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Musculoskeletal and Sports Medicine

Pronator Teres Myotendinous Junction Tear in a Tennis Player: A Case Report

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 2

    Poster Presenter(s)

  • William Xiang, MD (he/him/his)

    Resident Physician
    New York Presbyterian Hospital (Columbia and Cornell) PM&R Program
    New York, New York

    • Co-Author(s)

  • PD

    Prabhav Deo, MD

    Assistant Professor
    Weill Cornell Medicine
    New York, New York

Disclosure(s):
William Xiang, MD: No financial relationships to disclose
Case Diagnosis: A 63-year-old male tennis player with a grade 2 tear of the pronator teres myotendinous junction.

Case Description or Program Description: The patient presented with acute-onset right forearm pain that occurred while hitting a tennis forehand with his dominant right arm. His symptoms consisted of localized anteromedial forearm pain that subsided after several minutes of rest. There was no associated pop, bruising, numbness, or tingling in the extremity.

Setting: Outpatient sports medicine clinic

Assessment/Results: Physical exam was notable for full elbow and wrist range of motion. There was tenderness to palpation at the proximal flexor tendon mass in the right forearm and the medial epicondyle. The patient experienced pain with pronation but otherwise strength and sensation were preserved.
Magnetic Resonance Imaging (MRI) demonstrated a grade 2 partial tear of the pronator teres involving the deep myotendinous junction, as well as an associated hematoma. Initial management consisted of rest; however, on 1-week follow up the patient reported slightly worsening symptoms of pain. Physical exam was otherwise unchanged. At this time, the hematoma was evacuated via ultrasound-guided aspiration, which produced 2 milliliters of serosanguinous fluid.
At 3-month follow-up, the patient had completed a course of physical therapy beginning with manual therapy to the anterior forearm, followed by elbow flexor strengthening and isometric pronation exercises. His PROMIS Physical Function T-score improved from 43 initially to 54 at this visit. By this point, he had returned to playing tennis with no further significant pain.

Discussion (relevance): Isolated pronator teres tears are rare injuries associated with sporting activities requiring repeated resisted pronation, such as the forehand shot in tennis in this case report.

Conclusions: Effective initial management of a pronator teres tear without associated strength or sensory deficits consists of rest from sporting activities and isometric exercises in physical therapy. Ultrasound-guided hematoma aspiration can be effective for pain relief in the acute stages of injury.