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Syd Uni sports clinic
16-03-2006, 11:49 AM
Just saw an interesting patient who is 60 yo and plays social tennis. Managed to completely rupture lat dorsi tendon during a serve and play the rest of the match out. Has a big bruise and a big divot, but surprisingly has very little shoulder pain or restriction of movement (the injury happened a week ago).

I appreciate the textbook treatment of this would be surgical management, but since the guy is wanting to head out and play next week, it seems like overkill to have him spend 6 weeks in a sling waiting for a surgical repair to knit. I'm going to watch him and see how he goes without a lat dorsi tendon.

Interested if anyone has seen something similar (particularly an older patient who might have regretted decision to not have an operation).

Rod Whiteley
23-03-2006, 01:44 PM
Hmmm - how about Steve Waugh - fits the criteria for 'older patient' although he did go on to have surgical treatment, and I understand a full recovery - he did bowl again.

Rod Whiteley
23-03-2006, 02:51 PM
The most recent edition of Physical Therapy (Physical Therapy Volume 86 Number 3 March 2006) presents a case report on surgical management of a Latissmus Dorsi tear, the abstract claims that they include a literature review. Might be worth looking at (I haven't yet):

Rehabilitation Following Repair of a Torn Latissimus Dorsi Tendon
Robert Burks, Wendy Burke, and Milan Stevanovic

Background and Purpose. This report describes the rehabilitation of a patient following surgical repair of a torn latissimus dorsi tendon. The scientific rationale for the treatment progression is discussed. Case Description. A 35-year-old man with a ruptured latissimus dorsi tendon 6 weeks following surgical repair was referred for physical therapy to recover range of motion and strength sufficient for return to work as a police officer on the SWAT team. A review of tendon healing in animal studies is presented and related to the development of the plan of care for this patient. Outcomes. Latissimus dorsi muscle isometric force generation on the injured side was 92% of that of the uninjured side. The patient returned to work as a SWAT team member. Discussion. No detailed reports of postoperative latissimus dorsi tendon rehabilitation are available. The program for this patient was based on research demonstrating the timeline for recovery of tensile strength in healing tendons. This approach can direct rehabilitation following repair of other tendons, especially in uncommon injuries where specific guidelines have not been developed. [Burks R, Burke W, Stevanovic M. Rehabilitation following repair of a torn latissimus dorsi tendon. Phys Ther. 2006;86:411-423.]

Unregistered
05-06-2006, 09:13 PM
Just saw an interesting patient who is 60 yo and plays social tennis. Managed to completely rupture lat dorsi tendon during a serve and play the rest of the match out. Has a big bruise and a big divot, but surprisingly has very little shoulder pain or restriction of movement (the injury happened a week ago).

I appreciate the textbook treatment of this would be surgical management, but since the guy is wanting to head out and play next week, it seems like overkill to have him spend 6 weeks in a sling waiting for a surgical repair to knit. I'm going to watch him and see how he goes without a lat dorsi tendon.

Interested if anyone has seen something similar (particularly an older patient who might have regretted decision to not have an operation).
hi im an average 17 stone plus ex bodybuilder and just started training again after a long lay off and somehow managed to rupture my right hand side lat muscle due to a heavy set of standing barbell shoulder presses(free-weight)i noticed that i wasnt in pain and only noticed it when i raised my arms above my head,my right hand shoulder seemed to have dropped and my lat muscle which is very prominent wasnt there?im currently visiting hospital and physio at this moment and they seem baffled as they havent seen anything like it?will i need surgery i dont know as the orthopedic doctor said it might attach itself due to the formation of scar tissue.i will keep you updated what the doctors do or say,thankyou. steve.