture was also identified in conjunction with the labral tear.

Implications:

• This case highlights the importance of advanced imaging in diagnosing complex shoulder injuries.
• Pectoralis major tears and labral tears with associated fractures require prompt orthopaedic evaluation.
• Understanding these injuries is vital for physical therapists managing athletes and active individuals.