How come Zhivago develops a massive shoulder at the end?

and just before he falls, he blows a raspberry.

I'm not really sure, but I thought perhaps he had some kind of a stroke upon seeing her while on the bus.

I think that's just an effect of the way the shot was filmed. As he stands up and goes to chase Lara, he has a heart attack, he hunches over sideways and clutches at his chest; his distorted posture throws his shoulder up and out so that it looks bigger, but isn't really. It's just distorted because of his position. Also, it appears that he has shoulder pads in his jacket which accentuate the misalignment of his shoulder. As he's running, he is crouching to his right, making the left shoulder go unnaturally up.

You can see from the earlier shot in the streetcar that his shoulder is quite normal; it's the heart attack groping that makes it look odd. See the scene here:

https://www.youtube.com/watch?v=zvA-7VuKQCU

He's on his way to audition for the lead role in The Hunchback of Notre Dame.
Being Russian, he's a method actor and remains in character at all times.



"He was a poet, a scholar and a mighty warrior."

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