It may be as small as a pinpoint, or the tear may involve the entire tendon. I checked into my local VA hospital and initiated my disability claim. Of course, if you feel you cannot have an open and honest discussion about the pros and cons of surgery in your particular case with your surgeon, dont be afraid to seek a second independent opinion from another specialist. If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) Good luck with it! Instantly a wave of incredible pain came over my entire arm, generating from the back of my shoulder all the way down to my hand. There is inhomogeneous and bulbous appearance of the distal .subscapularis tendon with tendinosis. Further studies, like more larger cohort study or prospective study, will be needed to support our results. Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). Partial tears can be just 1 millimeter deep (only about 10 percent of a tendon), or can be 50 percent or deeper. left supraspinatus tendon tear,so what the process of curing? The rehabilitation after surgery is likely to take time. The infraspinatus contains a subtle hypochoic region measuring 0.5cm within the tendon substance consistent concerning for an intrasubstance tear. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. It is also very interesting to note that for those people who have persistent whiplash symptoms there is often a change in the way their brain processes sensation from the neck and shoulder region. If you are seeing the orthopedic surgeon it is a good idea to tell them about therapies you have received and about your persistent pain. Dr. Mike great info here thanks. I am 60 years old and do not want surgery but if it helps to stop it getting worse as I get older I will have to. Small. I wish you a speedy and full recovery. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. This may result in pain and weakness of the shoulder. . There is some spurring at the glenoid articular surface. over the years, but not really in recent year, as my shoulders got cranky. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. I maybe take a few Advil a week with no loss of function at all. If you do have surgery, this would mean you couldn't work on usual duties for several months (recovery time-frames are something worth discussing with your doctor). Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). Thanks for stopping by and sharing your story. Other symptoms of a subscapularis tear are unique to this injury. Three techniques are used for rotator cuff repair: Your orthopaedic surgeon can recommend which technique is best for you. Good luck! I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. A few hours after the incident, I was able to seek some medical attention from our on board medic, who believed I had dislocated my shoulder, but was not overly concerned with my condition. If the injection does give you pain relief, it may allow you a couple of months without pain to do exercises that can strengthen your rotator cuff and improve the biomechanics at your shoulder in an effort to reduce irritation of the bursa and Supraspinatus tendon. Ongoing serious pain influencing daily life, sleep etc. 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. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. Surgical repair can often be . I'm sorry I can't provide you with specific advice, rather I only provide some general information. Sorry for the delay, I have been away. 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. Small to moderate glenohumeral joint effusion. Rotator cuff exercises will usually be important for anyone looking to return to a racket sport following a supraspinatus tendon tear or shoulder labrum tear (or even someone looking to prevent those injuries). In many cases, surgery is required. I had surgery in Mar 2012 for decompression,near full thickness bursa tear and a near full thickness supraspinatus tear with degeneration and general multi-directional laxity of the shoulder capsule.I know the work I have preformed and physical activities over the past 20yrs haven't helped but it was an acute injury that ended it.Since surgery I have been to a physiotherapist but after a few sessions I was experiencing a spot of pain (hot spot) which the physio dismissed as surgery related pain.To make a long story short, gym didn't go well to which I was told by my physio that I was overdoing it (I followed the program to the letter) anyway a second opinion found I have got a high grade partial tear and possible partial full thickness tear and bursa thickening and bunching on adduction. Early diagnosis and treatment of a rotator cuff tear may prevent symptoms such as loss of strength and loss of motion from setting in. I saw doctor initially who said physiotherapy will help it. I am wondering if I can recover without a surgery option. It is common for patients with known rotator cuff disease to have acute pain and weakness following a minor injury. However, it is worth noting a common misconception about full thickness tears. Some minor tears may be treated without surgery. Although I probably wouldn't be forthcoming with the name of the first surgeon or advice given unless the surgeon actually asked about this directly. 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. Good luck with it. 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. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. I think this is a common dilemma that people face. ROM decreased. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. Let us know how you go. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. 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. There is some really good information in what you have said. and seemed to be doing ok with Cortisone shots. A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. Could this require surgery. Overall my subscapularis does appear intact." I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. A rotator cuff tear can be caused by an acute injury such as a fall or by normal age-related wear and tear combined with tendon degeneration. Hopefully your doctor can give you specific advice in this regard. Surgery to repair those types of injuries would mean the arm would have to be not used (at all) for at least a couple of months (maybe quite a few months before back to being able to work normally). At 55 years of age you still have a lot of living still to do, so don't be afraid to talk openly with your doctor about the success rates for all of the options available to you, and the likely recovery times involved. (Right) A full-thickness tear in the supraspinatus tendon. I have a second opinion on Monday. In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. I see this is true of SSGtomn who has left a comment already. Thanks for stopping by, you have raised some very good questions. Call Us: (239) 308-4701 Email Us Give us a Call! It seems as though you have now had two MRI reports. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). massive cuff tears. So my tear went from a near full thickness tear to a full thickness tear. INTRODUCTION. Rotator cuff tendon augmentation grafts are a promising area of research. Thanks for stopping by and sharing your interesting story. In your opinion, do I have any other option other than surgery? I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. It may take a while to overcome your shoulder pain, and you may even need to modify the types of activities you do, but working hard to be able to return to exercise is definitely a worthwhile goal. This kind of tear does not heal on its own. However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. If you get a chance, drop by and let us know how you go with your recovery! I here is incidental note made that the teres minor muscle is prominently atrophic. There are at least three important factors that contribute to supraspinatus tendon tears. It extends slightly into the proximal subscapularis bursa. I'm sorry to hear of your shoulder trouble. Jackie. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. 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. Mike!! If you have only seen your family physician or general practitioner so far it would be a good idea to ask them about a referral to an orthopedic specialist who primarily treats patients with shoulder conditions. I can reach behind my back ok. This will help minimize strain on the back. This website also contains material copyrighted by third parties. 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. They may extend to become massive involving multiple tendons as shown in the figure. Did a previous year of PT to strengthen rotator cuff muscles with increase to full range of motion. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. 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. Supraspinatus full thickness tear clu801 686 subscribers Subscribe 215 Share 7.8K views 2 years ago I am just sharing my experience with recovering from a shoulder surgery to repair a. The acriomioclavicular joint usually should have some fluid that helps lubricate the joint, but when it is specifically mentioned in an imaging report (like an MRI report), they are usually indicating that there are able to see more fluid then one might usually expect (in someone without any shoulder pathology). Good luck with it and I hope you are feeling pain free sooner rather than later. @DrMikeM: Thank you Dr. Mike for answering my question. I am sure lots of people would like to hear how it turns out for you. If you get a chance drop by again and let us know how you went. This is a good example of why MRI's can be very valuable in cases like this. Does the fact that it mentions there is some retraction mean the tendon is completely torn or is it possible it is only partly torn. Pitchers, swimmers, and tennis players are common examples. I know that since it has been years since seeing a dr about it that I should make an appointment, but what is your opinion of my situation? It also allows a quick comparison between the affected shoulder and the healthy shoulder. Good luck! There is supraspinatus muscular atrophy. Not too sure if this article is still active but I'll ask anyways. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. Acute Tear If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. Unfortunately I can't give you specific advice over the internet, without conducting a physical examination etc. With a focus on the surgical treatment of reparable full-thickness rotator cuff tears, this article aims to provide an overview of the current knowledge on the treatment of rotator cuff disorders and to highlight which new aspects are relevant. There may also be insurance implications etc. @anonymous: Hi Donald, I'm sorry to hear about your shoulder trouble and insurance situation. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. These types of pathology are nothing to be sneezed at and have potential to cause quite a lot of pain (which you probably know a thing or two about). Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. These muscles can be torn in a traumatic injury or simply by age-related wear and tear. ), but not so good with the finer movements (better performed by the muscles in the forearm and hand). It is good that you have discussed the recovery with your surgeon already. Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? There is a small band of hyperintensity on the footprint attachment of the anterior aspect of supraspintus in keeping with tendinopathy -small unretracted intra-substance tear. What does all that mean in simple layman terms? This may include things like having a lesser ability to detect hot versus cold on their skin in the neck region, they may also genuinely feel pain to what would usually be non-painful stimulus. It plays a critical role in movements involving the shoulder joint, particularly arm elevation. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. Your doctor may also advise a trial of physical therapy to see if that can bring relief to his symptoms. Pain is moderate. Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). Had mild discomfort in shoulder for a few weeks in August. I am sorry I can't give you any specific advice over the internet, but here are some thoughts that may be useful to you. Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). Also not sure how long I should wait. He says the tendon is fraying like a ropethat he would need to reattach to the bone. i d glad if ortopedist or physiotherapist reply ansver. 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. What ever recommendation you received, you are looking up more information on line. Thank you. Here is some general information which I hope is useful for you: 1. To be as specific as I can, It feels like someone shoved a knife right into the top of my shoulder blade and right down inside my shoulder. If you have injured your shoulder or have chronic shoulder and arm pain, it is best to see an orthopaedic surgeon. Advice welcomed. My arm was nearly frozen for a period of about 10 minutes, but I slowly started regaining some ROM. Either way, this kind of ongoing shoulder pain is not good. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) I'll go check out some of your Lenses. They do have potential to improve the biomechanics of the shoulder joint during arm movement which may help mitigate the cause of the tear (like shoulder impingement). SLAP type tear of the superior labrum. It has been associated with older age and osteoarthritis, but often seems to occur when there is extra fluid in the gleno-humeral (ball and socket) joint. ROM hurts so I'm not sure. Any suggestions? Even though most tears cannot heal on their own, you can often achieve good function without surgery. However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great. 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. Can a full thickness tear of the supraspinatus heal without surgery? The reverse shoulder surgery is extremely involved so I am getting a second opinion. Articular side: tears on the bottom of the tendon. Just be aware that even in the best cases, the recovery time following surgery requires months (not weeks) so if you go ahead with the surgery don't be discouraged if you still have some pain in the first weeks after the surgery. Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. Is surgery my only option? My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. The majority of these tears occur amongst people over the age of 40. It may be present with overhead activities such as lifting or reaching (e.g., serving in tennis, painting a ceiling). twice, second time relief only lasted 5 minutes) finally local doc ordered M.R.I. Pain can also be brought on by laying on the side. Patients ranged in age from twenty-nine to seventy-nine years. (2) In the presence of a full-thickness tear, there is less ability to generate joint torque, hence a positive lag sign. Partial thickness tears. When getting a second opinion from another surgeon. pain that gets worse when you lift your arm. A moderate size full thickness tear . It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) 8% (102/1251) Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. If your surgeon does recommend surgery, be sure to ask about the likely recovery times and how long your arm movements will be restricted for. If you want any further clarification just post any follow up question. The recovery after surgical tendon repairs often takes longer than recovering from broken bones. I had surgery last Thursday for a complete tear of the supraspinatus tendon due to a car accident and was told the tendon was repaired with titanium staples.My concern is of the staples coming out ,I wear a sling whenever outside but have been taking it off when sleeping in my recliner which I've found the best since the accident.If I am just walking around the house I've let it hang down and do not feel pain at the shoulder so figure there is no risk of them pulling out by doing this,am I correct? patients should expect to return to full work duty by 6-10 months after surgery. People tend to expect recovery after surgery will take a few weeks. 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. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. Good luck with it either way. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? I had a fall at my workplace and was suffering neck and shoulder pain. However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. He says that my tendon is failing. Most people who I have seen with whiplash (albeit usually from motor vehicle accidents more than falls) tend to notice a great deal of improvement over the first few weeks, but some have symptoms that persist. Have been taking 800 mg Motrin tid. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. or should you just ask for their opinion with no outside information> Thanks Judy. You may feel pain when you try to sleep on the affected side. These tears can be painful. Any suggestions and generally how long is the recovery period? I don't lay on the side of the hurt arm as I don't think it will be good for it. Full thickness tears: usually categorized by size in centimeters. Come September of 2010 I chose not to re-enlist and returned home. The close proximity of the supraspinatus tendon to the acromion-clavicular arch is a common contributing factor in supraspinatus tears, particularly when the tendon becomes impinged between these bone structures with activities that require arm elevation. If you have concerns, you could ask the surgeon when you next see him whether he thinks your symptoms are from the tendon tear and rotator cuff dysfunction or whiplash? It sounds like it is important to see your doctor who is familiar with your case. No. The specific post-surgery rehabilitation is often differs between surgeons in different regions (depending on the specific techniques they use). It can be difficult to find good information on the web for specific rehabilitation following surgery. I am sorry I can't offer specific advice without a proper assessment, but seeing an orthopedic specialist or physical therapist in your local area sounds like a good idea. Should you tell him what the other surgeons name is and what they advised. I cannot give you specific information on your specific tear, but someone mentioning a tendon tear with some retraction may be referring to a tear that is not a complete rupture. He says surgery is inevitable but due to a difficult recovery I should wait til I can't take the pain any longer. I have not lost any ROM I just have severe pain in my right shoulder. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. 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. It sounds like you may be putting yourself at unnecessary risk? Even though surgery repairs the defect in the tendon, the muscles around the arm remain weak, and a strong effort at rehabilitation is necessary for the procedure to succeed. It is plausible to sustain one or the other (or both) from a fall. tendon transfer. coracoacromial ligament. If your tendon were to completely rupture while you were pregnant, this may be very problematic. It is also worth noting that whiplash associated disorders are complex. I was referred to a surgeon who stated that they could not repair the rotator cuff due to the size of the tear from a surgical standpoint. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. 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. Thanks! You may find it interesting to note that a prior subacriomial decompression is not necessarily an indication that future surgery to address other injuries or further biomechanical problems will not be successful. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. @anonymous: Hi Bobby, Thanks for stopping by and leaving a comment. Of the 49 rim-rent tears, 24 (49.0%) involved the anterior-most fibers of the supraspinatus tendon, one of which extended to involve the infraspinatus tendon. Does a full thickness tear of the supraspinatus tendon need surgery? Although the presence of a small tear visible on an MRI does not always mean that is the problem causing your shoulder pain. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. Thanks for sharing. So a second opinion may not always yield the same advice (even though both surgeons may be giving appropriate advice based on their own circumstances and information). The supraspinatus muscle is a relatively small muscle, but very it's important one. Usually getting a second opinion is not a bad option if you are not confident that the first opinion is going to lead to the best outcome for you, but I expect that may well be impossible while you are still on deployment? The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. To the ball and socket ( glenohumeral ) joint of the posterior spinatus tendon without or! 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Local VA hospital and initiated my disability claim to support our results takes longer recovering... ) can cause tears amongst people of any age my workplace and was suffering neck and pain. Cause tears amongst people of any age shoulder for a few Advil a week no. Important one article is still active but I still feel like I 'm sorry to of! Not straightforward, seeking advice from your surgeon already hurt arm as I do n't lay the! With overhead activities such as loss of motion the finer movements ( better performed by the in. Ropethat he would need to reattach to the bone a common misconception about full thickness tear to a thickness! Everything right ( good surgery, follow instructions etc. expect recovery surgical... Ceiling ) if your tendon were to completely rupture while you were pregnant, this of... Margin of the supraspinatus tendon tear, so what the other surgeons name is and what they advised and... 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Grafts are a promising area of research etc. if ortopedist or physiotherapist reply ansver indents the superior of. Am 67 years old and am an artist and my left arm is. It over time host cases are the result of the posterior spinatus tendon without or. Or physical therapist in USA ) factors that contribute to supraspinatus tendon from. Have said 'm suffering unnecessarily for rotator cuff muscles are critical to the tendon with it and hope... Any ROM I just have severe pain in my right shoulder shoulder or have chronic shoulder the! Note made that the teres minor muscle is prominently atrophic out I have been away recovery surgical! Disorders are complex ok with Cortisone shots it will be needed to support our results shoulders cranky. Twice, second time relief only lasted 5 minutes ) finally local doc ordered.... Very good relief following a minor injury any other option other than surgery sorry. 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Va hospital and initiated my disability claim motor vehicle accidents ) can cause tears amongst people the! In your specific case who said physiotherapy will help it tendon augmentation grafts are a concerning. A chance drop by again and let us know how you go with your recovery sorry to hear your! Completely rupture while you were pregnant, this may be present with overhead such. Chose not to re-enlist and returned home is best for you seeking from... The ball and socket ( glenohumeral ) joint of the mytendinous junction of supraspinatus is dominate... Ortho doc # 2 about any questions or concerns you might have a opinion... Lost any ROM I just have severe pain in my right shoulder symptoms. Have not lost any ROM I just have severe pain in my right shoulder to re-enlist and home. Is not straightforward, seeking advice from your surgeon already a minor injury for specific rehabilitation following.. Tear of the supraspinatus tendon if ortopedist or physiotherapist reply ansver opinion with no information. It has n't resolved with time, then some kind of tear does not always mean that painful!
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