Players involved in sports requiring fast throwing actions (baseball) or overhead hitting (volleyball, tennis) may also sustain a traumatic injury to their rotator cuff and the supraspinatus tendon in particular. Dr. Burks explains what the injury is and when to . tendon transfer. If you are in doubt, don't be afraid to get a second opinion. 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. I hope I will not follow suit! Supraspinatus tears are often accompanied by adjacent structural deficits. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. It sounds like you are not following your surgeons instructions! The types of findings you have described are consistent with some quite substantial pathology in your shoulder. Moderately large joint effusion. There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. If you get a chance drop by again and let us know how you went. It is common for patients with known rotator cuff disease to have acute pain and weakness following a minor injury. In my reports say that I have less fluid and possible tear. These four muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) stabilize the glenohumeral joint, enable rotation around the joint, and provide a counterforce to . These include . A full-thickness tear will decrease the capacity of a muscle to do work. My arm was nearly frozen for a period of about 10 minutes, but I slowly started regaining some ROM. There are at least three important factors that contribute to supraspinatus tendon tears. I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. or should you just ask for their opinion with no outside information> Thanks Judy. INTRODUCTION. Sleeping on my right side became impossible. So my tear went from a near full thickness tear to a full thickness tear. Thanks for sharing. 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! Remaining tendons of the rotator cuff are normal in signal and morphology. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. 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. X-rays are often not very useful in diagnosing shoulder injuries. Thanks for stopping by and sharing your interesting story. An important thing to consider (as you have correctly mentioned) is that a reverse shoulder replacement is probably unlikely to restore normal shoulder function and resolve the pain if substantial soft tissue problems are still present in the tendons around the shoulder. That being said, if you are unsure, I would definitely make a review appointment with your referring doctor to clarify your situation so you can find out what the best plan of attack is. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. 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 presence of greater tuberosity cortical irregularity and joint fluid was most important in the diagnosis of full-thickness supraspinatus . 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). My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. Could this require surgery. Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. Either way, I wish you all the best with it (and a safe deployment and return). Most people with ongoing pain will usually try the conservative interventions before considering surgery. There is some really good information in what you have said. Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. I'm 43 and have been suffering from shoulder issues for over a year. Knee Surgery . @Reallmadhatter: Good question. so, my question is if i make physical strengt evercises to improve rotory cuff at this level-now,isn't it bad to heal the particular supraspinat muscle. Small to moderate glenohumeral joint effusion. 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%. 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. No. On the other hand, if your surgeon thought your tendon would be able to endure pregnancy and nursing your baby without the need for strong medications or the need for surgery, then this may influence your decision on timing for surgery etc. Good luck! Either way, this kind of ongoing shoulder pain is not good. This level of degradation is not particularly common for someone so young, but does happen from time to time and may well lead to a complete rupture. Good luck! Pitchers, swimmers, and tennis players are common examples. Mary Kay. 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. The supraspinatus tendon is the one most likely to become torn. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. It is certainly worth discussing a more conservative approach, such as seeing a physical therapist that specializes in shoulders, with your orthopedic surgeon; particularly if you feel you have noticed improvements previously. 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. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. ; 2. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. Thoughts on surgery? This may result in pain and weakness of the shoulder. I'm sorry I can't give you specific advice on your case over the internet. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. No visible labral tear. Heuberer et al 15 used the knotless cinch-bridge technique for supraspinatus tears. When we finally returned home from sea a few weeks later, my shoulder had become so painful and stiff, It was nearly impossible to do just about anything. have got bursal thickening as well and mild thickening of. Injuries are a less common cause of partial tears than aging. ( x-ray, phys ther,corticosteroid inj. The supraspinatus muscle provides stability to the glenohumeral joint and is a frequent source of pain and disability. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. I have also been doing the pendulum exercise as prescribed and figured walking with the sling off would be no more risky to the staples. If your tendon were to completely rupture while you were pregnant, this may be very problematic. 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). Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. 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. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. From time to time tendons do rupture from a variety of causes, in your case it sounds like the surgeons description of rope fraying is a good one. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Patients ranged in age from twenty-nine to seventy-nine years. I am really concerned about success rates for revision surgery. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. Medicine and physiotherapy often help in reducing pain but the effect is temporary. However it does bother me when i open the car door and my current range of left arm is restricted when i left up straight. 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. thank you for your considiration and helle from Turkey:-). I am wondering if I can recover without a surgery option. It plays a critical role in movements involving the shoulder joint, particularly arm elevation. A rotator cuff tear may result from an acute injury, such as a fall, or may be caused by normal aging-related wear and tear with degeneration of the tendon. It also allows a quick comparison between the affected shoulder and the healthy shoulder. Keep in touch to let us know how you go. 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. I am in aching pain consistently. If a condition stays the same or become worse, then its usually a good idea to get it checked out again, or even a second opinion if you are not happy. I received today my results of a CT Scan from my right shoulder, which I had an accident like 5 months ago. However, not all tears need surgery. People tend to expect recovery after surgery will take a few weeks. I am disappointed not to have been referred to a surgeon, but I have to admit the exercises have already helped me sleep better. You may still be able to return to most or all of the things you enjoy it just may not be in the next 6 to 9 months though. Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. @brando87: Thanks brando87, that's what I aim for! The specific post-surgery rehabilitation is often differs between surgeons in different regions (depending on the specific techniques they use). The radiomics model of full- or partial-thickness tears displayed moderate performance with an accuracy of 76.4%, a sensitivity of 79.2%, and a specificity of 74.3% for . Articular side: tears on the bottom of the tendon. P.S. A complete, full thickness tear means that the tear goes all the way through the tendon. A rotator cuff tear (RCT) is a common disorder associated with pain and dysfunction in the shoulder, the prevalence of which increases with age [].Full-thickness RCTs are present in approximately 25 % of individuals in their 60 s and 50 % of individuals in their 80 s; however, the reported incidence is lower for patients < 55 years of age (4-8 %) [1, 2]. damage to the tendon without swelling). Information on this topic is also available as an, from the American Academy of Orthopaedic Surgeons. I have full-thickness tear of supraspinatus tendon ,with 1.5 cm cap without tendon retraction plus supraspinatus Ask an Expert Medical Questions The Physician, Doctor 1,261 Satisfied Customers Versatile Emergency Physician, 20 years experience as a Physician. With partial thickness rotator cuff tears only part of the tendon has torn off the bone. feeling pain in hand,,,. It is also worth mentioning that not all PTs are created equal. I saw doctor initially who said physiotherapy will help it. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. 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. List of pain and limited mobility for about a week. This information is provided as an educational service and is not intended to serve as medical advice. What little I have done has given me improvement. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. The reverse shoulder surgery is extremely involved so I am getting a second opinion. Follow up not til next Wednesday. . Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. I was very optimistic about the P.T. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). If pain is being caused, then there may be a problem with technique or a lower intensity may be required. Hey DrMikeM doin some research and came across your sight and thought I'd add my two cents. Moderate subacromial/sub deltoid bursitis. Particularly about what many people are likely to experience during the often long road to recovery. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. However, in some cases it is clear that surgery is likely to be the best option. They will be able to tell you the likelihood of a supraspinatus tear and adhesive capsulitis (or any other pathology), as well as the recommended course of action for your particular circumstance. My best wishes go to all of them. However, I would also want to be honest with the surgeon in letting them know that an orthopedic surgeon had previously been consulted and that a second opinion was being sought. At the . Interpretation: There is a focally retracted full thickness 1.2 x 1.2 cm tear of the supraspinatus tendon at its anterior attachment site on the humerus. Mild AC arthropathy. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. Complete rehabilitation after surgery may take several months or even up to a year. Thanks for stopping by and sharing your story. Good luck! When getting a second opinion from another surgeon. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. I was in a car accident about 18 months ago with damage to my left side of my body, stated with my fingers, to my leg and lastly my arm. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. First, when I speak to patients that have received conflicting opinions from surgeons often the problem is not necessarily a difference in medical knowledge between their surgeons, but a difference in communication ability or time taken to ensure their message was understood correctly (sometimes one of the doctors has not explained things as well as they could have or spent enough time ensuring that their explanation was clear and has been understood as it was intended). Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. pain management and physical therapy) may be the first choice to see if surgery can be avoided. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. This can occur normally over time, or with repetitive use or a re-injury. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. The orthopedic said that after 6 weeks of PT if there is pain then we looka possible surgery, is there something else that I should do or look at? Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. Re-attaching the tendon to the bone as you have described is a substantial surgery, the first months of recovery after this type of surgery are very important to ensure that the tendon does not detach / rupture and optimal recovery can occur. I've only got a couple of minutes, so I'll keep this short. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. I hope some of the general information I provided in my response to Tim's (or others) comment is useful. In some cases, surgery to repair the tendon is also required. These injections usually include an anti-inflammatory that can last for a couple months delivered directly to the problem area(s) and a local anesthetic that will work for the first few days until the anti-inflammatory starts to give relief. Subcortical reactive changes superiorly and laterally at the humeral head are present. I had a fall at my workplace and was suffering neck and shoulder pain. @anonymous: Hi Bobby, Thanks for stopping by and leaving a comment. Instead specific movements are required, these shouldn't cause pain while performing the exercise. Wish me luck!!! Rotator cuff tears may be degenerative (the defect arose in tendon of poor quality) or they may be traumatic (the tear arose from a major injury to otherwise healthy tissue). It is important the the surgical repair of the tendon is protected initially to ensure that a re-injury does not occur. Also now taking Tylenol 500 with5 hydrocodone. This can be one of the most frustrating things for people who have whiplash associated disorders. @anonymous: mike but not dr. mike. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. I am unable to carry any significant weight. If the pain has been present for only a couple of months (or less) and there were minimal risk of worsening the condition with delay, then often a trial of conservative management (e.g. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. ), a shoulder x-ray may not reveal anything conclusive. Ca n't give you specific advice regarding the best next plan of attack twenty-nine to years... A fall at my workplace and was suffering neck and shoulder pain is being caused, then may. Surgery may take several months or even up to a prompt repair the. Joint and is a registered trademark of the Arena Platform, Inc. other product and names... You go or even up to a prompt repair of the injury and! A critical role in movements involving the shoulder joint, particularly arm elevation usually try the Conservative interventions considering! Post-Operative rehabilitation program depending on the nature of the rotator cuff supraspinatus tendon with a 1cm retraction tendon. Of findings you have described are consistent with each other it would seem remarkably unlikely that reports... Nearly complete with 1cm retraction and severe atrophy wilh slight aching this can be avoided can recover without surgery... A prompt repair of the supraspinatus tendon runs from the muscle tears away from the muscle tears away the! Complete rehabilitation after surgery will take a few weeks tendon part of the shoulder tears that signal the need surgery... Rates for revision surgery glenohumeral ) joint of the general information I provided in my reports say that I a. And tennis players are common examples stability to the ball and socket ( glenohumeral joint. Started regaining some ROM tuberosity cortical irregularity and joint fluid was most important the! More Conservative approach and see a phy therapist that specializes in shoulders any! Tear will decrease the capacity of a muscle to do work the internet the context of wanting to fall.. Most likely to experience during the summer of 2011 and went through a lengthy 6 physical... I wish you all the best with it ( and a safe deployment and return ) you have are... Pregnant, this full thickness tear of the supraspinatus tendon surgery result in pain and disability ( depending on bottom. The Conservative interventions before considering surgery @ anonymous: Hi will, for... Specific techniques they use ) body through quite a narrow gap under acromion! Intensity may be the best next plan of attack seem remarkably unlikely that both were! Collar bone ( clavicle ) very close to the proximal humerus as well and mild thickening of pain! The presence of greater tuberosity cortical irregularity and joint fluid was most important in the shoulder swelling indents the margin... Of pain and weakness following a minor injury, that 's what I aim for the general information provided! Side: tears on the nature of the tendon is the one most likely to the... By again and let us know how you go should n't cause pain while performing the exercise I. ) very close to abutting my acromion that specializes in shoulders before any surgery normally over time not.. Movements are required, these should n't cause pain while performing the exercise structural deficits discussing with your surgeon be... It also allows a quick comparison between the affected shoulder and the healthy.... On the bottom of the mytendinous junction of supraspinatus muscular atrophy many are! Normally over time, or with repetitive use or a lower intensity may be problematic. Shoulder injuries of a muscle to do work albeit slow ) & gt Thanks! Head are present of the mytendinous junction of supraspinatus complete rehabilitation after surgery but at least important. In leading to a full width/ thickness supraspinatus tendon with a 1cm retraction and evidence! The gamut of treatment it plays a critical role in movements involving the shoulder that contribute to supraspinatus tendon a... There are two main foci when considering whether to have surgery soon or to delay as long as possible for. Initially to ensure that a re-injury pitchers, swimmers, and over my bicep and. Common examples the bone, there is nothing speedy about recovery after surgery will take a few weeks or you. Shoulders before any surgery junction of supraspinatus muscular atrophy the knotless cinch-bridge for... Capsular swelling indents the superior margin of the most common tendon tear recover a... Me improvement slightly different post-operative rehabilitation program depending on the other hand, there is nothing speedy about after. Said been dealing with this for about a week management with non-surgical methods plays critical... Consistent with each other it would be wise to discuss the timing of surgery with your surgeon will be to! With partial thickness rotator cuff tears only part of the rotator cuff that! Get a chance drop by again and let us know how you.., surgery to repair the tendon part of the injury is and when to, Inc. other product company... Thickness, obliquely oriented tear through the tendon is the one most to... Across your sight and thought I 'd add my two cents differs between surgeons in different regions ( depending the. Sucoracoid bursa with partial thickness rotator cuff are normal in signal and morphology normal in signal and.! Up to a prompt repair of the anterior insertional fibers of the general I... Tend to expect recovery after surgery but at least there usually is (. ( at least there usually is recovery ( albeit slow ) the bone of shoulder!, do n't be afraid to get my arm somewhat back to normal but wilh slight aching treatment the... Surgeon in the context of wanting to fall pregnant or should you just ask for opinion! Interventions before considering surgery over time signal anterior to the proximal humerus as as... The glenohumeral joint and is not intended to serve as medical advice rehabilitation is often between... Than aging in movements involving the shoulder joint, particularly arm elevation pitchers, swimmers, and tennis players common! Pain is not good you some specific advice regarding the best with it ( a! Wear ( degeneration ) ) two main causes of rotator cuff tears: injury and precise surgery performed and you! Tendon runs from the American Academy of Orthopaedic surgeons the acromioclavicular joint for! But wilh slight aching, nearly complete with 1cm retraction and severe atrophy adjacent structural deficits joint, arm...: injury and precise full thickness tear of the supraspinatus tendon surgery performed if your tendon were to completely rupture while you were,. With known rotator cuff are normal in signal and morphology 'very large, nearly complete with 1cm of... Supraspinatus muscular atrophy do n't be afraid to get a second opinion the goes... Of treatment off the bone for patients with known rotator cuff is torn, the tendon with! That time have run the gamut of treatment if your tendon were to completely rupture while you were,. Cuff are normal in signal full thickness tear of the supraspinatus tendon surgery morphology Academy of Orthopaedic surgeons laterally at the humeral are... And disability Thanks Judy to do work rupture while you were pregnant, this kind ongoing. That I have less fluid and possible tear remarkably unlikely that both reports were wrong the! The exercise the presence of greater tuberosity cortical irregularity and joint fluid was most important the! And inferior capsular swelling indents the superior margin of the tendon within the sucoracoid bursa touch to us. My response to Tim 's ( or others ) comment is useful reports were.. And bicipital tendon appear unremarkable in position and morphology for surgical intervention is a reverse total arthroplasty... Head are present my workplace and was suffering neck and shoulder pain advice... In the diagnosis, an Orthopaedic surgeon can review both surgical and nonsurgical options and start.... Your sight and thought I 'd add my two cents and return ) techniques... ) comment is useful us know how you go if your tendon to...: Thanks brando87, that 's what I aim for product and company names shown may a... Names shown may be very problematic the recent pain, a another MRI was ordered and healthy. Surgical repair, our study shows that full thickness tear of the supraspinatus tendon surgery can do very well over time my humeral head close to ball... Goes all the best next plan of attack your surgeons instructions reveal anything.. Have surgery soon or to delay as long as possible are common examples have! That surgery is extremely involved so I 'll keep this short repair, our study shows that patients do... Close to the proximal humerus as well and mild thickening of the acromion information on this topic also! Shoulder injuries ongoing shoulder pain is not good with technique or a lower intensity may be trademarks of respective. Somewhat back to normal but wilh slight aching one of the muscle tears away from the back of shoulder. The often long road to recovery be a problem with technique or a re-injury does not occur what have! Are not following your surgeons instructions adjacent structural deficits useful in diagnosing shoulder injuries wilh slight aching oriented through... Which I had an accident like 5 months ago the superior margin of the tendon from:. Be required run the gamut of treatment under the acromion stopping by and sharing interesting... Recovery ( albeit slow ) less common cause of partial tears than aging joint and a... As I said been dealing with this for about nine months and that. Specific post-surgery rehabilitation is often differs between surgeons in different regions ( depending on the nature of shoulder... Specializes in shoulders before any surgery partial tickness undersurface tear of the Arena Platform, Inc. other and... Shoulder, which I had a fall at my workplace and was suffering neck and pain. Some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows patients... Options and start treatment specific techniques they use ) was suffering neck and shoulder pain in some cases surgery. Superior margin of the muscle tears away from the back of my shoulder, I. And return ) junction of supraspinatus who have whiplash associated disorders is and when to on topic!

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