You have asked for information about potential options. You don't need to lean over as far as demonstrated in this video. I worked closely with a physiotherapist for a good four months and pain got worse. I had a fall at my workplace and was suffering neck and shoulder pain. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! Many professions require repetitive or heavy overhead work (roof plasterer etc.). However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. 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. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. At the final follow-up, the VAS, Constant, ASES, and UCLA scores were 1.1 0.9, 84.3 16.4, 88.3 17.4, and 31.1 6.0, respectively. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). Good luck! I guess my question is does this always require surgery? It extends slightly into the proximal subscapularis bursa. Let us know how things turn out for you. !!! . It is possible this tear may communicate with the bursal surface anteriorly. I hope I have not waited to long for having this checked, and the only option will be surgery. With complete tears, the tendon has come off (detached) from where it was attached to the bone. I think it would be wise to listed to the advice from your doctor on this one! 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. Good luck with it and I hope you are feeling pain free sooner rather than later. 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. The technicians wont say more and nor will my doctor. Thank you. 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. Went down a water slide on a mat head first arms supporting my body. Wish me luck!!! Good luck! MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. Thanks for stopping by and sharing your story. damage to the tendon without swelling). Cold therapy cold therapy cold therapy!! When he says your tendon is failing, I think what he is trying to convey is that once some strands of a rope start to break, then there is more load on the remaining strands which may cause more strands to break (and then more load on remaining individual strands, more strands tear and so on). I'm sorry I can't give you specific advice over the internet about the best option for your situation. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. Thanks for stopping by and sharing your story. I'll go check out some of your Lenses. It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) They may extend to become massive involving multiple tendons as shown in the figure. 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. Our results suggest that surgeons should carefully check subscapularis tendon during surgery in posterior delamination patients. In the interim, physio, chiro, massage, taping were part of my pain management and ROM for all pain sites relating to MVA. Can you help me out at all? This will help minimize strain on the back. MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain This is partly because rehabilitation following surgery will depend on the surgical technique used. 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. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. Sleeping on my right side became impossible. Advertisement. It is not possible for me to give you any specific advice over the internet etc., but here are some general thoughts. After the injury, you had a partial width full thickness tear of your supraspinatus tendon. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. Thanks to my hubby for finding this site. There is no question that the word 'small' can be misleading regarding the amount of pain and discomfort that a supraspinatus tendon tear can cause. Surgery to repair tendons generally involves a long recovery period. The pain is manageable if you stay on top of it with pain medication. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. shoulder or arm weakness. There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. Instead specific movements are required, these shouldn't cause pain while performing the exercise. I had an arthogram-MRI which showed a 4 mm near full thickness u-shaped tear involving the supraspinatus tendon anteriorly near but not actually at the numeral attachment. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. This information is provided as an educational service and is not intended to serve as medical advice. 2. Your orthopaedic surgeon can prescribe an appropriate program based on your needs and the findings at surgery. coracoacromial ligament. Any thoughts on treatment for this considering previous surgery? 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. I will congratulate you on actually doing your exercises! 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. Drugs, supplements, and natural remedies may have dangerous side effects. That being said, contemporary surgical repairs and surgical re-attachments have relatively high rates of success (albeit after a difficult post-surgical recovery period) when performed in a timely manner. Thanks again Dr. 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 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. I appreciate your thoughts on this matter. 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! On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) It sounds as though you know a little bit about your shoulder situation already, so I won't re-state details about the anatomy that is affected. 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. I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. There are some biomechanical and physiological attributes associated with the types of tendon injuries you have described that make them difficult to successfully repair. The radiomics model of no tears or tears achieved a high overall accuracy of 93.6%, sensitivity of 91.6%, and specificity of 95.2% for supraspinatus tendon tears. So first off, I should say that I have certainly seen situations where a small supraspinatus tear has been surgically repaired, only for a worsening of symptoms to occur after further pathology (such as other rotator cuff tendon tears) either develop or become easier to detect on imaging (e.g. 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. I have a second opinion on Monday. Questions: 1. 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. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. Dr. Burks explains what the injury is and when to . It's a supraspinatus tendon tear with 50% thickness and no labral tear. The recovery after surgical tendon repairs often takes longer than recovering from broken bones. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). It was a small rotator cuff tear. After surgery, the repair must be protected from certain activities that may put healing at risk. Front view (left) and overhead view (right) of the tendons that form the rotator cuff. What I really want right now is to regain enough to get through normal everyday activities and not feel limited trying to lift an object and also not drop things so frequently. With full thickness tears the entire tendon has separated or torn from the bone. and still end up with an unexpected problem. A full rupture will require surgery (usually quite urgently). . I was released from the P.T. However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great. 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! The reverse shoulder surgery is extremely involved so I am getting a second opinion. I am 55 yrs. What I can say is that for anyone looking to return to unrestricted badminton following a partial thickness supraspinatus tendon tear and shoulder labrum tear (particularly a SLAP lesion) will not be quick or easy. I then went to see another orthopaedic surgeon who said I have whiplash. I have had shoulder pain for years and years. but can get back fairly good motion about the shoulder . I all of a sudden lost all my strength in my right arm and dropped the box. 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. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. Sometimes in cases like this your surgeon may want to try an injection. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. Acromioclavicular joint degenerative changes, which means nothing to me. Dr Mike, Please help me understand what options I might have in my case of job relater incident. The majority of these tears occur amongst people over the age of 40. In 9 of the 24 the tear was smaller. This is a good example of why MRI's can be very valuable in cases like this. Some days later, I was called back to the VA so they could tell me what they found. However, in some cases it is clear that surgery is likely to be the best option. Thankyou. 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. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. sorry for the double posting, first time user. 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. 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.). Children are such a blessing and that time nursing your newborn is such a special and important time. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. 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. Massive. Starting with Physio treatment is a good idea. Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. 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. Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. I have lost about 45+% of my ROM in my right arm. 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. SLAP type tear of the superior labrum. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. Good luck with it. Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. Also, if you were concerned about any advice given by your doctor, don't be afraid to ask for a second opinion from another doctor who can conduct a full examination and look at your MRI. Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull. You are also right that many people often don't understand that you are not 'putting on an act'. The supraspinatus is part of the rotator cuff of the shoulder. Good luck! I do so appreciate the advice and direction you have given to myself and others through this posting. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. Subcortical reactive changes superiorly and laterally at the humeral head are present. My best wishes go to all of them. Good luck! Overall my subscapularis does appear intact." Call Us: (239) 308-4701 Email Us Give us a Call! These four muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) stabilize the glenohumeral joint, enable rotation around the joint, and provide a counterforce to . Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. Symptomatic full thickness rotator cuff tears can be managed surgically. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). It seems to be a long recovery period with a great deal of physical therapy following. Pitchers, swimmers, and tennis players are common examples. However, your doctor should be able to provide you with good advice in this regard after they speak with you, conduct an assessment and look at your scan. With partial thickness rotator cuff tears only part of the tendon has torn off the bone. You may feel pain when you try to sleep on the affected side. I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. feeling pain in hand,,,. I just found out this week that I have Bursitis, and a tear in my Supraspinatus. I can say though that PT's are trained to help people with painful ROM. 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