Summary Latissimus dorsi rupture is a very rare condition that has been reported as a cause of pain in the thrower’s shoulder. Diagnosis is suspected with pain over the latissimus dorsi made worse with shoulder adduction/internal rotation and confirmed with an MRI. Treatment is nonoperative for the majority of patients. Surgery is indicated in competitive athletes with completed tears. Epidemiology Incidence very rare condition Etiology Mechanism felt to be eccentric overload during the follow-through of the throwing motion Anatomy Latissimus dorsi muscle Presentation Physical exam local tenderness and deformity over latissimus dorsi muscles pain with shoulder adduction and internal rotation Imaging MRI shows increased T2 signal and retraction of latissimus dorsi muscle Treatment Nonoperative short period of rest followed by PT indications allow resumption of activities in low demand patients technique physical therapy goals are to restore shoulder motion and strength throwing can be allowed after full, pain-free motion and good strength balance of the rotator cuff and scapular rotator muscles Operative primary repair vs reconstruction indications for high demand athletes (currently there are no defined indications for surgical repair) technique early primary repair is favored to prevent retraction and scarring