Just before the move that partially tore my latissimus dorsi. Note the upper body rotation.

Monday January 18, 2010 I hiked into the remote Diamond Head crag in Eldorado Canyon State Park with a few friends to try some obscure climbs that I had long dreamed about. Just as we arrived at the base of the climb the wind picked up and a fresh bank of clouds rolled in plummeting the temperature 20 degrees. I donned my heavy winter down coat, but my under garments were all wet from the nearly two hour hike and I remained rather chilly. Due to our location at the crag and a lack of any easily accessible warm up climbs we opted to get on Cameron’s Corner . I did a set of 30 jumping jacks before my lead. This was only my second day of climbing since my wife and I took a two week vacation and my body felt great having just recovered from a minor upper back injury to the middle of my right trapezius. 40′ above the ground you climb past a large ledge into the crux corner (.11b) which consist of making a rotating reach with your left hand for a great ledge while holding a chest high right hand crimper. The foot work mostly freezes your hips and the rotation and extension come primarily from the upper back. As I pulled into the move I felt a transverse shooting pain along my right middle back which nearly caused me to fall off. However, I wanted the onsight badly and reset my foot slightly to get a bit more left hip rotation and fought my way through the back pain successfully. Some ten minutes later lounging at the belay I was uncertain of what I had injured or the extent.

My partner and I were unsure of what to do next, but long story short I ended up trying to climb a 15′ thin head wall with a crux pseudo mantle that was probably around .10+.  On the third attempt I aggravated the newly acquired back injury. After abandoning the head wall I talked my partner into leading the last pitch of Shibumi and confined myself to following the rest of the day.

Once at home the symptoms set in immediatley as follows:

• Sharp pains at two or three points horizontally across my back from near the spine to my arm pit about one to two inches below my shoulder blade. Near my arm pit was a nasty pain that felt like a small knife. The pain begins as soon as I get up from bed and only subsides when laying down. When sitting if I slouch by moving my butt forward about 6-8″ it’s almost totally relived.
• A deep dull ache in the trapezius extending from about C3 to C10.
• Later in the day I get dull throbbing sensations across the lower transverse aspect of my pectoral extending up into my arm pit.
• Dull ache in both my right tricep and lower forearm. Probably due to a pinched nerve that accompanied the injury.

The initial self diagnosis was rotater cuff strain/tear, but notably I was able to sleep comfortably and the pain was in a lower position then when I previously had posterior shoulder impingement injuries (AKA rotater cuff). After digging through a sports injury manual I temporarily settled on frozen shoulder, but given my lack of any recent long term inactivity with my left shoulder it made little sense.  It had been five days since my injury and I still had no idea what was injured mostly due to the multiple pain locations.  I had been icing it and taking NSAIDS daily, but the pain persisted which told me I had a major injury to deal with that desperately needed diagnosis.

Finally, my brain reached deep into it’s recesses and pulled a rabbit from the mental hat – latissimus dorsi. An hour of googling and I had it nailed down.  To definitively determine if I injured my latissimus doris and/or teres major would require an MRI which I will probably forgo. Sadly, middling latissimus dorsi injuries are “uncommon” which means the literature about diagnosis, treatment and prognosis is virtually non existent. I found one abstract of a study of 11 major league baseball players who had either latissimus dorsi or teres major injuries (e.g., one with both the lat and teres major).  All were treated nonoperatively and returned to full pitching form in 3 months.

My treatment plan for now is more ice (i.e., 3X daily) and ibuprofen.  Once the swelling and accompanying pain are under control I will begin heat therapy.  My guess is this will be a 2-3 month battle to regain full use with probably the first two months being non weight bearing. Queue the sad music.