RT Journal Article SR Electronic T1 Unsafe workout: a weak and painful shoulder in a professional volleyball player JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e228084 DO 10.1136/bcr-2018-228084 VO 12 IS 5 A1 Andrea Ermolao A1 Michela Brogi A1 Veronica Baioccato A1 Sara Rovai YR 2019 UL http://casereports.bmj.com/content/12/5/e228084.abstract AB 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.