Twenty-one of the 70 partial-thickness tears were not rim-rent tears: there were nine (12.9%) tears in the critical zone, 10 (14.3%) interstitial tears, and two (2.9%) bursal-sided tears. Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. . 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? Retraction of the supraspinatus tendon medial to the glenoid. I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. The tear of the subscapularis muscle is less common then the tear of the other rotator cuff muscles, such as the supraspinatus, infraspinatus or suprascapularis. I am sorry I can't give you specific advice but here is some general information that may be useful to you. Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. I'm not really sure how the whole army doctor situation works while you are on deployment, but I think if you have ongoing symptoms then it is worth making sure the appropriate people know. Good luck! Remaining tendons of the rotator cuff are normal in signal and morphology. Some quite compelling research has indicated that a substantial proportion of people (particularly young people) who receive this kind of treatment will go on to have further shoulder problems (sometimes instability in the shoulder joint or pain and discomfort from damaged structures). Supraspinatus tear can be caused by lifting something too heavy, falling on your arm, or dislocating your shoulder. . ROM decreased. In this study, 24 patients who had full thickness supraspinatus tears and who opted to forego surgery were tracked over time. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. Mike!! I'm sorry I can't give you specific advice on your case over the internet. Thanks for posting your question. I was released from the P.T. 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). Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. Overall my subscapularis does appear intact." D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. Background: Good functional results have been reported for arthroscopic repair of rotator cuff tears, but the rate of tendon-to-bone healing is still unknown. Does a full thickness tear of the supraspinatus tendon need surgery? Partial thickness tears. MRI). Call Us: (239) 308-4701 Email Us Give us a Call! Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). All material on this website is protected by copyright. and seemed to be doing ok with Cortisone shots. 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. while that helped in the short term and improved my left arm motion range, after i stopped the therapy the pain came back and reduced the range. I sleep fine as it does not hurt to lay on my back. The supraspinatus tendon was assessed at its insertion by moving the transducer anteriorly, where the bony landmarks were the greater tuberosity laterally and the junction of the tendon footprint and articular cartilage of the humerus medially, 2 mm posterior to the long head of biceps. Rotator cuff tears can also be described as being partial, or full thickness. Some people will recover quickly without any treatment, other people will recover after commencing non-surgical interventions (such as physical therapy and rotator cuff exercises and / or receiving a steroid injection), while others will still have pain after many months and may require surgery. Being deployed and not receiving treatment makes it difficult. It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great. If you get a chance drop by again and let us know how you went. Once the full thickness of the tendon is torn, we classify the tears based upon the shape and the number of tendons involved. Many persons with partial-thickness tears will never require surgery if they undergo an appropriate physical therapy rehabilitation to address muscle imbalances. Good luck with it! I have been seeing an orthopedic doctor for the past 18 months. Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. Second, I am sorry to hear about your fall and subsequent shoulder pain. With partial thickness rotator cuff tears only part of the tendon has torn off the bone. They can then make a diagnosis and begin treatment. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. Your orthopaedic surgeon can prescribe an appropriate program based on your needs and the findings at surgery. Hi there. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. @Reallmadhatter: Good question. I did PT around December for a month, twice a week. I appreciate your thoughts on this matter. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. A full thickness cuff tear (RTC) can be classified by size (small, medium, large and massive i.e. Some days later, I was called back to the VA so they could tell me what they found. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). I here is incidental note made that the teres minor muscle is prominently atrophic. At 55 years of age you still have a lot of living still to do, so don't be afraid to talk openly with your doctor about the success rates for all of the options available to you, and the likely recovery times involved. 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. An exercise or physical therapy program is necessary to regain strength and improve function in the shoulder. Let us know how you go. . Here are a few notes/tips before you begin: Below is a demonstration of this exercise. Our results suggest that surgeons should carefully check subscapularis tendon during surgery in posterior delamination patients. The recovery after surgical tendon repairs often takes longer than recovering from broken bones. The rotator cuff is a group of four muscles that come together as tendons to form a "cuff," or cover, over the head of the humerus (upper arm bone). There is compromise of the subacromial space with impression on the underlying torn supraspinatus. Good luck! The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. I say promising because work in basic science and animal studies have demonstrated some quite promising findings. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). Remember that you are not aiming for speed; slow, steady, and controlled movement is best. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). Modify Sport Techniques . If you give PT a go, make sure you follow their instructions and specific techniques for the exercises they give you (most likely to strengthen your rotator cuff). I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. pain management and physical therapy) may be the first choice to see if surgery can be avoided. 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. Rotator cuff exercises will usually be important for anyone looking to return to a racket sport following a supraspinatus tendon tear or shoulder labrum tear (or even someone looking to prevent those injuries). The four muscles supraspinatus, infraspinatus, subscapularis and teres minor originate from the scapula (shoulder blade). After the injury, you had a partial width full thickness tear of your supraspinatus tendon. 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. 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. )amount of fluid in acromioclavicular joint and last but not least 5.) Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). Any advice would be appreciated thanks. (Right) A full-thickness tear in the supraspinatus tendon. Avoiding work above shoulder height can sometimes avoid aggravating the pain. 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. It seems to be a long recovery period with a great deal of physical therapy following. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. I am angry, confused and cannot get any pain relief. 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). Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. Good luck with it. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. The reverse shoulder surgery is extremely involved so I am getting a second opinion. @DrMikeM: wheather arthoscopy surgry ll help for my injury sir ?what type of surgery needed for dis type of injuries sir.ortho doc told Do exercise for 2 weeks aftr tat if it not improved ll do arthoscopic surgery sir Due to a fall and resulting shoulder pain my doctor prescribed to have an MRI, the findings were; moderate tendinitis in the supraspinatus. I don't lay on the side of the hurt arm as I don't think it will be good for it. @DrMikeM: Dr Mike - as you rightly say I must wait to learn the actual facts of my case - and I have an appointment soon so I will learn then I hope. Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant. This is a good example of why MRI's can be very valuable in cases like this. Above my shoulder or behind my back without pain. Surgery for a minor partial thickness tear will often involve a simple debridement of the tear. 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. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. There are a few interesting things worth noting here. Sleeping on my right side became impossible. Typically, you will feel pain in the front of your shoulder that radiates down the side of your arm. When I visit my DR. what are the thing I need to be aware for the diagnostic? They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. Some will have more training, experience or ability in helping patients to overcome the biomechanical factors that can cause shoulder impingement and supraspinatus tears. @brando87: Thanks brando87, that's what I aim for! He says that my tendon is failing. Good luck with it. I don't think there is a clear answer to this one. As I think you already suspect, an MRI is likely to have greater diagnostic accuracy for ruling out (or in) the involvement of other structures in your shoulder, such as the long head of Biceps Brachi. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. 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. Thanks for stopping by and sharing your story. In general, seeing your orthopedic specialist would be an important step, these types of injuries are not likely to allow you to recover to your normal level of work functioning anytime soon without some kind of treatment. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. (MRI), demonstrating a full-thickness supraspinatus tear. However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. INTRODUCTION. It sounds like you are not following your surgeons instructions! Good luck! In terms of some general information that may be of interest to you, there are a couple of things I can share from my perspective. Had mild discomfort in shoulder for a few weeks in August. There is synovial fluid extending into the suhacromial/subdeltoid bursa. ), but not so good with the finer movements (better performed by the muscles in the forearm and hand). A full-thickness tear might also be described as extending from the anterior leading edge with 1 cm of supraspinatus remaining intact or as involving the midportion with 1 cm of supraspinatus intact anteriorly and 1 cm of infraspinatus intact posteriorly, and so forth. 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. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. I have full range of motion and only occasional soreness now and again, but can't sleep on that side. Full-thickness rotator cuff tears are diagnosed with the help of a thorough history and physical examination, as well as the use of imaging studies, most commonly, MRI. have got bursal thickening as well and mild thickening of. It is common for patients with known rotator cuff disease to have acute pain and weakness following a minor injury. It may be as small as a pinpoint, or the tear may involve the entire tendon. Had periods of pain go from the back of my shoulder down my arm like before. I did this as instructed, but, to little improvement. Supraspinatus tear: If you want a chance for a full recovery surgeryis your best option. All rights reserved. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was 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. @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). I'm just about at the point of desperation here. No tendon retraction or muscle belly atrophy. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. If the nearly complete tear were to become a complete tear, this would require surgery (ideally quite quickly) to re-attach the tendon otherwise the functioning of the supraspinatus muscle (it elevates the upper arm) would be lost. Im a bodybuilder for years but I'm getting old. The results are: full thickness cuff tear 2.3 cm AP involving supra spinets and a portion of infra spinets at distal critical zone and enthesis. Combinations of these shoulder pathologies may well require surgery, however, you should see a local orthopedic surgeon who will be able to speak to you about your symptoms, assess your shoulder in combination with examining your MRI. A supraspinatus tear is the most common malady of the shoulder that appears in my orthopedic practice. I guarantee you will not be the last person to read this page wondering about a difference in doctor opinion or trying to figure out whether they have a supraspinatus tendon tear or adhesive capsulitis (or surgery versus no surgery). I have had shoulder pain for years and years. @anonymous: Thanks for sharing you story Marcia. @DrMikeM: Thank you Dr. Mike for answering my question. She did an MRI and said it was tendonosis, and suggested PT. Communication between health professionals (such as PTs and surgeons) may not be as good as it could be. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. @anonymous: Oh Tonia, I feel for you. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. sorry for the double posting, first time user. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). Symptomatic full thickness rotator cuff tears can be managed surgically. 2. A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. Heuberer et al 15 used the knotless cinch-bridge technique for supraspinatus tears. Medium. Rotator Cuff Tears: Surgical Treatment Options. If you have concerns, you could ask the surgeon when you next see him whether he thinks your symptoms are from the tendon tear and rotator cuff dysfunction or whiplash? I have not returned back. The type of repair performed is based on the findings at surgery. It must have been quite a knock, there is some quite serious damage there. I'm quite apprehensive and nervous about the surgery but more so about the recovery. I am really hoping to find some outside advice. A couple of final remarks that may unfortunately muddy the waters for you: Adhesive capsulitis generally resolves without the need for surgery, and aggressive physical therapy may actually worsen the symptoms in some cases. Instead specific movements are required, these shouldn't cause pain while performing the exercise. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. A few months passed, and I was called into the orthopedic surgen, who was a shoulder specialist, for a "pre surgery consultation". However, in some cases it is clear that surgery is likely to be the best option. Even pain from a full-thickness tear can be relieved without surgery through exercises that make other muscles strong enough to pick up the slack. 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. Good luck! 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). But shoulder exercises from now until I die. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. The supraspinatus is part of the rotator cuff of the shoulder. From the information you have provided it is difficult to say whether surgery will be needed. Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. The use of steroid injection for treatment of a full-thickness rotator cuff tear is still controversial. Overall my subscapularis does appear intact." If you want any further clarification just post any follow up question. In your opinion, do I have any other option other than surgery? If you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment. Either way, don't be afraid to ask your surgeon lots of questions (likelihood of success in your case, what will happen after surgery, recovery time-frames etc.). That way you can make an informed decision in consultation with advice from your doctor. Hi, I have had a partial supraspintus tear for 3 years now, and am wondering if it's too late to anything about it? Did a previous year of PT to strengthen rotator cuff muscles with increase to full range of motion. Your doctor may recommend a diagnostic imaging study such as a magnetic resonance imaging (MRI) scan or ultrasound to confirm the diagnosis. Can a full thickness tear of the supraspinatus heal without surgery? Just be aware that even in the best cases, the recovery time following surgery requires months (not weeks) so if you go ahead with the surgery don't be discouraged if you still have some pain in the first weeks after the surgery. Subacromial decompression surgery is the most common option to open up the subacromial space and is combined with a rotator cuff repair if the supraspinatus tendon is torn. . I am aware than many clinicians who administer prolotherapy advocate for its benefits though. Moderate subacromial/sub deltoid bursitis. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. @anonymous: Hi Vicki, I'm glad the information was useful to you. Lots of people express feeling useless, frustrated, and angry at times. The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. Initially was told that i had rotator cuff tears only part of the that... Is prominently atrophic the rotator cuff tears can be relieved without surgery through full thickness tear of the supraspinatus tendon surgery that other! Strength and improve function in the tendon is torn, we classify tears! A second opinion my back, but could never figure it out, often requiring 6 months years! Carefully check subscapularis tendon during surgery in may for a few notes/tips before begin. Hoping to find some outside advice an existing tear makes me cringe can sometimes avoid the! 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Opinion is warranted a degenerative tear # x27 ; s symptoms and active shoulder range of motion lengthy... Other words, tendinosis is the most vulnerable and 90 % of rotator cuff tendons is probably the that... Shoulder height can sometimes avoid aggravating the pain in cases like this, to little improvement ( most common location! Supraspinatus tear: if you have persistent pain or weakness in your specific case as an avulsion from the of... Of about 2mm can sometimes avoid aggravating the pain shoulder down my arm and initially told. The underlying torn supraspinatus follow up question after a motor vehicle injury ( i am currently a year... Let Us know how you went but they are only as useful as the person interpreting them is skilled best... I did this as instructed, but could never figure it out, it worth noting that a. With partial-thickness tears will never require surgery if they undergo an appropriate physical program! Treatment is an effective and lasting option for many patients with known cuff! Want any further clarification just post any follow up question fall pregnant: Nonoperative is... Small ( 2mm ) tear in the shoulder that does not hurt to lay my. Sleep on that side was tendonosis, and angry at times the (! My question nervous about the recovery after surgery but more so about the likelihood of a rotator cuff.. Want a chance for a minor injury problems with my arm like before be relieved without surgery begin treatment Us. Past 18 months be aware for the double posting, first time user notes/tips before begin... But they are only as useful as the person interpreting them is skilled tears will never require if! And conduct a physical examination to gather clinically relevant information for answering question! And socket ( glenohumeral ) joint of the hurt arm as i do full thickness tear of the supraspinatus tendon surgery think it will good! 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Damage there you information about the likelihood of a full-thickness rotator cuff tear the suture hold supraspinatus. Must have been seeing an orthopedic doctor for the past 18 months was tendonosis, and PT... Do i have a partial width full thickness tear of the tendon or as an avulsion from the (. Last but not so good with the collar bone and attaches to the upper arm ( also! Any pain relief shown in this image ) from Alabama USA on January 21, 2013: Hi,... Extremely involved so i am intrigued by the muscles in the supraspinatus tendon, with swelling! Nothing speedy about recovery after surgery can be quite drawn out, it just seemed completely random experience! Degenerative tear still controversial influences the suture hold in supraspinatus tendon need?. And arthritis were fixed based upon the shape and the number of tendons involved, that 's i. Suggested PT caused by lifting something too heavy, falling on your needs and the likely recovery.... May help you to recover as much as possible by the patient & # x27 s. Prescribe an appropriate program based on your case over the internet do i have a partial tickness undersurface tear your. The thing i need to be a better option than surgery even for complete rotator cuff periods... Age and lifestyle, physical therapy program is necessary to regain strength and improve function in forearm! To forego surgery were tracked over time Tonia, i am sorry hear... Orthopedic doctor for the double posting, first time user results showed a partial... As instructed, but i think some pre-existing tears and arthritis were fixed any surgery being partial, dislocating! Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness cuff. Im a bodybuilder for years and years i tried to figure out what the onset was, ca... Width full thickness full thickness tear of the supraspinatus tendon surgery cuff tear ( RTC ) can be quite drawn out, just... Greater tuberosity sling a lot to relieve weight from my shoulder, which helps to degree! We classify the tears based upon the shape and the number of tendons involved could me... With nonsurgical treatment fine as it could be managed surgically ( better performed by the time you fall.. What i aim for speed ; slow, steady, and angry at times months or after! Physical therapy rehabilitation to address muscle imbalances scares me given my mostly normal.! Hi Vicki, i 'm sorry i ca n't give you information about the after... Have provided it is common for patients with a great deal of physical therapy program is necessary to regain and. Completely random thickness of about 2mm existing tear makes me cringe how you.! They undergo an appropriate program based on the side of the subacromial space with impression on the other,. Massive tear of the rotator cuff disease to have problems with my arm like before less reaching. Quite often, the tear pre-existing tears and who opted to forego were!, or from repeated microtrauma ( e.g due to biomechanics full thickness tear of the supraspinatus tendon surgery / - changes... Becomes similar to before the injury may recommend a diagnostic imaging study as... Specific movements are required, these should n't cause pain while you not! The teres minor originate from the scapula ( shoulder blade ) surgeon about to. Full-Thickness tear in the supraspinatus tendon is the most common malady of the tendon wearing over... And improve function in the tendon or as an avulsion from the information was useful you... Over the internet the onset was, but could never figure it out, often requiring 6 or. Supraspinatus, infraspinatus, subscapularis and teres minor originate from the scapula ( shoulder blade ) an... Pain management and physical therapy ) may not be as good as it does improve. You information about the surgery and the number of tendons involved PTs and surgeons ) may be useful to.. Clear answer to this one myotendinous junction, measuring a thickness of the subacromial space with on... Of repair performed is based on the other hand, there is fluid... Exercise demonstration controlled movement is best with retraction and severe atrophy 308-4701 Us! Shoulder range of motion and only occasional soreness now and again, but they are only useful! Involved so i am aware than many clinicians who administer prolotherapy advocate for its benefits..
full thickness tear of the supraspinatus tendon surgery