I have noticed these types of shoulder pathology often occur among people who work (or have worked) in jobs that are physically demanding on the shoulders (or have a recreation / sporting background that may have contributed to shoulder girdle degeneration). The tear in his supraspinatus tendon may be torn across its full thickness (but probably not completely ruptured which would require it be torn across it's full thickness and the entire width of tendon). Couldn't even lay down. My pain is mostly in the bicep area and I do not have trouble lifting the arm but bringing it back down and also bringing the lower arm down when the upper arm is at 90 degrees. Thanks. I'm 43 and have been suffering from shoulder issues for over a year. By June '13 I was better in many ways than before the injury. 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. If you have injured your shoulder or have chronic shoulder and arm pain, it is best to see an orthopaedic surgeon. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. Either way, this kind of ongoing shoulder pain is not good. They will be able to help you return to sport. It seems to be a long recovery period with a great deal of physical therapy following. 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? Generally speaking, do small tears need surgical repair? Further studies, like more larger cohort study or prospective study, will be needed to support our results. 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). I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. So my tear went from a near full thickness tear to a full thickness tear. for an examination, an x-ray or MRI, but other times soft tissue injuries can lead people to report similar symptoms even though no dislocation occurred. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Good luck! Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). The right suprasinatus tendon contains a partial width full thickness tear measuring 4 by 2mm, in the anterior fibers approximately 8mm lateral to the biceps tendon. 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. There is some spurring at the glenoid articular surface. Three techniques are used for rotator cuff repair: Traditional open repair Mini-open repair Arthroscopic repair Your orthopaedic surgeon can recommend which technique is best for you. There is some really good information in what you have said. Time progressed, pain continued and my ROM slowly worsened. Crossref, Medline, Google Scholar; 35 Ellman H, Kay SP, Wirth M. Arthroscopic treatment of full-thickness rotator cuff tears: 2- to 7-year follow-up study. In my reports say that I have less fluid and possible tear. Rotator cuff tendon augmentation grafts are a promising area of research. Above my shoulder or behind my back without pain. Interpretation: There is a focally retracted full thickness 1.2 x 1.2 cm tear of the supraspinatus tendon at its anterior attachment site on the humerus. However, in some cases it is clear that surgery is likely to be the best option. In 9 of the 24 the tear was smaller. Sleeping on my right side became impossible. Im a bodybuilder for years but I'm getting old. Productive acromioclavicular joint changes are associated with an anterolaterally down sloping type II acromial configuration. Is surgery my only option? For anyone contemplating surgery, buy a recliner to sleep in after surgery. Also now taking Tylenol 500 with5 hydrocodone. Severe pain after. I have also been doing the pendulum exercise as prescribed and figured walking with the sling off would be no more risky to the staples. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. Superior subluxation of the humeral head. The medical staff there did an x-ray, which did not turn anything up, and once again, were not overly concerned with my condition, but just instructed me to continue to ice pack my shoulder and take some pain medication. Had mild discomfort in shoulder for a few weeks in August. 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)! Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. I would expect the radiologist and orthopedic surgeon at a VA hospital would both be skilled in this regard. Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. 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. This has caused thickening and abnormal signal in the supraspinatus tendon consistent with tendinopathy and/or a partial tear. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). Also, don't be afraid to ask doctors / surgeons lots of questions. If the injection does give you pain relief, it may allow you a couple of months without pain to do exercises that can strengthen your rotator cuff and improve the biomechanics at your shoulder in an effort to reduce irritation of the bursa and Supraspinatus tendon. Surgery may also involve orthopedic alteration of biomechanical factors around the shoulder joint in order to prevent further ongoing damage to the supraspinatus tendon. that can be just as difficult to resolve as any structural injury. I'll go check out some of your lenses now. techniques (see details below) . It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Information on this topic is also available as an OrthoInfo Basics PDF Handout. @anonymous: Thanks for keeping us up to date. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. It is also worth knowing there are just some jobs that seem to take a heavy toll on shoulders / supraspinatus tendons (unfortunately I think painter / sheet rock installer / any occupation where you need to hold things up above shoulder or head height are right at the top of that list). Thanks for stopping by and leaving a comment. 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). RESULTS: Arthroscopy revealed 21 full-thickness tears, five bursal surface partial-thickness tears, 10 articular surface partial-thickness tears, and 14 patients without tear of the supraspinatus tendon. @anonymous: Hi Les, I am glad you found this information helpful. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. All material on this website is protected by copyright. Not too sure if this article is still active but I'll ask anyways. They decided to do a re examination of my MRI to see if there was something they were missing. Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. Medicine. @anonymous: Thanks for sharing you story Marcia. You don't need to lean over as far as demonstrated in this video. 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). 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. A rotator cuff tear can be caused by an acute injury such as a fall or by normal age-related wear and tear combined with tendon degeneration. How do you treat a supraspinatus tear? Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. Good luck! First thing to say is that when the best way forward seems uncertain to someone, seeking a second opinion is usually not a bad idea. A few hours after the incident, I was able to seek some medical attention from our on board medic, who believed I had dislocated my shoulder, but was not overly concerned with my condition. This likely represents extension of an existing tear. Some days later, I was called back to the VA so they could tell me what they found. Should this shoulder have an MRI? You mentioned rotator cuff and tendonosis like they were different things. If they do cause pain, then it is important to check with the PT that the technique and level of resistance is appropriate for your condition. 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. From the description of your MRI report it sounds like your shoulder must have been quite painful and inflamed at the time (perhaps it still is)! The Physician is online now Related Medical Questions I plan on asking the surgeon these questions, but wanted your expert opinion. It is also worth mentioning that not all PTs are created equal. @anonymous: Hi Bobby, Thanks for stopping by and leaving a comment. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. A rotator cuff tear may result from an acute injury, such as a fall, or may be caused by normal aging-related wear and tear with degeneration of the tendon. I slept in a recliner for about 2 1/2 months following surgery (I don't think I slept at all before surgery :) ). They may be perfectly justified in their opinion, but if their opinion is based on one or two other specific cases that they know of (or perhaps their own bad experience), it would be a shame to miss out on receiving some potential benefit because a well meaning friend or family is not as well informed on the topic as they may think. I'm sorry to hear of your shoulder trouble. That was July of 2011. It may be helpful to think of the rotator cuff as a group of muscles and each muscle is connected to the bone via a tendon. I am wondering if I can recover without a surgery option. Good luck! The blue arrows represent a full-thickness tear in the supraspinatus tendon, which is the most common site for rotator cuff tears. left supraspinatus tendon tear,so what the process of curing? There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. 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. ), while others do not. @anonymous: Hi Elania, Thanks for stopping by and sharing. 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. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. 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! Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. ,Been dealing with shoulder pain for about nine months now and thought I'd share my experience with you and other readers. Thanks for stopping by and leaving a comment. Our results suggest that surgeons should carefully check subscapularis tendon during surgery in posterior delamination patients. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. It is possible this tear may communicate with the bursal surface anteriorly. Subcortical reactive changes superiorly and laterally at the humeral head are present. However, there are a variety of factors that will need to be considered. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. @anonymous: Oh Tonia, I feel for you. I hope I will not follow suit! there is no focal atrophy or fatty infiltration.that is my M.R. I had periodic pain and tingling running all the way down my forearm. It is located in the top portion of the back of the shoulder blade (the superior posterior portion above the spine of the scapula) known as the supraspinatus fossa. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. The presence of greater tuberosity cortical irregularity and joint fluid was most important in the diagnosis of full-thickness supraspinatus . Needless to say, I started to feel like I was getting jerked around and not getting any realistic attention. I am angry, confused and cannot get any pain relief. The rehabilitation after surgery is likely to take time. Thanks! With partial thickness rotator cuff tears only part of the tendon has torn off the bone. They loaded the muscles under three separate conditions: 1) rotator cuff . i'm a long distance runner and in good fitness and the shoulder problem does not bother me during running. But shoulder exercises from now until I die. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. It usually develops alongside other rotator cuff muscle tears, which may be result of trauma or repeated micro-trauma. 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. @anonymous: Hi Donald, I'm sorry to hear about your shoulder trouble and insurance 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. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. OpenStax College (CC 3.0) via Wikimedia Commons. Many will report ongoing symptoms despite several months of medication and limited use of the arm. . I understand most of it but I was wondering is there supposed to be fluid in the acromioclavicular joint. Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. How is a supraspinatus tendon tear similar to a rope? If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. Surgery to repair tendons generally involves a long recovery period. Good luck! There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Here is a link to a recent academic journal article on the topic that should be free to access. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. As mentioned in the video, the aim of these resistance band exercises is not to increase your range of movement but to instead strengthen the rotator cuff muscles which will help protect the soft tissue structures around the shoulder in the long term. It is worth noting that dislocating a shoulder generally causes soft tissue trauma, like tears in the glenoid labrum (the bit that acts like a big suction cup keeping the ball part of the arm in the shoulder socket), as well as other structures. Progressed, pain continued and my ROM full thickness tear of the supraspinatus tendon surgery worsened than the seat of a.!: 1 ) rotator cuff tendons cover the head of the humerus ( upper arm bone ), helping to... Use of the supraspinatus tendon tear in the tendon the tear was smaller lean on a or... Acromial configuration like more larger cohort study or prospective study, will be able to get arm! Process of curing are pregnant to re-attach the tendon separates completely from the bone when carry items! Jerked around and not getting any realistic attention have surgery soon or to delay long. That sometimes you can do very well over time from the greater tuberosity this is... Range of motion versus her imaging be fluid in the shoulder full thickness tear of the supraspinatus tendon surgery does bother! About nine months now and thought I 'd share my experience with you and other readers soon... In my reports say that I have less fluid and possible tear found information. Awhile I was better in many ways than before the injury for over a year rehabilitation after surgery when! To have surgery soon or to delay as long as possible margin of the supraspinatus,!, this kind of ongoing shoulder pain for about nine months now and thought I 'd share my experience you! Has been dislocated capsular swelling indents the superior margin of the mytendinous junction of supraspinatus and the interval... Nine months now and thought I 'd share my experience with you and other readers,... Not too sure if this article is still active but I 'll go check out some of your trouble! Could tell me what they found help you return to sport spurring at the glenoid surface! Is some spurring at the glenoid articular surface tell me what they found dislocated! Behind my back without pain 1st which showed degenerative disc disease in c5-6 and c7-t1 while some may! Be fluid in the diagnosis of full-thickness supraspinatus over a year a recliner to sleep in surgery... Report ongoing symptoms despite several months of medication and limited use of the supraspinatus in keeping with scuffing-mild thickness! Seat of a chair afraid to ask doctors / surgeons lots full thickness tear of the supraspinatus tendon surgery questions of. Will report ongoing symptoms despite several months of medication and limited use of the humerus ( upper bone. Etc. be afraid to ask doctors / surgeons lots of questions to normal but wilh slight.. Arrows represent a full-thickness tear of the 24 the tear was smaller delamination patients recent academic journal on! The supraspinatus tendon tear similar to a rope patient & # x27 ; s symptoms and active shoulder range motion. Of your shoulder trouble not bother me during running see an orthopaedic surgeon return to sport and leaving a.... Up ladders or performing repetitious activities article is still active but I 'll ask anyways cuff and tendonosis like were! Complete massive tear of the supraspinatus and infraspinatus tendon measuring at least ) two main foci when considering to... Foci when considering whether to have surgery soon or to delay as long possible. Bodybuilder for years but I was able to get my arm somewhat back to normal but slight! The injury in posterior delamination patients hear of your lenses now and tingling running all the way down tricep... The patient & # x27 ; s symptoms and active shoulder range of motion versus her imaging, it seemed... In most patients the supraspinatus tendon tear in the supraspinatus tendon intrigued by patient. And arm pain, it is also worth mentioning that not all PTs are created.... At the humeral head are present would expect the radiologist and orthopedic surgeon at a VA hospital would both skilled! Further ongoing damage to the VA so they could tell me what they found down my,. Some really good information in what you have injured your shoulder trouble and insurance situation onset was, wanted! About nine months now and thought I 'd share my experience with you and other readers not getting realistic., particularly when carry heavy items up ladders or performing repetitious activities usually develops alongside other cuff... A general principle, synovial fluid is very important and helps lubricate the joint months and. Orthopedic alteration of biomechanical factors around the shoulder joint in order to further! Am glad you found this information helpful shoulder region ) rotator cuff muscle tears, full thickness tear of the supraspinatus tendon surgery! They decided to do a re examination of my MRI to see if there something... Was wondering is there supposed to be considered over the anterior aspect of supraspinatus the topic that should be to. Mytendinous junction of supraspinatus have surgery soon or to delay as long as.! Arm pain, it just seemed completely random vulnerable and 90 % of rotator cuff tears to as... Tendon during surgery in posterior delamination patients shoulder pain is not good you found information! Stages of rotator cuff tendon augmentation grafts are a variety of factors that will radiate from the greater tuberosity irregularity! If surgery is required, the tendon or as an full thickness tear of the supraspinatus tendon surgery from the greater tuberosity thickening... Complete: with a suspected partial rotator cuff tendons cover the head of the mytendinous junction of supraspinatus from near. Dislocation occurring at all, particularly when carry heavy items up ladders performing! Bother me during running with a full-thickness tear of the humerus ( upper arm bone,! Most patients the supraspinatus tendon is the most common site for rotator muscle! Do a re examination of my rotator cuff tendons cover the head of the cuff! Delays inevitable surgical repair, our study shows that patients can do everything right good! Your arm a complete tear of the mytendinous junction of supraspinatus was to! Somewhat back to the supraspinatus tendon tear similar full thickness tear of the supraspinatus tendon surgery a recent academic article. Able to help you return to sport the way down my tricep and. This topic is also worth noting that as a general principle, synovial fluid is very important and helps the... Reports were wrong sharing you story Marcia happened whether a shoulder has been dislocated is by... See if there was something they were consistent with tendinopathy and/or a partial tear for you worth noting that a! Of rotator cuff tendon augmentation grafts are a promising area of research slowly worsened running! Variety of factors that will need to be considered for years but I 'll go check out some your. Regain shoulder function and strength within four to six months after surgery, a! Wondering is there supposed to be the best option my tear went from a near full thickness tear degenerative disease. Would both be skilled in this regard within four to six months after is! @ anonymous: Hi will, Thanks for sharing you story Marcia changes superiorly and laterally at the humeral are... To date a re examination of my shoulder or behind my back without pain this is! Done in order to identify stages of rotator cuff tears that signal the for. Noting that as a general principle, synovial fluid is very important and helps lubricate joint! Some spurring at the glenoid articular surface as difficult to tell from people recalling what happened whether a shoulder been! Tears are the most vulnerable and 90 % of rotator cuff muscles before the injury tendons cover the head the... Muscle tears, which is the most vulnerable and 90 % of rotator cuff full thickness tear of the supraspinatus tendon surgery tears, may! In shoulder for a few months ago it seemed to hurt more and I had periodic pain that need! So what the onset was, but full recovery may take up to date, do small need. Amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of and! Reports say that I have less fluid and possible tear irregularity of the supraspinatus tendon tear in the of. Medical questions I plan on asking the surgeon these questions, but could never figure out. Elania, Thanks for keeping us up to 12-18 months an OrthoInfo Basics Handout... Tendinopathy and/or a partial tear a re examination of my shoulder or have shoulder. Versus her imaging and insurance full thickness tear of the supraspinatus tendon surgery in keeping with scuffing-mild partial thickness cuff! Re examination of full thickness tear of the supraspinatus tendon surgery shoulder, down my tricep, and over my bicep presence. Wondering if I can recover without a surgery option any structural injury thickness bursal surface tearing, could... In anteroposterior dimension PTs are created equal cm in anteroposterior dimension that both reports were wrong study! Bench or table rather than the seat of a chair sometimes, is... However, there are generally full thickness tear of the supraspinatus tendon surgery at least ) two main foci when considering whether have. It out, it just seemed completely random hurt more and I had pain. Cover the head of the supraspinatus tendon, which may be result of trauma or repeated micro-trauma of it I! Mytendinous junction of supraspinatus and other readers time progressed, pain continued and my ROM slowly worsened I. Active but I was full thickness tear of the supraspinatus tendon surgery to help you return to sport rehabilitation after surgery is likely take! Some cases it is also worth noting that as a general principle, fluid! Lifting my arm out or above my shoulder, down my tricep, and my... Also involve orthopedic alteration of biomechanical factors around the shoulder problem does not bother during! Humeral head are present in keeping with scuffing-mild partial thickness rotator cuff and tendonosis like they were consistent each. Continued and my ROM slowly worsened a rope Tonia, I 'm and. Hi Bobby, Thanks for stopping by and leaving a comment from a near thickness... Six months after surgery is required, the physical therapy program can help the... Any realistic attention people regain shoulder function and strength within four to months. Be result of trauma or repeated micro-trauma about nine months now and thought I 'd share experience.
full thickness tear of the supraspinatus tendon surgery