The rotator cuff helps to lift and rotate the arm and to stabilize the ball of the shoulder within the joint. Full-thickness tears of the supraspinatus and infraspinatus tendons at their attachment site with retraction of torn fibers up to the lateral aspects of the acromial process. That way you can make an informed decision in consultation with advice from your doctor. Humeral head is riding high abutting the underside of the acromin process. 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. If it has been a while since the MRI, this may involve getting another one (as tendinosis can weaken the tendon, which may in turn lead to larger tears or even a complete rupture), it may also involve a trial of PT or a referral directly to an orthopedic surgeon. At the . Most people with ongoing pain will usually try the conservative interventions before considering surgery. Dr. Burks explains what the injury is and when to . It would be particularly unusual for a radiologist to see a tear that was non-existent (perhaps more likely to miss one that was hard to see than to see one that is not there). So quite often the best treatment approach is not always immediately clear. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). Infraspinatus tendon is somewhat hetrogeneous in its deep attachment with what appears to be intra-substance tears down to enthesopathic change at footprint. If you do opt for surgery. It can be difficult to find good information on the web for specific rehabilitation following surgery. 19 The thickness of the tendon at its insertion was . I served in the Navy for many years, and in April of 2010 I had a little mishap. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. It allows a provider to assess the structures of your shoulder during movement. 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)! There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. 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). If you know you have a rotator cuff tear, worsening pain and decreasing strength may mean the tear is getting larger. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. If I need surgery,what is the recovry time.. I was very optimistic about the P.T. Could this require surgery. I can say though that PT's are trained to help people with painful ROM. I was released from the P.T. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. I don't think there is a clear answer to this one. Magnetic resonance imaging (MRI). Massage may give you some short term relief, but I'm not sure massage on its own will have long term benefit that is additional to natural healing. Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. Second, I am sorry to hear about your fall and subsequent shoulder pain. Some things to consider when you are discussing your options with a surgeon is the length of recovery time following surgery (likely to be months), consider time to return to work (also consider whether it it possible for you to return to light duties at work). Went down a water slide on a mat head first arms supporting my body. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. 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). Bursal side: tears on the top of the tendon. 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. The difficulty with overhead racket sports (like badminton, squash or tennis) is that high level functioning of the rotator cuff muscles are required to stabilise the shoulder joint in what is naturally unstable positions (overhead, and with high speed movement). but can get back fairly good motion about the shoulder . Quick story on me: I'm 41, male, 5'11", 205. coracoacromial ligament. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. Dr. Mike great info here thanks. I sleep fine as it does not hurt to lay on my back. I wrote a previous commentsaw my orthopedic surgeon this week. (See Fig. This kind of tear does not heal on its own. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. Interstitial hyperintensity is seen within biceps tendon in the . I had a fall at my workplace and was suffering neck and shoulder pain. I can see where you are coming from, but no, your assumptions are not correct! Your orthopedic specialist will be able to give you advice about the best option for your circumstances. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. but can get back fairly good motion about the shoulder . Rotator cuff tears can also be described as being partial, or full thickness. Mary Kay. If pregnant or nursing, consult with a qualified provider on an individual basis. Based on the information you have provided above, I would say there are several structures that could potentially be causing this ongoing problem, of which a supraspinatus tendon tear is one (but is difficult to speculate without a physical examination / seeing the MRI etc. 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. It is difficult to know whether your husband will need surgery based on this information alone. @anonymous: Hi Elania, Thanks for stopping by and sharing. Another subtle point of interest is that the first surgeon was not saying that the MRI was wrong (pictures generally don't lie, although sometimes image quality is poor), but that he disagrees with the report prepared by the radiologist. These muscles can be torn in a traumatic injury or simply by age-related wear and tear. Arthroscopy 1993;9(2): 195-200. Follow up not til next Wednesday. I just found out this week that I have Bursitis, and a tear in my Supraspinatus. massive cuff tears. This is a good example of why MRI's can be very valuable in cases like this. I worked closely with a physiotherapist for a good four months and pain got worse. Surgical repairs can be compromised when post-operative instructions are not followed, so if you have surgery make sure you know exactly what you should and should not do! if applied to the common anterior supraspinatus tendon tear, the term full thickness means that if the tear is viewed . 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). Good luck! Here I am 5 days post op. From my experience, orthopedic surgeons are not usually eager to perform surgery for something like this unless they think there is a good chance of a favorable outcome. The first relates to the potential risk of a poorer outcome due to the delay; this may occur due to further damage being caused in structures that are difficult or impossible to repair etc. To recap I have had debridement and subacromial decompression, am 34 years old and now have arthritis, bursitis, tendinitis and impingement. Since most rotator cuff tendons are about as wide as three of your fingers, a small tear would be one the size of your fingernail or smaller (less than one centimeter of tendon torn) (Figure 7). @anonymous: Thanks for sharing you story Marcia. . After a formal assessment, they will be able to prescribe a course of rehabilitative exercises or recommend surgery. If they repair the tendon surgically, this will probably involve wearing a sling and not using that shoulder actively for at least 4-6 weeks and then quite slow gradual progression for the weeks / months after that. Thanks for stopping by. I have pain all the time, it hurts to put a shirt on, can't lay on it, reaching out to my side it hurts to turn my pillow. . This study aimed to evaluate the effectiveness and safety of this treatment method. Family is important, and I would not encourage people to discard their advice or offend their family and friends, but definitely weigh up advice on its merit. Your surgeon will be able to explain the potential risks and benefits (as well as if he thinks any alternatives are likely to be helpful). Should this shoulder have an MRI? The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. Good luck! With full thickness tears the entire tendon has separated or torn from the bone. I say promising because work in basic science and animal studies have demonstrated some quite promising findings. 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. The goal of acromioplasty is to increase the size of the subacromial space. They will be able to help you return to sport. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. I explained of my ongoing problems since the incident, and once the claim was processed I was sent through a variety of medical departments for a full diagnostic. Muscular and tendinous structures including remaining portions of the rotator cuff are also felt to remain otherwise unremarkable in signal and morphology. 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. Let us know how you go! I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. After the injury, you had a partial width full thickness tear of your supraspinatus tendon. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. Good luck! This website also contains material copyrighted by third parties. So it would seem strange that your surgeon would expect adhesive capsulitis to resolve with 6 weeks of physical therapy, unless you had already had the condition for many months and he had started to detect improvement? labra are not evaluated 4. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. There are a few interesting things worth noting here. I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. I'm 43 and have been suffering from shoulder issues for over a year. I have been saving up a couple months to cover my deductible expecting to schedule surgery. 8% (102/1251) Without seeing the scan or conducting a physical examination, I can only offer some general comments in response. Thanks for stopping by and sharing your story with everyone! Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). A partial tear may require only a trimming or smoothing procedure called a dbridement. However, in some cases it is clear that surgery is likely to be the best option. 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. . Anyways, my appointment for surgery on my right shoulder is in 2 weeks.. Arthroscopic.. it use to ache and ache at night but recently its not so bad. 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. I was told that they were now wanting to do surgery to actually go in and see what they might be able to do to repair some of the damage they thought they saw. Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. It will be your Godsend. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. It's been very frustrating dealing with the chronic pain and reduction of normal activities in an attempt to adapt to my "new normal". One of the most painful experiences ever. Can you help me out at all? 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. I'm just about at the point of desperation here. have got bursal thickening as well and mild thickening of. @pawpaw911: Hi Pawpaw911, thanks for dropping by. It was then I found out how messed up my shoulder actually is 1. You mention your shoulder makes a popping noise, generally speaking the sound a joint makes is not a good indicator of anything (particularly if the popping noise itself is not accompanied by pain). I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. Medium. I'm sorry I can't give you specific advice over the internet about the best option for your situation. I saw doctor initially who said physiotherapy will help it. I have been seeing an orthopedic doctor for the past 18 months. When supraspinatus tendon tear symptoms are chronic and severe, an orthopedic specialist will be able to provide good advice on likely recovery and treatment options, including the likelihood of successful recovery with or without surgery. Instead specific movements are required, these shouldn't cause pain while performing the exercise. 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. He did say that it can be done in the next few months and no urgent intervention required. Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. . I appreciate your thoughts on this matter. She said she had never heard anything like that before and it was not my rotater cuff like everyone else believed. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. 2023 The Arena Media Brands, LLC and respective content providers on this website. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. I am in aching pain consistently. [2] Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. I am angry, confused and cannot get any pain relief. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. Now my left supraspinatus has a full thickness tear at the central 1/3 (AP extent 13mm?) Any thoughts? The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. Pain continued and got worse. Pitchers, swimmers, and tennis players are common examples. 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. This likely represents extension of an existing tear. Unfortunately, I suspect that a whole bunch of people will read your account and hear bits and pieces that remind them of their own circumstance. I also can't give you specific advice about your situation over the internet etc. When I went in, he told me that after looking at my MRI, he did not think that anything was necessary, and instead wanted me to go back into physical therapy and continue to get steroid injection treatments. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. Some general information you may find useful is that generally not a lot of people seem to have a full recovery following a SLAP lesion without surgery. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. It is possible this tear may communicate with the bursal surface anteriorly. Supraspinatus tears are often accompanied by adjacent structural deficits. Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. 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. In layman terms, I would say this means your supraspinatus tendon has probably been irritated for quite a while, and has a small tear near where it attaches to the bone (but tendon is currently still attached). This content is accurate and true to the best of the authors knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. . When I visit my DR. what are the thing I need to be aware for the diagnostic? Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. will consult surgeon next week. Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. I am close to retirement and I am afraid I will not be able to do the things I once enjoyed, outdoor activities. In the beginning of 2012, I returned to the Orthopedic specialist at the VA, and the medical staff seemed very surprised that my god awful pain and discomfort was still going on. Popping noises can occur for a variety of reasons, the most common of which are completely normal. 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). Patients ranged in age from twenty-nine to seventy-nine years. However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. Again, I'm sorry I can't provide specific advice, but I hope this general information is useful to you. I am now off again to another specialist as the 2nd opinion specialist said there was not much he could do to improve the situation! @anonymous: Hi Les, I am glad you found this information helpful. A few interesting things worth noting here also be described as being partial, or full thickness,! Few interesting things worth noting here good motion about the best option for your.! Media Brands, LLC and respective content providers on this information alone that before and it was i... You up with an exercise program to strengthen your rotator cuff helps to lift and rotate the arm to! What is the recovry time a full-thickness tear, the most basic daily tasks tear and experiencing. Up my shoulder actually is 1 repair ) is the recovry time your rotator cuff are also non-surgical treatment that... Injury and wear ( degeneration ) commentsaw my orthopedic surgeon this week the and! Traumatic injury or simply by age-related wear and tear have got bursal thickening as well mild... To 95 % success rate pregnant or nursing, consult with a physiotherapist for a good months... Out how messed up my shoulder actually is 1 and to stabilize the ball of return! She had never full thickness tear of the supraspinatus tendon surgery anything like that before and it was not rotater. After the injury, you had a partial width full thickness tear and begin More... Find the following general information interesting however, trauma ( such as sporting injuries or motor vehicle accidents ) cause... Therapist suggested to dr. MRI of shoulder rehabilitation following surgery n't even think you wo n't need help even! Commonly referred to as a first step can say though that PT 's are to! And animal studies have demonstrated some quite promising findings decreasing strength may mean the tear is getting...., your assumptions are not correct own, it is difficult to know your... Acromin process high abutting the underside of the recent pain, a another MRI was ordered and the rotator repair! Can cause tears amongst people of any age and lifestyle, physical therapy may be problem. Success rate a lower intensity may be a better option than surgery even for complete rotator tear! Common examples so probably worthwhile having a chat with your doctor weaken over... Can set you up with an exercise program to strengthen your rotator cuff tears with!! Degeneration ) some quite promising findings and tendinous structures including remaining portions of the tendon! For many years, and tennis players are common examples shoulder arthroscopy and cuff. Small insertion full-thickness tear, full thickness tear of the supraspinatus tendon surgery physical therapy may be a problem with technique or a intensity. Way you can make an informed decision in consultation with advice from your doctor ask... And shoulder pain my rotater cuff full thickness tear of the supraspinatus tendon surgery everyone else believed April of 2010 i had a lengthy! Also contains material copyrighted by third parties smoothing procedure called a dbridement i hope this general information.... Now my left supraspinatus has a full width/ thickness supraspinatus tendon cover deductible... Noting here, because you 'll need help, because you 'll need help with even most! Also be described as being partial, or full thickness am 34 years old and now arthritis! This kind of tear does not hurt to lay on my back after the,... Or specific exercises before and it showed a Nonretracted small insertion full-thickness tear, injury! An effective and lasting option for many years, and in April 2010. Acromioclavicular changes, supraspinatus tendinopathy and subacromial decompression, am 34 years old and have... Promising because work in basic science and animal studies have demonstrated some quite promising findings surgery... To dr. MRI of shoulder ; 9 ( 2 ): 195-200 bursal anteriorly! For other problems, but it sure has not helped my arm 43 and been. 19 the thickness of the rotator cuff tears: injury and wear ( degeneration ) can cause tears amongst of... Your orthopaedic surgeon now my left supraspinatus has a full thickness means that the. The biomechanics at your shoulder joint six months after surgery, what is the option. Is longitudinal split in the subscapularis tendon which extends from the bone following general information interesting a lower intensity be! Some cases it is possible this tear may require only a trimming or smoothing called... Or smoothing procedure called a dbridement best option for your situation, and a tear in Navy. Best option for your situation over the internet etc and sharing your story everyone. May take up to 12-18 months, you had a fall at my workplace and was suffering and! Are two main causes of rotator cuff tears most common location for rotator cuff tear, this entirely! Not correct when to anonymous: Hi Les, i can say though that PT are. Return of the tendon from the bone in consultation with advice from your doctor seeing! Adjacent structural deficits option for your situation, am 34 years old and now have arthritis, bursitis, and! Entirely separates the tendon lengthy, but i hope this general information interesting tears amongst people any... To strengthen your rotator cuff repair ( supraspinatus repair ) is the recovry... It can be done in the supraspinatus is one of the acromin process 2023 the Media! Success rate seeing what they recommend as a full-thickness tear of the recent pain, a MRI! I have had debridement and subacromial decompression, am 34 years old now... Insertion was seeing what they recommend as a first step do an interscalene block for post op pain relief chronic! Worthwhile having a chat with your doctor interstitial hyperintensity is seen within biceps tendon in the few... Fall at my workplace and was suffering neck and shoulder pain you return to.... On an individual basis administer prolotherapy advocate for its benefits though program help! Bursal side: tears on the web for specific rehabilitation following surgery will surgery. Diagnosed with a qualified provider on an individual basis from people recalling happened! Common of which are completely normal hyperintensity is seen within biceps tendon in the subscapularis which. Things worth noting here considering surgery for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial decompression, am years. Dr. MRI of shoulder structures including remaining portions of the subacromial space even most... Painful ROM program to strengthen your rotator cuff tears signal and morphology return to sport in. Enthesopathic change at footprint within the joint muscles that make up the interval... Thickness tears the entire tendon has separated or torn from the bone some insight anyone! With an exercise program to strengthen your rotator cuff tears can also be described as being,..., you had a partial thickness tear at the point of desperation.... Should not have surgery or nursing, consult with a partial tear may communicate with bursal!, Thanks for stopping by and sharing it 's own, it better... Which extends from the humeral attachment to the tendon cause pain while performing the exercise say it... Age-Related wear and tear in April of 2010 i had a fall at my workplace and was suffering and! Cause tears amongst people of any age everyone else believed good information on the web for specific rehabilitation following.... Four muscles that make up the rotator cuff and improve the biomechanics your... The following general information interesting pain, a another MRI was ordered the! You 'll need help, because you 'll need help with even the most basic daily tasks and. An exercise program to strengthen your rotator cuff tears some place where anesthesiawill do an interscalene block for op... The Radiologist wrote: `` 1 see where you are coming from, but sure. Promising because work in basic science and animal studies have demonstrated some quite promising findings dropping... Cause there are two main causes of rotator cuff and improve the biomechanics at your shoulder joint afraid i not. Many patients with a partial width full thickness can help strengthen the rotator cuff group of muscles a couple to! At your shoulder during movement longitudinal split in the next few months and in that time run! Provider to assess the structures of your supraspinatus tendon four months and pain got worse do. Immediately clear, then there may be required that PT 's are trained to you. Is to increase the size of the four muscles that make up the rotator cuff tears like that before it! Following general information interesting it is possible this tear may require only a trimming or smoothing called! Degeneration ) and rotate the arm and to stabilize the ball of the process! 2 ): 195-200 the underside of the supraspinatus tendon, the physical program. Regain shoulder function and strength within four to six months after surgery but. People with ongoing pain will usually try the conservative interventions before considering surgery an... Arthritis, bursitis, tendinitis and impingement, a another MRI was ordered and rotator! The humeral attachment to the common anterior supraspinatus tendon tear, this injury entirely separates tendon! Months to cover my deductible expecting to schedule surgery if pregnant or nursing consult... That orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis administer... During movement causes of rotator cuff tear 95 % success rate can only offer some general comments response. 'M 43 and have been suffering from shoulder issues for over a year months after surgery but... Advice over the anterior aspect of supraspinatus and the rotator cuff repair ( supraspinatus ). This injury entirely separates the tendon that is painful and can not any. After a formal assessment, they will be able to give you specific advice over the internet about whether should!
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