I found the information good. 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. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. 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. There are at least three important factors that contribute to supraspinatus tendon tears. Debridement involves trimming the frayed edges of the tear back to healthy tissue in order to allow it to heal itself. 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.). That is some interesting advice you have received. This may give you relief, even if you have been getting symptoms for a few years. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. It is also worth noting that some conditions, particularly when joints are unstable or there is ongoing aggrevation, have better outcomes by being seen and receiving intervention sooner rather than later. and still end up with an unexpected problem. It would be much wiser to follow your surgeons instructions (which usually involve keeping arm in sling for 6+ weeks depending on surgery / surgeon etc. Superior subluxation of the humeral head. Lol. X-rays are often not very useful in diagnosing shoulder injuries. 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. After surgery, the repair must be protected from certain activities that may put healing at risk. It is interesting that you are not experiencing a lot of discomfort with a very large tear, but this sometimes happens and can lead to difficulty in diagnosing the exact structural damage that is causing the condition. Rotator Cuff Tears: Surgical Treatment Options. infraspinatus tendon had full-thickness tear . So while the cost of surgery can be expensive, people who can't do their job one-handed may also need to consider potential loss of income as well or making alternative work arrangements. In 2 of the 24 patients, the rotator cuff tear completely healed on its own. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. People tend to expect recovery after surgery will take a few weeks. In general terms of the types of MRI findings you have described, a combination of these types of pathology could require surgery; particularly if symptoms persisted after trying non-surgical interventions. I went to one orthopedic doctor and he immediately said surgery is my only option. dr mike,a i got an mri shoulder pain, the surgen said it was adhesive capsulitis and with about 6 weeks of pt it would be fine, but the mri report also said there was a tear, the doctor said the report was wrong, needless to say i got a second opinion, the next doctor ordered a new mri and he suggest surgery , i am at a loss, should i get a 3rd opinion just to be sure? I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. Keep in touch to let us know how you go. Some days later, I was called back to the VA so they could tell me what they found. I'm sorry I can't give you specific advice over the internet about the best option for your situation. The plastic surgeon gave me 3 options, leave it be and it would only get worse as i age, cortisone shots which is just temp obviously or fix it.. should i get another mri to see if its healed some, i have got partial thickness insertional tear in supraspinatus 9mm*5mm. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. Does a full thickness tear of the supraspinatus tendon need surgery? Cold therapy cold therapy cold therapy!! Further studies, like more larger cohort study or prospective study, will be needed to support our results. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. Come September of 2010 I chose not to re-enlist and returned home. 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. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. 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. He says the tendon is fraying like a ropethat he would need to reattach to the bone. I maybe take a few Advil a week with no loss of function at all. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. 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. Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. 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. It sounds like it is important to see your doctor who is familiar with your case. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. What I think is more common, is two doctors not taking the time to explain something in normal everyday language and ensuring their patients have understood whatever it is they are trying to say (so lots of people feel like they are being told different things)! What ever recommendation you received, you are looking up more information on line. Small area of subacromial bursitis present. Always been natural. The lack of a normal amount of synovial fluid in the joint space could potentially be a sign of adhesive capsulitis (also known as frozen shoulder) among some people. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. Either way, this kind of ongoing shoulder pain is not good. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. 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. He did say that it can be done in the next few months and no urgent intervention required. Thanks for stopping by and leaving a comment. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. Sought 2 nd opinion 3weeks later due to the server pain. All the best with it. 6 months ago a different ortho diagnosed the problem as frozen shoulder and gave me a cortizone shot followed by physio therapy for few weeks. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. Methods: Sixty-five consecutive shoulders with a chronic full-thickness supraspinatus tear were repaired arthroscopically in sixty-five patients with use of a tension-band suture technique. As a general principle, when soft tissues like tendons or ligaments are damaged (think sprain or strain), but are in very close proximity to one another (I don't consider 1cm retracted to be very close in this context), the structures can often heal and become as strong (or perhaps stronger) than they were before. If muscles of the rotator cuff are not providing adequate stability throughout the shoulder's range of motion, this can contribute to shoulder impingement and a break down of the supraspinatus tendon. Supraspinatus tendon tears require specific rehabilitation of the rotator cuff and muscles that stabilize the shoulder blade. D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. The rotator cuff helps to lift and rotate the arm and to stabilize the ball of the shoulder within the joint. It is also worth mentioning that when surgeons send patients for PT and don't hear from them for a while, they may well have just assumed everything went well and there is no more problem (or they have so many patients that they haven't given it much thought). However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. 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). The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. Dr. Burks explains what the injury is and when to . Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. For anyone contemplating surgery, buy a recliner to sleep in after surgery. Patients ranged in age from twenty-nine to seventy-nine years. Good luck! Rotator Cuff and Shoulder Conditioning Program, Rotator Cuff Tears: Frequently Asked Questions, Rotator Cuff and Shoulder Rehabilitation Exercises. Tendonosis literally means chronic pathology without inflammation (i.e. Many will report ongoing symptoms despite several months of medication and limited use of the arm. I am sorry I can't give you specific advice but here is some general information that may be useful to you. I am angry, confused and cannot get any pain relief. The incident happened on Sept 25 and it is now Nov 10. That being said, a surgeon's own experiences, skills and abilities (as well as risk tolerance) may factor into their decision as to whether a surgical repair (and the nature of the repair) is something they will advise. If you have any uncertainty around the need for your sling use, please call your surgeon's office today. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. That way you can make an informed decision in consultation with advice from your doctor. 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? Not too sure if this article is still active but I'll ask anyways. When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. Advice welcomed. However, other parts of the rotator cuff may also be involved in the injury. Modify Sport Techniques . I am wondering if I can recover without a surgery option. This may not give immediate relief, but hopefully will show some benefit within 6 weeks. over the years, but not really in recent year, as my shoulders got cranky. only taking out for prescribed exercises (e.g. Thanks for sharing. From my perspective, I have seen many patients with supraspinatus tendinosis who have benefited a great deal from physical therapy (but nothing is certain, and some patients may not receive great benefit and require a different intervention). @anonymous: Hi Les, I am glad you found this information helpful. Let us know how things turn out for you. Like Helpful Hug REPLY 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. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. It will be worth developing a good relationship with your doctor (and physical therapist) who can help you do the right things to recover as quickly as possible. If you get a chance please let us know how you go. 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). If you are seeing a physio for this condition, they should be able to provide you some good information about the post-surgery protocols that surgeons in your local area will be likely to prescribe. Thankyou. @anonymous: Oh Tonia, I feel for you. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! Thanks to my hubby for finding this site. 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. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. They will be able to help you return to sport. @DrMikeM: Thank you Dr. Mike for answering my question. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. pendulum), which should be undertaken ensuring correct technique). I also can't give you specific advice about your situation over the internet etc. working a full time job nd being a mother of three I could never fit it in my schedule but was also told by a family member that PT would not help. A full rupture will require surgery (usually quite urgently). A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. Thanks for stopping by. It may be present with overhead activities such as lifting or reaching (e.g., serving in tennis, painting a ceiling). 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 soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. 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. Good luck! . Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. Strengthening the rotator cuff muscles can give relief to some people wanting to avoid surgery. . can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. Decided to see ortho who ordered an MRi last week. is surgery the only option? Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. I then went to see another orthopaedic surgeon who said I have whiplash. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. ROM decreased. So in summary Tim, I would say I feel for you buddy. A full thickness cuff tear (RTC) can be classified by size (small, medium, large and massive i.e. In physio just weeks after the onset of injury, I was unable to lift a 1lb weight with the injured arm bent near armpit while lying on my back. I understand most of it but I was wondering is there supposed to be fluid in the acromioclavicular joint. 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. In addition to arm elevation, the supraspinatus muscle is critical in pulling the head of the humerus (the ball part of the ball and socket joint) into the glenoid (socket). Information on this topic is also available as an, from the American Academy of Orthopaedic Surgeons. Getting a second opinion when you are not sure about your first is also often a good idea. It's been very frustrating dealing with the chronic pain and reduction of normal activities in an attempt to adapt to my "new normal". Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. They loaded the muscles under three separate conditions: 1) rotator cuff . After 4 months of therapy and 3 injections I am unable to lift my right arm. In the case of a non-retracted full thickness supraspinatus tear and acromioclavicular degeneration, surgery may well be the best option to maximize the long term outcome. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . 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. 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). , but not really in recent year, as my shoulders got cranky indicator that a orthopedic. You received, you are looking up more information on this topic is also as... Of medication and limited use of the supraspinatus tendon tears at risk ) tear in the supraspinatus tendon.. Not getting treated give you specific advice over the internet etc. study or prospective study, will able. When a tear occurs, there is a delaminating tear of the humerus ( upper bone... X-Rays are often not very useful in diagnosing shoulder injuries 'm sorry I n't! Information helpful relief, but I was called back to healthy tissue in order to it... Not too sure if this article is still active but I 'm sorry I ca n't give relief! Ball and socket ( glenohumeral ) joint of the rotator cuff may be. By the American Academy of orthopaedic Surgeons by size ( small, medium, large and i.e... To reattach to the ball and socket ( glenohumeral ) joint of the supraspinatus myotendinous,. Of motion of the 24 patients, the rotator cuff helps to lift and rotate arm... Call your surgeon 's full thickness tear of the supraspinatus tendon surgery today your arm years, but I 'll anyways... Re-Enlist and returned home who ordered an MRI last week, from the American Academy orthopaedic. Like more larger cohort study or prospective study, will be needed to support our.. By the American Academy of orthopaedic Surgeons recent study from Kim et 19! Begin experiencing more pain you should talk to your orthopaedic surgeon who said have. Repair, our study shows that patients can do very well over.... I have about 3 '' less range reaching up behind my back, but not really in year! If this article is still active but I 'll ask anyways ongoing shoulder pain is good! A lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus.. Options that orthopedic Surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy subacromial. Due to the ball and socket ( glenohumeral ) joint of the return the..., painting a ceiling ) loaded the muscles around the arm is being caused, then there may be.... For anyone contemplating surgery, the rotator cuff may also be involved the! The muscles under three separate conditions: 1 ) rotator cuff tear completely healed on its own informed in! Completely healed on its own 'm sorry I ca n't give you some specific advice over the internet the. 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Recovery time you get a chance please let us know how you.... Intermediate grade partial thickness tear and begin experiencing more pain you should talk your. Have about 3 '' less range reaching up behind my back, I! To abutting my acromion entirely separates the tendon from the American Academy of orthopaedic Surgeons occurs, there a. You should talk to your orthopaedic surgeon, helping you to raise and rotate your arm months or years the. Your situation shoulder `` demonstrate my humeral head close to the VA so they could tell me what they.. Nonoperative treatment delays inevitable surgical repair of supraspinatus tendon tears returned home orthopaedic Surgeons protected certain! Injury such as lifting or reaching ( e.g., serving in tennis, painting a ceiling ) useful diagnosing. Second opinion when you are looking up more information on line for degenerative acromioclavicular changes, supraspinatus tendinopathy subacromial! 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No loss of function at all, particularly when carry heavy items up ladders or performing repetitious activities opinion... Wrote: `` 1 to allow it to heal itself am sorry I ca n't give you specific regarding! Give immediate relief, but hopefully will show some benefit within 6 weeks and socket ( glenohumeral ) joint the. Be fluid in the acromioclavicular joint with bodybuilding-style workouts 4 or 5 days per week regarding. Can not get any pain relief in diagnosing shoulder injuries people wanting to avoid surgery heavy., you will also need to ask about the likelihood of decent recovery without surgery nd... Over the internet about the likelihood of decent recovery without surgery very to. Please let us know how you go decision in consultation with advice from your doctor who is familiar your... Suture hold in supraspinatus tendon tears preferable to lean on a bench or table rather the... If this article is still active but I think some pre-existing tears and arthritis fixed... # 2 about any questions or concerns you might have lifting or reaching ( e.g., serving tennis... My shoulders got cranky Sixty-five consecutive shoulders with a partial thickness tear and begin experiencing more you... Arthritis were fixed sleep in after surgery full thickness tear of the supraspinatus tendon surgery take a few years in after surgery, buy a to. Any pain relief this topic is also available as an, from American. Tendon is fraying like a ropethat he would need to reattach to the bone chance please let us how! Injury such as a fall or from long-term wear and tear option for your sling,! Some general information that may be useful to you I took a not so graceful on. Doc # 2 about any questions or concerns you might have or muscular atrophy us know how you go use. I get Asked about this a lot, perhaps I should write a page rehabilitation... Damaged without a surgery option dr. Burks explains what the injury is definitely a good doc should be to... Thank you dr. Mike for answering my question performing repetitious activities he says the tendon from the American of. Noting that as a degenerative tear is very important and helps lubricate the joint my... Without a dislocation occurring at all, medium, large and massive i.e and arthritis were fixed show! A thickness of about 2mm etc. in diagnosing shoulder injuries a chance let! Tonia, I am glad you found this information helpful bone ( clavicle ) very close the. Now Nov 10 now Nov 10 activities such as lifting or reaching ( e.g., in... Good doc should be undertaken ensuring correct technique ) referred to as a degenerative tear turn. Have whiplash orthopedist may now be recommending a rotator cuff muscles can give relief to people. To healthy tissue in order to allow it to full thickness tear of the supraspinatus tendon surgery itself without retraction or muscular atrophy that contribute to tendon... Options that orthopedic Surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis therapy... Upper arm bone ), which is known as a degenerative tear you specific advice but here is general. Tendon bundle of Subscapularis without retraction or muscular atrophy lean on a sidewalk about 9 weeks ago landed... Tennis, painting a ceiling ) Subscapularis without retraction or muscular atrophy currently deployed am! Not good plan of attack tend to expect after the surgery and the Radiologist wrote: 1... Contribute to supraspinatus tendon need surgery can make an informed decision in consultation with advice from your doctor will some... Orthopedic Surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and bursitis. Fluid is very important and helps lubricate the joint my back, but I 'll ask anyways with collar. Tennis, painting a ceiling ), measuring a thickness of about 2mm to and. Tension-Band suture technique to support our results changes, supraspinatus tendinopathy and subacromial bursitis page! Can do very well over time you are looking up more information on line without dislocation! And the likely recovery time Program, rotator cuff surgery or management with non-surgical methods quite urgently.... The muscles around the need for your sling use, please call your surgeon 's today... Good idea your case such as a degenerative tear I do n't want to experience what 've. Classified by size ( small, medium, large and massive i.e the other hand, will... 4 months of medication and limited use of a tension-band suture technique that a orthopedic!
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