Hello,
First of all, thank you for all the great content you are providing.
I had pain in pulling motions (not deadlift) in my right lat for 2 weeks, no major concern until yesterday evening. I was pulling deficit deadlift, I was tired overall but feeling very nice during the lift. I jumped from 180kg (which moved so nicely) to 200kg and felt a big big tear in my right lat, just like when you chunk into a thick piece of meat, when the weight came off of the floor.
I went to the mirror and checked, light bruising - almost non existent - but a bulged muscle in the axillary crest. Loss of strength of course because of the pain and no loss of ROM.
After a relatively good night sleep, I have lost a significant amount of ROM (to be expected) accompagnied with pain (to be expected) and loss of strength.
It appears that the bulge is still here. There is no bruising yet but a swelling in the arm till the fingers, chest and upper back because of the inflammation.
I know I tore something and I have an MRI scheduled on Thursday to assess the degree of the tear. My concerns are towards surgery :
I found limited case studies on surgery for the lats and teres major. How often have you encountered such a tear and what are the criterias for surgery ? (I work in the fitness environment, I need my strength).
Thanks a lot.
Hoshoryu,
Welcome to the forum, though I wish it were under better circumstances. I’ll start by saying this is probably best addressed via a consultation, as we’re somewhat limited on what we can do via the forum.
On the one hand, your experience during the incident could most certainly be the result of a muscle strain/tear. I can’t speak to the muscle “bulge” and whether or not that’s your normal anatomy vs a deformity. The lack of bruising is a positive sign, as muscle tears do typically bruise in proportion to greater tissue disruption. Deeper tears sometimes take longer for the bruising to appear.
Regarding surgery, I have seen a number of tears in the latissimus dorsi. To my knowledge, surgery is mostly limited to complete tears of the tendon and/or failed non-surgical management. To be clear, this isn’t advice for you…just what I’ve seen.
I also think keeping an open mind about what could be going on is likely helpful for the rehab process. We’d love to help at any point in your journey.
-Jordan
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Thank you Jordan for your quick reply.
I will keep the thread updated with the results from the MRI. The bulge was definitely not there before. I really hope surgery isn’t going to be necessary. I will get a consultation if the health providers are not well informed about the subject in my area.
Update :
The MRI showed “Findings consistent with a contusion at the humeral insertion of the teres major and the long head of the triceps brachii, without hematoma or identifiable intramuscular tear.”
Really weird findings to be honest, but still no hematoma, I regained a lot of ROM over the days.
I just tried squatting today and I was too hasty, put too much weight on the bar, made a too big of a contraction on the way up and felt a weird pain again. The pain was actually not that bad but the feeling was a muscle rolling over another one. So no heavy squats I suppose.
To summarize, the pain is way better, the ROM is way better, the strength is a little bit better but the feeling is so weird and I have a ping-pong sized ball under the arm pit like the muscle was contracted? Anyways, who would’ve known that the intensity and feeling of the pain was not necessarily connected to the level of injury eh?
Cheers
After a whole lot of research and testing with my PT, there is a higher chance for me to have a serratus anterior avulsion (at least partial). I have an echography scheduled.
The symptoms of the serratus anterior avulsion fits better :
Pain around the scapula, no loss of ROM (I regained everything), a mass appeared at the location of the serratus anterior, pain while sneezing and coughing.
Interesting case study showing the same mass, although mine is higer: Traumatic Avulsion of the Serratus Anterior Muscle in a Collegiate Rower: A Case Report - PMC
Could be! That said, and this is not medical advice, it’s unclear to me that there would be significant benefits from pursuing additional imaging, as it’s not likely to change management.
I think rehab is the way to go, which may go better with a professional at the helm for program management.
Update.
It’s been 7 weeks and I did yet another MRI. This time, they confirmed the complete latissimus dorsi tear.
I have consulted a surgeon who did the surgery 3 times, which is apparently a lot since the rarity of the pathology.
Unfortunately, the time is against me since the more I wait, the less easy the surgery is.
Jordan, or anyone, what would you do? The surgery is a real pain in the ass but the thought of living without one of the major back muscle with potential loss of function is bothering. Would you do it?
I’m guessing this was a tendon tear vs. a muscle tear. I know that these are mostly treated non-operatively, save for a complete avulsion (tendon from the bone) or if the tear occurs in the middle of the tendon. I am not familiar enough with this procedure and your specific case to make a recommendation for you.
However, I do think talking to the surgeon about potential risks and benefits of going through the procedure vs. managing it more conservatively would be reasonable.
We are happy to consult with you on this, but there are limitations to what we can do over a forum.
Thank you for your reply Doc.
The surgeon talked to his colleagues and 7 week out is too late for this type of surgery. I will have to manage it conservatively, the risks are too high for the surgery because the lat sticks to a nerve and an artery. The risk of re rupture is also very high the longer you wait.
The question is now, will I be able to go from 130kg painfully to 300kg deadlift painfree? Maybe your team will help me with that!
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