Here's another great anatomical look from @chicagosportsdoc that reiterates a few important lessons about latissimus dorsi.
1️⃣Note how far down on the humerus the lat attaches. Because of this more distal attachment point, the lat can't control the positioning (arthrokinematics) of the humeral head during larger global movements like extension, adduction, and internal rotation (osteokinematics). This is why you need a strong and well-timed rotator cuff to "keep up" with the lats.
2️⃣Humeral attachment lat injuries may be missed because a standard shoulder MRI isn't distal enough to capture the lat's insertion further down on the humerus. The miss is even more likely with an arthrogram, which allows visualization of an even smaller area. MRIs of suspected lat injuries should be viewed more as an upper arm injury than a shoulder injury.
3️⃣It's not uncommon for sports medicine professionals to incorrectly label humeral attachment lat injuries as biceps tendon issues, bursitis, or rotator cuff injuries. This is because the lat attaches on the front of the humerus, where symptoms are often felt from these other pathologies.
If you're a pitcher who has a suspected lat injury, make sure you're going to a sports medicine professional who has specific expertise with lat pathology. It can be a challenging diagnosis, and somewhat complex return to action plan based on that diagnosis.
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Proximal humerus muscular attachments http://ow.ly/ZBfz30mSNQR #sportsmedicine #orthopedicsurgery #orthopedicsurgeon #surgery #medicine #surgeon #sportssurgery #chicago #anatomy