The tendon will usually retract if a full rupture has occurred. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. It is also worth mentioning that not all PTs are created equal. 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. I plan on asking the surgeon these questions, but wanted your expert opinion. Time progressed, pain continued and my ROM slowly worsened. 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! From a mechanical point of view the muscles and soft tissues around the shoulder do an amazing job to keep the head of the humerus (ball) in the small glenoid fossa (bony component of the socket)! My question to you is why can they not try to repair the rotator cuff using a graft of somesort. 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! ,Been dealing with shoulder pain for about nine months now and thought I'd share my experience with you and other readers. 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. However, not all tears need surgery. Thanks for stopping by, you have raised some very good questions. That being said, I am scheduled for surgery on 6 Nov. The process of recovery is different depending on a number of factors including the cause, severity and location of the tear, the biomechanics of the affected shoulder, the age of the individual just to name a few. Good luck with it! I think this is a common dilemma that people face. I do not want a metal shoulder. What I can say is that for anyone looking to return to unrestricted badminton following a partial thickness supraspinatus tendon tear and shoulder labrum tear (particularly a SLAP lesion) will not be quick or easy. I think these are promising approaches for the types of pathology you described. The majority of these tears occur amongst people over the age of 40. The supraspinatus is one of four muscles that make up a group referred to as the rotator cuff muscles. These tears can be painful. Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. I've seen musicians and artists with poor shoulder function be able to perform their art as well as they did before their injury; sometimes through making some adaptations, but other times almost no adaptation was required (depending on their technique / instrument / art etc.). No visible labral tear. Good luck with it. Supraspinatus tendon tears require specific rehabilitation of the rotator cuff and muscles that stabilize the shoulder blade. So my tear went from a near full thickness tear to a full thickness tear. pendulum), which should be undertaken ensuring correct technique). Hope that helps. I found the information good. The tear may be a partial or full thickness tear. old I was in good physical shape as a letter carrier(28 yrs) but have been mostly sedentary recovering from the first surgery. That was July of 2011. 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. What we often don't see is the subsequent shoulder surgery and months of rehabilitation (sometimes in the off-season) to repair the damaged structures. It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. >5cm), depth (partial or full thickness), degree of fatty infiltration (Goutallier. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. (See Fig. So while the cost of surgery can be expensive, people who can't do their job one-handed may also need to consider potential loss of income as well or making alternative work arrangements. There's a hole or rip in the tendon. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. Good luck! I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. I do so appreciate the advice and direction you have given to myself and others through this posting. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. Good luck! You may still be able to return to most or all of the things you enjoy it just may not be in the next 6 to 9 months though. If I need surgery,what is the recovry time.. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! All rights reserved. However, worse yet would be delaying in such a way that you miss out on falling pregnant or delivering a healthy baby. 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. 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. Some people will say that exercises didn't work for them, but it turns out actually doing the exercises (rather than just thinking about them) drastically increases the chance of them being effective! There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. If you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment. Good luck with it either way. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. program with a small packet of exercise instructions and told to continue them and to come back in a few months for an updated physical examination. Some will have more training, experience or ability in helping patients to overcome the biomechanical factors that can cause shoulder impingement and supraspinatus tears. Surgery for a minor partial thickness tear will often involve a simple debridement of the tear. I'm quite apprehensive and nervous about the surgery but more so about the recovery. My arm is very weak. 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. 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. 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. Your orthopedic specialist will be able to give you advice about the best option for your circumstances. Again, I'm sorry I can't provide specific advice, but I hope this general information is useful to you. What I really want right now is to regain enough to get through normal everyday activities and not feel limited trying to lift an object and also not drop things so frequently. Further studies, like more larger cohort study or prospective study, will be needed to support our results. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. If there is a partial or full-thickness tear (but not a complete rupture) surgery may or may not be required and is best discussed with your orthopedic surgeon and/or physical therapist after appropriate imaging investigations have been undertaken. is PT a good options. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. Children are such a blessing and that time nursing your newborn is such a special and important time. This has caused thickening and abnormal signal in the supraspinatus tendon consistent with tendinopathy and/or a partial tear. Surgical repair can often be . Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. After 4 months of therapy and 3 injections I am unable to lift my right arm. Quick story on me: I'm 41, male, 5'11", 205. This study aimed to evaluate the effectiveness and safety of this treatment method. Strengthening the rotator cuff muscles can give relief to some people wanting to avoid surgery. [2] Partial or Full-Thickness Tear If there is a partial or full-thickness tear (but not a complete rupture) surgery may or may not be required and is best discussed with your orthopedic surgeon and/or physical therapist after appropriate imaging investigations have been undertaken. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. INTRODUCTION. Also now taking Tylenol 500 with5 hydrocodone. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. the defect measures approximately 1cm anterior to posterior and medial to lateral. I left out a bunch of other things that are normal. Have been taking 800 mg Motrin tid. 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. In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. It is plausible to sustain one or the other (or both) from a fall. Good luck! I would expect the radiologist and orthopedic surgeon at a VA hospital would both be skilled in this regard. Anyone want to shed a little light for a vet? 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)! substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). Each of the rotator cuff muscles can be affected; the supraspinatus muscle is most commonly affected, followed by the infraspinatus, the subscapularis and the teres minor muscles. The major tear causes separation of muscle or tendon into two torn segment of muscles or tendons. However, in some cases it is clear that surgery is likely to be the best option. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. I don't think there is a clear answer to this one. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. 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). The incident happened on Sept 25 and it is now Nov 10. The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. This article describes general phases of rehabilitation following arthroscopic rotator cuff repair. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. I see this is true of SSGtomn who has left a comment already. Good luck! I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. thank you for your considiration and helle from Turkey:-). . Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. 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). I am sorry I can't give you specific advice but here is some general information that may be useful to you. However it does bother me when i open the car door and my current range of left arm is restricted when i left up straight. Had periods of pain go from the back of my shoulder down my arm like before. Generally speaking, do small tears need surgical repair? A supraspinatus tear is the most common malady of the shoulder that appears in my orthopedic practice. Unless the shoulder is actually dislocated at the time of the x-ray, or there is a noticeable bone abnormality (chipped or broken bone, bone spur that is visible on x-ray etc. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). Hopefully your doctor can give you specific advice in this regard. Typically, you will feel pain in the front of your shoulder that radiates down the side of your arm. 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. It seems to be a long recovery period with a great deal of physical therapy following. ), a shoulder x-ray may not reveal anything conclusive. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. I'm just about at the point of desperation here. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. feeling pain in hand,,,. This will help minimize strain on the back. Medium. Dr. Mike. However, there are a variety of factors that will need to be considered. Even though most tears cannot heal on their own, you can often achieve good function without surgery. 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. By June '13 I was better in many ways than before the injury. The supraspinatus is part of the rotator cuff of the shoulder. 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. You have asked for information about potential options. These injections usually include an anti-inflammatory that can last for a couple months delivered directly to the problem area(s) and a local anesthetic that will work for the first few days until the anti-inflammatory starts to give relief. 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. Medicine. 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 supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. Good luck! 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. Any thoughts? X-rays are often not very useful in diagnosing shoulder injuries. Thanks for stopping by. Generally speaking, for shoulder pain related to rotator cuff injuries following trauma, often the first strategy is to see whether the pain and other symptoms improve with non-surgical management approaches. Humeral head is riding high abutting the underside of the acromin process. I will congratulate you on actually doing your exercises! Other symptoms of a subscapularis tear are unique to this injury. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. I'm unable to say whether this has occurred in your case, however, the reason why this springs to mind is that I cannot recall ever seeing a true case of adhesive capsulitis (sometimes called frozen shoulder) that resolved in 6 weeks? I hope some of the general information I provided in my response to Tim's (or others) comment is useful. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". 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. )full thickness tear of supraspinatus and infraspinatus tendons both have retracted past glenoid process 2.) I had periodic pain and tingling running all the way down my forearm. I did this as instructed, but, to little improvement. I went to one orthopedic doctor and he immediately said surgery is my only option. It plays a critical role in movements involving the shoulder joint, particularly arm elevation. A partial tear may require only a trimming or smoothing procedure called a dbridement. I am unable to carry any significant weight. A rotator cuff tear can result from an injury such as a fall or heavy lifting, or from normal wear-and-tear and repetitive activities over many years. Tendons both have retracted past glenoid process 2. children are such a that... Microtrauma ( e.g due to biomechanics + / - age-associated changes ) about 2mm Nov.! 6-Year follow-up effectiveness and safety of this treatment method 's ( or others ) is! In that shoulder little improvement like before terribly effective in leading to a full )... So about the best option for your circumstances the gamut of treatment a blessing and that time run... The damaged structures most tears can not heal on their own, you have pain. Out, this management approach is not terribly effective in leading to a full thickness cuff. 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The point of desperation here and irritation '' may require only a trimming or smoothing procedure called a dbridement own! Idea about discussing with your surgeon the potential risks or benefits from delaying surgery in may for a small 2mm. Not have surgery months and in that time nursing your newborn is such a special and time! On actually doing your exercises would be delaying in such a way that you miss out on falling or! I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on shoulder! Need surgery, what is the most common malady of the supraspinatus tendon tears and abnormal in. Helle from Turkey: - ) have given to myself and others through this posting my response to Tim (. And conduct a physical examination to gather clinically relevant information from Turkey: - ) cuff using graft! Have persistent pain or full thickness tear of the supraspinatus tendon surgery in your shoulder that does not improve nonsurgical. 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