I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. I slept in a recliner for about 2 1/2 months following surgery (I don't think I slept at all before surgery :) ). Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. No. Partial or full thickness tears that are not complete ruptures are generally far more common than complete ruptures (not common, but require surgery with some level of urgency). It was sometime in the early months of 2011 that I was sent off to have an MRI done. If your doctor does end up recommending surgery, make sure you have a good chat about what to expect after the specific surgery they are planning. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. I've started having a smoothie everyday of red vege's (beetroot) and fruit (all the berries) with a slice of ginger and the big one for inflammation turmeric! However, in other cases, it may be that delaying will not reduce the chance of surgical success, but permit a trial of more conservative treatments that may eliminate the need for surgery, or strengthen muscles that provide stability to the joint to help optimize the outcome following surgery. What ever recommendation you received, you are looking up more information on line. I am angry, confused and cannot get any pain relief. P.S. I have spoke with people that have had surgery on their shoulder and they say that is a very painful surgery, and they still have problems from time to time with their shoulder. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. Risk of infection and nerve damage are worthy of consideration for any surgery, particularly one as involved as a reverse shoulder replacement. Pain continued and got worse. Thanks again Dr. I was an elite athlete most of my life and have accepted that I will no longer be able to return to my sport 100%. I can't comment on the nature of care you have received, but I can say that you are not alone in this type of experience! In general, seeing your orthopedic specialist would be an important step, these types of injuries are not likely to allow you to recover to your normal level of work functioning anytime soon without some kind of treatment. It is located in the top portion of the back of the shoulder blade (the superior posterior portion above the spine of the scapula) known as the supraspinatus fossa. i d glad if ortopedist or physiotherapist reply ansver. Partial or Full-Thickness Tear If there is a partial or full-thickness tear (but not a complete rupture) surgery may or may not be required and is best discussed with your orthopedic surgeon and/or physical therapist after appropriate imaging investigations have been undertaken. It is good that you have discussed the recovery with your surgeon already. The supraspinatus muscle is a relatively small muscle, but very it's important one. Any suggestions and generally how long is the recovery period? Edema is seen involving an intracapsular segment of biceps tendon with possible interstitial tears. I am close to retirement and I am afraid I will not be able to do the things I once enjoyed, outdoor activities. Some general information that may be useful to know is that some people who have similar pathology to that which you have described end up having surgery while other do not. Unfortunately I can't give you specific advice over the internet, without conducting a physical examination etc. Articular side: tears on the bottom of the tendon. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. However, improving rotator cuff functioning is usually a good idea and your physio should be able to assess your current situation and provide you with a suitable tailored program of exercises as they see fit. Sorry for the delay, I have been away. Recovery after surgical supraspinatus tendon repairs will often require the arm to be in a sling for approximately 6 weeks or so, then another ~6-8 weeks gradually starting to building up strength again. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. pain management and physical therapy) may be the first choice to see if surgery can be avoided. Some people will say that exercises didn't work for them, but it turns out actually doing the exercises (rather than just thinking about them) drastically increases the chance of them being effective! They may extend to become massive involving multiple tendons as shown in the figure. I'm just about at the point of desperation here. Here is some general information which I hope is useful for you: 1. What may be useful is for me to share some of my experiences and give you some questions to think about and discuss with your doctor. Due to the nature of what we were doing, I was unable to immediately seek medical attention, so after regaining some composure, I managed to carry on with my duty, but not without immense pain. What little I have done has given me improvement. Dr. Mike great info here thanks. Sorry for the delay in response. I decided to go to the local army medical hospital. I'll go check out some of your lenses now. She did an MRI and said it was tendonosis, and suggested PT. Lol. I just had an MRI I have a tiny, focal intratendon tear of the supraspinatus fibers at the humeral insertion measuring 2mm with minor impingement changes are noted in the greater tuberosity of the humerus. @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. I have not lost any ROM I just have severe pain in my right shoulder. patients should expect to return to full work duty by 6-10 months after surgery. You may feel pain when you try to sleep on the affected side. Remaining tendons of the rotator cuff are normal in signal and morphology. I am not aware of any studies that have shown rotator cuff exercises impair healing in supraspinatus tendons that have a partial thickness tear. Unfortunately, I suspect that a whole bunch of people will read your account and hear bits and pieces that remind them of their own circumstance. Is surgery my only option? No tendon retraction or muscle belly atrophy. Thanks. Good luck! Good luck! I see this is true of SSGtomn who has left a comment already. It is plausible to sustain one or the other (or both) from a fall. As you have correctly identified, there is quite a long recovery period following surgical repairs of rotator cuff injuries, but on the other hand, there is a pretty good success rate among people who follow the post-operative instructions. Getting a second opinion when you are not sure about your first is also often a good idea. The rotator cuff is made up of 4 muscles. The pain is mostly in neck and shoulder blade and collar. I am really hoping to find some outside advice. I am unable to carry any significant weight. Like Helpful Hug REPLY The primary indication for an acromioplasty in a patient with a full-thickness or bursal rotator cuff tear is for a type 2 or 3 acromion with a frayed CA ligament attachment. The majority of rotator cuff tears can be treated nonsurgically using one or more of these treatments: The goals of treatment are to relieve pain and restore strength to the involved shoulder. The tear in his supraspinatus tendon may be torn across its full thickness (but probably not completely ruptured which would require it be torn across it's full thickness and the entire width of tendon). Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. . Although the presence of a small tear visible on an MRI does not always mean that is the problem causing your shoulder pain. Supraspinatus tendon tear symptoms commonly go on for months (or even years) until the underlying problem is resolved (usually through improving the functioning of the rotator cuff, surgery, or both). Thanks for stopping by and leaving a comment. Unless the shoulder is actually dislocated at the time of the x-ray, or there is a noticeable bone abnormality (chipped or broken bone, bone spur that is visible on x-ray etc. The tear of the subscapularis muscle is less common then the tear of the other rotator cuff muscles, such as the supraspinatus, infraspinatus or suprascapularis. Moderately large joint effusion. Cold therapy cold therapy cold therapy!! However, in some cases it is clear that surgery is likely to be the best option. Even though most tears cannot heal on their own, you can often achieve good function without surgery. . . I'm only 38 and am not willing to give up everything I love doing and from what I read there are many more options available. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. The rotator cuff is a group of four muscles and their associated tendons that originate from locations on the scapula and insert onto the humeral head. Your shoulder specialist will be able to provide you with specific advice regarding your chance of recovery without surgery, as well as what to expect if you do decide to go down the surgery path. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. Thanks for stopping by and sharing your story with everyone! If not what is this indictative of. Popping noises can occur for a variety of reasons, the most common of which are completely normal. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. While it is true that rotator cuff tears are more common among middle aged and older people, they can indeed occur among younger people too; particularly when they are performing heavy work or have some kind of trauma event (contact sport, car accident, gym accident etc.). Although very uncommon, it is possible that the report did contain an error. Basically, it creates a hole in the tendon. I hope your shoulder has now recovered! Surgery to repair tendons generally involves a long recovery period. 2. If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) feeling pain in hand,,,. There may also be insurance implications etc. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. If surgery is not indicated, your doctor should be able to refer you to a physical therapist who will likely assess your shoulder movement and be able to provide you with a tailored program to help strengthen your rotator cuff. By June '13 I was better in many ways than before the injury. @anonymous: Hi Elania, Thanks for stopping by and sharing. While I cannot comment on your specific case, I am not sure ART (Active Release Techniques) then PRP (Platelet-Rich Plasma) or Prolotherapy is the approach that is best supported by contemporary scientific evidence for the treatment of supraspinatus tendon tears (or any other rotator cuff tear tendon tear). My story is a little lengthy, but I am desperate to find some insight for anyone that could help. So don't give up on your ambition to participate in exercise. Another subtle point of interest is that the first surgeon was not saying that the MRI was wrong (pictures generally don't lie, although sometimes image quality is poor), but that he disagrees with the report prepared by the radiologist. Debridement involves trimming the frayed edges of the tear back to healthy tissue in order to allow it to heal itself. It was then I found out how messed up my shoulder actually is 1. When the supraspinatus tendon is torn but not completely ruptured, usually a period of conservative management with a physical therapy program will be trialed rather than rushing into surgery. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". I am sorry, this is not a nice situation to be in, but doesn't sound as though you are at the end of the line yet. It is also worth knowing there are just some jobs that seem to take a heavy toll on shoulders / supraspinatus tendons (unfortunately I think painter / sheet rock installer / any occupation where you need to hold things up above shoulder or head height are right at the top of that list). Let us know how you go. Good luck with it either way. Had mild discomfort in shoulder for a few weeks in August. The majority of these tears occur amongst people over the age of 40. People doing repetitive work above shoulder height may find themselves at higher risk of a supraspinatus tear. Because of the risk of infection and and nerve damage. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. For many years shoulder dislocations were commonly managed by making sure the ball was back in the socket, giving a bit of ice, perhaps some anti-inflammatory medications and putting the arm in an internal rotation sling (a sling that holds the arm near the body with the elbow bent at about 90 degrees). 4. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. tendon transfer. This can be one of the most frustrating things for people who have whiplash associated disorders. I was told that there were a few other muscles around the supraspinatus that were torn and I also had some bone spurs that could also be causing some irritation. On the other hand, if surgery is inevitable or at least the most likely outcome, then the treating doctor / surgeon(s) may recommend early surgery. Sometimes in cases like this your surgeon may want to try an injection. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. Modify Sport Techniques . I'm sorry I can't give you specific advice over the internet about the best option for your situation. On the other hand, physical therapy can often help supraspinatus tendon tears but sometimes they do need surgery in order for a suitable recovery to occur. Many people have seen sporting heroes dislocate a shoulder during a heavy contact, have a medic "pop" it back in, then continue on 15 minutes later. There is some really good information in what you have said. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. Any advice would be appreciated thanks. Couldn't even lay down. and still end up with an unexpected problem. Subcortical reactive changes superiorly and laterally at the humeral head are present. A rotator cuff tear can result from an injury such as a fall or heavy lifting, or from normal wear-and-tear and repetitive activities over many years. I have lost about 45+% of my ROM in my right arm. I then took the second opinion of an orthopaedic surgeon who found a superantanaus partial tendon thickness tear and rotator cuff dysfunction through mri scan. Shoulder muscles are very good for stabilizing the ball and socket joint and making large movements (to help lift things, throw objects etc. The individual shape of the bone structures (particularly the acromion) and soft tissues around the tendon will contribute to whether the tendon is able to move freely or become impinged between structures with arm elevation. Full-thickness rotator cuff tears are diagnosed with the help of a thorough history and physical examination, as well as the use of imaging studies, most commonly, MRI. My best wishes go to all of them. I'm quite apprehensive and nervous about the surgery but more so about the recovery. Keep in touch to let us know how you go. This is partly because rehabilitation following surgery will depend on the surgical technique used. I found it very helpful as I am sure all your other subscribers found it to be too. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. sir i am a shuttle badminton player.. i got injury on my shoulder .. doc told to tke MRI scan.. after taking MRI scan these are the final impressions.. 1.partial tear in the supraspinatus tendon at the level of insertion in the greater tubersity for a length of about 15mm with intact insertion, 2 partial tear in the anterior superior labrum. Not all the time, but it was intermittent. Particularly about what many people are likely to experience during the often long road to recovery. Either way, don't be afraid to ask your surgeon lots of questions (likelihood of success in your case, what will happen after surgery, recovery time-frames etc.). However, not all tears need surgery. A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle, which is located at the back of the shoulder. I am sorry I can't provide you specific advice over the internet. A rotator cuff tear can extend or get larger over time. Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. Even pain from a full-thickness tear can be relieved without surgery through exercises that make other muscles strong enough to pick up the slack. As far as general information goes, it is also worthwhile noting that chronic pain and inflammation at a joint can lead to secondary changes (weakening muscles, changes in the way the body processes pain etc.) Must also have to bring the arm back with my other arm if I am lying and have the arm overheadwhich now longer will lie flat on the floor if it is overhead.It has been recommende to do ART then PRP and possibly prolotherapy. First thing to say is that when the best way forward seems uncertain to someone, seeking a second opinion is usually not a bad idea. Don't be afraid to ask your surgeon about all your treatment options. Purpose: The objective of this study is to report on the complete arthroscopic repair of full-thickness tears of the supraspinatus.Type of Study: Prospective cohort study. Went down a water slide on a mat head first arms supporting my body. . Also, don't be afraid to ask doctors / surgeons lots of questions. A full-thickness tear, which usually means the tendon is torn from its insertion on the humerus (the most common injury), is repaired directly to bone. That is some interesting advice you have received. Any thoughts on treatment for this considering previous surgery? Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. A full-thickness rotator cuff tear is characterized by a focal transmural tendon discontinuity, . If your tendon were to completely rupture while you were pregnant, this may be very problematic. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. All the best. It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) As another rule of thumb, if you are getting mixed opinions from non-specialist doctors, it is often a good idea to refer you to a specialist (who will have most likely have seen your condition ever other day and have plenty of experience treating it). Let us know how you go! In my reports say that I have less fluid and possible tear. Now I have these results stated above. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. The enthesis is the bit right at the end of the tendon (at the bone end of the tendon, rather than the muscle belly end of the tendon) and it is plausible for a full thickness tear in this region to be from an acute event (e.g. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. Pitchers, swimmers, and tennis players are common examples. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full Reallmadhatter Mar 14, 2013 @ 3:44 pm. As mentioned in the video, the aim of these resistance band exercises is not to increase your range of movement but to instead strengthen the rotator cuff muscles which will help protect the soft tissue structures around the shoulder in the long term. Good luck! Similarly pain and dysfunction in the shoulder may cause you to use it less, which may in turn lead to weaker muscles and tendons (which may lead to more difficulty during and after a subsequent surgery). Jackie. Some minor tears may be treated without surgery. If the tendon has been completely ruptured (no longer attached), then surgery will definitely be required with some level of urgency for the tendon to be successfully reattached. I'm sorry I can't provide you with specific advice, rather I only provide some general information. This information is provided as an educational service and is not intended to serve as medical advice. Children are such a blessing and that time nursing your newborn is such a special and important time. That was July of 2011. However, you would need to discuss this with your surgeon who will also be able to take a detailed history and conduct a full examination etc. Second, I am sorry to hear about your fall and subsequent shoulder pain. Surgery for a minor partial thickness tear will often involve a simple debridement of the tear. The primary purpose of these muscles is to prevent the head of the humerus, or upper arm bone, from driving into the shoulder joint as you lift your arm away from your body or overhead. As defense lawyers are quick to point out, rotator cuff tendons, just like lots of our other joints and tendons, tend to degenerate as we age. Acromioclavicular joint degenerative changes, which means nothing to me. I'm unable to say whether this has occurred in your case, however, the reason why this springs to mind is that I cannot recall ever seeing a true case of adhesive capsulitis (sometimes called frozen shoulder) that resolved in 6 weeks? I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). First, sorry for the delay in response. coracoacromial ligament. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. The incident happened on Sept 25 and it is now Nov 10. 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Am 67 years old and am an artist and my left arm which is the causing... Get my arm somewhat back to healthy tissue in order to identify stages of rotator cuff tendons probably... Mild discomfort in shoulder for a MRI Monday everything right ( good surgery, follow instructions etc., for... On right shoulder and wanted to know if you have discussed the recovery period second, i been. About your first is also worth noting that sometimes you can do everything right ( good surgery, particularly as! Was then i found out how messed up my shoulder actually is 1 of Orthopaedic Surgeons sharing your with... Benefits from delaying surgery in your case is not intended to serve as advice. 'Ll get back to normal but wilh slight aching that could help, or referenced... Perhaps capsular strain themselves at higher risk of infection and nerve damage insight for anyone that could help on. But wilh slight aching on treatment for this considering previous surgery, seeking advice your! 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