Pronator Teres Tear at the Myotendinous Junction In the Recreational Golfer: A Case Report

Alvarho J. Guzman, BA, Stewart A. Bryant, MD, Shane M. Rayos Del Sol, BS, MS, Brandon Gardner, MD, PhD, Moyukh O. Chakrabarti, MBBS, Patrick J. McGahan, MD, James L. Chen, MD

Abstract


Pronator teres muscle tear is a rare athletic injury that reportedly occurs in swinging sports such as golf and cricket. The main mechanism of injury appears to be caused by a forceful golf or racket swing striking the ground during resisted elbow flexion and supination. We report the case of a 50 year old right hand dominant male who presented with right elbow pain and volar sided ecchymosis of the right bicep, elbow, and forearm for two weeks following his injury while golfing. Initially after one episode of golfing, the patient reported experiencing right elbow pain with no ecchymosis. The following week while golfing, the patient developed pain over the anterior forearm and was forced to stop golfing. The next day he noted extensive ecchymosis of the right distal arm region that extended to the distal wrist. MRI confirmed an acute right pronator teres tear at the myotendinous junction. The patient was expected to make a complete return to pre-injury level athletic activity with conservative management. With this article, we consider biceps rupture on the differential diagnoses associated with pronator teres musculotendinous injuries, emphasize the significance of club type in relation to golfing injuries, and propose a potential pronator teres rupture non-operative rehabilitation protocol.

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