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Unsafe workout: a weak and painful shoulder in a professional volleyball player
  1. Andrea Ermolao,
  2. Michela Brogi,
  3. Veronica Baioccato and
  4. Sara Rovai
  1. Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
  1. Correspondence to Professor Andrea Ermolao, andrea.ermolao{at}


A 29-year-old professional volleyball player started complaining of a dull ache in the right lateral base of the neck. This pain arose during a preseasonal athletic training intense session. After 3 days, he presented deficiency of right scapula adduction, limitation of scapula elevation, right shoulder weakness and local mild pain. He had asymmetrical neckline with drooping of the affected shoulder, lateral displacement and minimal winging of the right scapula. After 1 week, hypothrophy of superior trapezius appeared. An electromyography of right upper limb showed a denervation in the upper, middle and lower components of the right trapezius muscle, due to axonotmesis of spinal accessory nerve (SAN). A subsequent MRI was consistent with muscular suffering caused by early denervation. This case shows idiopathic SAN palsy, likely secondary to an inappropriate use of a weight-lifting machine, where the athlete recovered after an adequate rest and rehabilitation period.

  • pain (neurology)
  • peripheral nerve disease
  • sports and exercise medicine

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  • Contributors AE has been involved in the clinic management of this patient. AE, MB, SR and VB reviewed the details of the case, drafted the case report and contributed to the editing of the final product.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.