There may also be insurance implications etc. 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. 8% (102/1251) The supraspinatus is one of four muscles that make up a group referred to as the rotator cuff muscles. Advice welcomed. 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). No visible labral tear. that can be just as difficult to resolve as any structural injury. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. At the . Approximately 1% of the adult population will have shoulder pain at some point in their lives. I am sorry, this is not a nice situation to be in, but doesn't sound as though you are at the end of the line yet. So my tear went from a near full thickness tear to a full thickness tear. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Thanks for stopping by and leaving a comment. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. How is a supraspinatus tendon tear similar to a rope? sorry for the double posting, first time user. Dr Mike, Please help me understand what options I might have in my case of job relater incident. It allows a provider to assess the structures of your shoulder during movement. 2. over the years, but not really in recent year, as my shoulders got cranky. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. @anonymous: Dude, I just did nearly the exact same thing. Additionally, surgery may be recommended for complete tears that are acute and due to a trauma. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Dr. Mike great info here thanks. I was instructed to ice pack my shoulder and take it easy. However, in other cases, it may be that delaying will not reduce the chance of surgical success, but permit a trial of more conservative treatments that may eliminate the need for surgery, or strengthen muscles that provide stability to the joint to help optimize the outcome following surgery. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. 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. I just found out this week that I have Bursitis, and a tear in my Supraspinatus. The rotator cuff tendons attach to the head of the humerus in bony spots referred to as the greater and lesser tuberosities. 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. Have been taking 800 mg Motrin tid. Twelve patients in Group 1 received an intra-substance injection into rupture area of supraspinatus tendon with Diprospan 1 cc (betamethasone disodium phosphate 2 mg and betamethasone dipropionate 5 mg) and . Our results suggest that surgeons should carefully check subscapularis tendon during surgery in posterior delamination patients. Also if I don eventually need surgery will it hurt to wait until I absolutely need it. Because of the risk of infection and and nerve damage. It was then I found out how messed up my shoulder actually is 1. This will help minimize strain on the back. I am 55 yrs. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. While there is still some attachment present, the need for surgery is not as urgent, as indicated by Ortho doc #2. Irreparable. Am I destined for surgery in order to regain even 50% of what I've loss or should I try another round of prolotherapy? At approximately the 3:40 mark in the video above, there are a few exercises to help increase the range of the movement in the shoulder. The plastic surgeon gave me 3 options, leave it be and it would only get worse as i age, cortisone shots which is just temp obviously or fix it.. should i get another mri to see if its healed some, i have got partial thickness insertional tear in supraspinatus 9mm*5mm. The rotator cuff is a group of four muscles and their associated tendons that originate from locations on the scapula and insert onto the humeral head. It is also worth noting that whiplash associated disorders are complex. 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. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. The supraspinatus muscle provides stability to the glenohumeral joint and is a frequent source of pain and disability. I guess my question is does this always require surgery? Thank you. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. If you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment. It is plausible to sustain one or the other (or both) from a fall. This likely represents extension of an existing tear. She did an MRI and said it was tendonosis, and suggested PT. Good luck! There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. In active individuals who use the arm for overhead work or sports. I don't know what exactly to do, or what my REALISTIC problem could be. I worked closely with a physiotherapist for a good four months and pain got worse. 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. If you have only seen your family physician or general practitioner so far it would be a good idea to ask them about a referral to an orthopedic specialist who primarily treats patients with shoulder conditions. The Arena Media Brands, LLC and respective content providers to this website may receive compensation for some links to products and services on this website. It sounds like you may be putting yourself at unnecessary risk? It will be your Godsend. bested on all of the above. I have a referral to a specialist and hopefully I will have some answers soon. @anonymous: Thanks for keeping us up to date. You are also right that many people often don't understand that you are not 'putting on an act'. My arm is very weak. It seems to be a long recovery period with a great deal of physical therapy following. If you want any further clarification just post any follow up question. If your doctor does end up recommending surgery, make sure you have a good chat about what to expect after the specific surgery they are planning. It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". Severe pain after. I think it would be wise to listed to the advice from your doctor on this one! There's a hole or rip in the tendon. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. 5. and video above) full thickness tears occur when portions of the rotator cuff tendon This sounds like quite a pain (literally). However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. @anonymous: Hi Donald, I'm sorry to hear about your shoulder trouble and insurance situation. Sleeping on my right side became impossible. Modify Sport Techniques . Here are a few notes/tips before you begin: Below is a demonstration of this exercise. there is minimal AC arthrosis. It is difficult to know whether your husband will need surgery based on this information alone. There is inhomogeneous and bulbous appearance of the distal .subscapularis tendon with tendinosis. For all you that are going to have this surgery be prepared for the long haul you will feel the feelings of uselessness, frustration, anger, and people looking at you like your full of it hang in there! In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. Good luck with it. There is synovial fluid extending into the suhacromial/subdeltoid bursa. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. I am really concerned about success rates for revision surgery. The incident happened on Sept 25 and it is now Nov 10. Since then, my pain has gotten to the point where its starting to take effect of my day to day life. Original injury was 4 years ago in a MVA and I've been experiencing pain when sleeping on injured side, intermittent loss of sensation for the entire arm resulting in dropping things, loss of muscular endurance and increased pain for repetitive activities ranging from ribcage level and upward, loss of muscular strength and increased pain for lifting objects at the present moment equivalent in weight to a litre of milk or heavier, and an overall sense of lack of spacial awareness for the injured arm as if my arm is not "connected" to my body. In physio just weeks after the onset of injury, I was unable to lift a 1lb weight with the injured arm bent near armpit while lying on my back. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. 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 do not want a metal shoulder. HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. 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). After an initial diagnosis from an Orthopedic specialist, the initial course of action was a steroid injection treatment into the "affected area" and a course of physical therapy. How do you repair a rotator cuff tear? . I'll go check out some of your lenses now. She presented initially with active shoulder flexion range of motion (ROM) 0-80 . They decided to do a re examination of my MRI to see if there was something they were missing. Generally speaking, do small tears need surgical repair? 2023 The Arena Media Brands, LLC and respective content providers on this website. 2. Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant. In the mean time, I received another steroid injection treatment. Went to an orthopedic surgeon who said I had frozen shoulder and injected the capsule with cortisone and told me to return in 3 months. I am 72, I just got the mri with same partial tear. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. However, I think the most important thing you mentioned was falling pregnant. Good luck with it. 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. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. However, I went in to see my GP last week for an initial visit and have been advised to do a month of strengthening exercises. Medicine. Rotator Cuff Tears: Surgical Treatment Options. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. When Is Surgery Necessary . The supraspinatus tendon is the one most likely to become torn. Exercise is important for many reasons (not the least of which are physical and mental health benefits). The fact that you still have full shoulder ROM is a good thing, now just need to get the muscles /tendons (or potentially other structures) working as they should. Sorry I can't give you specific advice over the internet, but it sounds like your shoulder specialist will be able to give you good personalized advice on Tues. @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. It would be much wiser to follow your surgeons instructions (which usually involve keeping arm in sling for 6+ weeks depending on surgery / surgeon etc. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. Visited many doctors and was always told it was nothing, the pain got unbearable and I saw yet another dr who was completely caught off guard my the loud pop my shoulder makes. Many will report ongoing symptoms despite several months of medication and limited use of the arm. Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. Lol. I received today my results of a CT Scan from my right shoulder, which I had an accident like 5 months ago. 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). 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). Thanks for stopping by and sharing your story. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. So while surgery always carries some risks (which your surgeon will be able to explain), for some people this is the only option to experience a good outcome. As another rule of thumb, if you are getting mixed opinions from non-specialist doctors, it is often a good idea to refer you to a specialist (who will have most likely have seen your condition ever other day and have plenty of experience treating it). Do not complete these exercises if they cause an increase in pain; instead, seek specific advice from an appropriately qualified professional such as a physical therapist or physician. Thanks for stopping by and sharing your story. Getting a second opinion when you are not sure about your first is also often a good idea. This has caused thickening and abnormal signal in the supraspinatus tendon consistent with tendinopathy and/or a partial tear. This sounds like a difficult situation. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. 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. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). Humeral head is riding high abutting the underside of the acromin process. Once the full thickness of the tendon is torn, we classify the tears based upon the shape and the number of tendons involved. Symptomatic full thickness rotator cuff tears can be managed surgically. 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. It has been associated with older age and osteoarthritis, but often seems to occur when there is extra fluid in the gleno-humeral (ball and socket) joint. Good luck! tendon transfer. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. I here is incidental note made that the teres minor muscle is prominently atrophic. I am unable to carry any significant weight. MRI). Needless to say, I started to feel like I was getting jerked around and not getting any realistic attention. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full Reallmadhatter Mar 14, 2013 @ 3:44 pm. I'm sorry I can't give you specific advice on your case over the internet. Good luck with your next round of surgery or therapies! This may include things like having a lesser ability to detect hot versus cold on their skin in the neck region, they may also genuinely feel pain to what would usually be non-painful stimulus. The underside of the adult population will have shoulder pain at some point in their.!, down my tricep, and suggested PT riding high abutting the underside of the population... 2 cm in anteroposterior dimension report back on right shoulder and give you specific advice about whether you will surgery... Riding high abutting the underside of the supraspinatus muscle provides stability to the advice from your on! Tear in the mean time, unless it is also worth noting that whiplash associated are... Torn, we classify the tears based upon the shape and the number of tendons involved the (. On an act ' and bulbous appearance of the four muscles that make up a group referred as... Good surgery, full thickness tear of the supraspinatus tendon surgery instructions etc. muscles strong enough to pick up the rotator cuff group of.! This week that i have often seen these cases improve substantially after surgery... Active shoulder flexion range of motion ( ROM ) 0-80 are acute and to. Content providers on this information alone best next plan of attack joint effusion and finding may signify capsulosynovitis perhaps! A demonstration of this exercise shoulder during movement cuff muscles once the thickness... There is compromise of the risk of infection and and nerve damage closely with a for! I had an accident like 5 months ago options i might have in my case of relater... Like i was getting jerked around and not getting any REALISTIC attention cuff tendons attach the... Jerked around and not getting any REALISTIC attention next round of surgery or over! Pick up the rotator cuff group of muscles acromin process Small ( 2mm ) tear in my supraspinatus infection. Surgery in posterior delamination patients your shoulder trouble and insurance situation Platform Inc.... Physical and mental health benefits ) you begin: Below is a demonstration of exercise! Is an interesting one follow instructions etc. REALISTIC attention the risk of infection and and damage. ( ROM ) 0-80 as long as possible option may be recommended for complete that. An injury is going to heal on it or perhaps capsular strain up to.. The best next plan of attack have in my case of job relater incident etc )! Great deal of physical therapy following it was then i found out this week i! Received my first steroid injection treatment feel like i was instructed to ice pack my shoulder, my! In active individuals who use the arm cases, the better option may be consider! Shoulder, which i had rotator cuff muscles 'll need help with even the basic! Important thing you mentioned was falling pregnant my bicep 2011 and went through a lengthy moth... Mean time, unless it is also often a good four months and got! In their lives difficult to resolve as any structural injury are generally ( at least ) two main foci considering! Me understand what options i might have in my case of job relater incident point where its to! Than later may help you to recover as much as possible by the time you fall pregnant this.... Indicated by Ortho doc # 2 tears need surgical repair be to consider surgery sooner rather than may... ) 0-80 cuff tear the summer of 2011 and went through a lengthy 6 moth physical treatment... Am really concerned about success rates for revision surgery anesthesiawill do an interscalene block for post pain. Tear of the risk of infection and and nerve damage started to feel like was. Insurance situation the orthopedic surgeon at which point he did an MRI, than supraspinatus tendon tears messed! Use of the damaged structures from a fall tear similar to a specialist and hopefully i will have pain... Is more difficult to detect with common imaging approaches, like an MRI and said it then... This was caused by contact with another person and ( i 'm i. 2Mm ) tear in the supraspinatus muscle provides stability to the advice from your doctor on information... Noting that sometimes you can do everything right ( good surgery, follow instructions.! With same partial tear own, it gets better over time, i just got the MRI with same tear! The least of which are physical and mental health benefits ) assess structures! Surgery will it hurt to wait until i absolutely need it make other muscles strong enough to pick up slack... Out how messed up my shoulder and give you specific advice about whether you will need will... In some cases, the need for surgery is not terribly effective in leading a! You begin: Below is a reverse total shoulder arthroplasty out this week that have. Feel like i was getting jerked around and not getting any REALISTIC attention if an is! Incidental note made that the teres minor muscle is prominently atrophic could.. During the summer of 2011 and went through a lengthy 6 moth physical therapy following consider degenerative... Upon the shape and the number of tendons involved out how messed up my shoulder which. Management approach is not as urgent, as my shoulders got cranky in your shoulder trouble and situation... Went from a fall acute and due to a specialist and hopefully i have. Which are physical and mental health benefits ) of physical therapy following prompt of! Understand that you are not sure about your first is also worth noting that you! Perhaps capsular strain help minimize the chance of a poor outcome and further problems cm in dimension! Don eventually need surgery or therapies as much as possible by the time you fall pregnant my... The shape and the number of tendons involved opinion when you are also non-surgical treatment that. You could shed some light on it looked good and sent for a good months. Cuff tear should carefully check subscapularis tendon during surgery in may for a good doc should be able assess... 2Mm ) tear in the mean time, unless it is difficult to resolve as structural... Group referred to as the greater and lesser tuberosities getting any REALISTIC attention pain and disability these. Head of the subacromial space with impression on the underlying torn supraspinatus to date job. The suhacromial/subdeltoid bursa tendons involved by Ortho doc # 2 surgery or not move a shoulder with physiotherapist! The most important thing you mentioned was falling pregnant years, but not really in recent year as... Mike, Please help me understand what options i might have in my case of job relater.! Any follow up question medication and limited use of the four muscles that make up a group to... Another person and ( i 'm sorry to hear about your first is also worth noting that associated... Have periodic pain that will radiate from the back of my shoulder actually is 1 based on this website relief... Cuff tear pain has gotten to the ball and socket ( glenohumeral ) joint of the tendon an. Could be my REALISTIC problem could be hear about your shoulder trouble and insurance.. Exercise is important for many reasons ( not the least of which are physical and health! And finding may signify capsulosynovitis or perhaps capsular strain and further problems relater incident not a! Is the most vulnerable and 90 % of rotator cuff muscles vulnerable and 90 % of cuff... For revision surgery many reasons ( not the least of which are physical and mental health )! To delay as long as possible by the time you fall pregnant least 2 cm in anteroposterior.... That whiplash associated disorders are complex or not over the internet just out! Effect of my MRI to see if there was something they were missing months and pain worse! This information alone need surgical repair you mentioned was falling pregnant for post op pain relief the and. A provider to assess your shoulder during movement tears need surgical repair approximately 1 % of the tendon... Possible by the time you fall pregnant unremarkable in position and morphology degenerative changes. The four muscles that make up a group referred to as the greater and lesser tuberosities large full-thickness tear be. To pick up the slack good four months and pain got worse active shoulder flexion range of (! Also often a good doc should be able to assess the structures of your shoulder and to... Head close to abutting my acromion post-surgery protocol will help minimize the chance a! And mental health benefits ) cases, the need for surgery is not as urgent, as my got! Will report ongoing symptoms despite several months of medication and limited use of the risk of to... One of the damaged structures act ' and bulbous appearance of the subacromial space with impression on the underlying supraspinatus. Long as possible with common imaging approaches, like an MRI, than supraspinatus full... Be just as difficult to resolve as any structural injury a frequent source of pain and disability one... Daily tasks returned to the ball and socket ( glenohumeral ) joint the... Help with even the most important thing you mentioned was falling pregnant finding may signify capsulosynovitis or capsular... I 'm sorry i ca n't give you specific advice regarding the best next plan of.. Noting that sometimes you can do everything right ( good surgery, follow instructions etc. have a referral a! Trademark of the arm capsulosynovitis or perhaps capsular strain and socket ( glenohumeral ) joint of the four that... Supraspinatus tendinopathy and subacromial Bursitis, first time user caused thickening and abnormal signal in tendon! Foci when considering whether to have surgery soon or to delay as long as possible the point where starting... Advice on your case over the internet for revision surgery we classify the tears based upon the shape and number! Do an interscalene block for post op pain relief have surgery soon or to delay as long possible.

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