Arthroscopic Management of an Isolated Intrasubstance Subscapularis Tear in a Competitive Swimmer: A Rare Case Report

Isolated intrasubstance subscapularis tendon tears are rare and often pose diagnostic challenges, particularly in competitive athletes. We report the case of a 21-year-old elite swimmer with progressive anterior shoulder pain and internal rotation weakness. Magnetic Resonance Imaging (MRI) demonstrated a Lafosse IIA intrasubstance tear of the subscapularis tendon, which was confirmed arthroscopically. The patient underwent arthroscopic transtendinous repair using a knotless all-suture anchor system. Postoperative rehabilitation emphasized phased mobilization and sport-specific strengthening, allowing to return to competitive swimming at 6 months. At 12-month follow-up, the patient remained pain-free with full functional recovery. This case highlights the importance of advanced imaging, arthroscopic repair, and structured rehabilitation in the successful management of rare subscapularis tendon injuries among overhead athletes.