I hope your shoulder has now recovered! Thanks for stopping by and sharing your story. I will surf again! Hopefully your doctor can give you specific advice in this regard. I am angry, confused and cannot get any pain relief. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. its been three months with some pt but no noticeable improvement. I agree that shoulder pain for years, that has not resolved is definitely a good indicator that seeing a doctor is a good idea! Our hypothesis was that arthroscopic repair of full-thickness supraspinatus tears achieves a rate of complete tendon healing equivalent to those reported in the literature with open or mini-open techniques. ; 3; Where can I found documentation in the web for the rehabilitation? Front view (left) and overhead view (right) of the tendons that form the rotator cuff. Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. If I need surgery,what is the recovry time.. Rotator cuff tendon augmentation grafts are a promising area of research. Good luck! In some cases, surgery to repair the tendon is also required. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. 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. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? @anonymous: Dude, I just did nearly the exact same thing. While I cannot comment on your specific case, I am not sure ART (Active Release Techniques) then PRP (Platelet-Rich Plasma) or Prolotherapy is the approach that is best supported by contemporary scientific evidence for the treatment of supraspinatus tendon tears (or any other rotator cuff tear tendon tear). I have lost about 45+% of my ROM in my right arm. 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. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. A full-thickness tear, which usually means the tendon is torn from its insertion on the humerus (the most common injury), is repaired directly to bone. Advice welcomed. People tend to expect recovery after surgery will take a few weeks. There is synovial fluid extending into the suhacromial/subdeltoid bursa. Unfortunately I can't give you specific advice over the internet, without conducting a physical examination etc. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. I am unable to carry any significant weight. However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great. He kind of scared me regarding the recovery for this. Call Us: (239) 308-4701 Email Us Give us a Call! Otherwise you will have signficantly reduced function (plus ongiong pain) in that 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 am sorry I can't provide you specific advice over the internet. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. 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. 8% (102/1251) What does he mean by my tendon is failing? For anyone contemplating surgery, buy a recliner to sleep in after surgery. Thanks for stopping by and sharing your story. In addition to arm elevation, the supraspinatus muscle is critical in pulling the head of the humerus (the ball part of the ball and socket joint) into the glenoid (socket). 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. 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). The primary purpose of these muscles is to prevent the head of the humerus, or upper arm bone, from driving into the shoulder joint as you lift your arm away from your body or overhead. I can't comment on the nature of care you have received, but I can say that you are not alone in this type of experience! I was an elite athlete most of my life and have accepted that I will no longer be able to return to my sport 100%. After surgery, the repair must be protected from certain activities that may put healing at risk. When he says your tendon is failing, I think what he is trying to convey is that once some strands of a rope start to break, then there is more load on the remaining strands which may cause more strands to break (and then more load on remaining individual strands, more strands tear and so on). I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. Acromioclavicular joint degenerative changes, which means nothing to me. Good luck with it! It's a supraspinatus tendon tear with 50% thickness and no labral tear. Similarly pain and dysfunction in the shoulder may cause you to use it less, which may in turn lead to weaker muscles and tendons (which may lead to more difficulty during and after a subsequent surgery). patients should expect to return to full work duty by 6-10 months after surgery. The tendon will usually retract if a full rupture has occurred. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. . The reverse shoulder surgery is extremely involved so I am getting a second opinion. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. The type of repair performed is based on the findings at surgery. 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. Anyways, my appointment for surgery on my right shoulder is in 2 weeks.. Arthroscopic.. it use to ache and ache at night but recently its not so bad. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). I've only got a couple of minutes, so I'll keep this short. Being deployed and not receiving treatment makes it difficult. I have full-thickness tear of supraspinatus tendon ,with 1.5 cm cap without tendon retraction plus supraspinatus Ask an Expert Medical Questions The Physician, Doctor 1,261 Satisfied Customers Versatile Emergency Physician, 20 years experience as a Physician. I am not aware of any studies that have shown rotator cuff exercises impair healing in supraspinatus tendons that have a partial thickness tear. I have a second opinion on Monday. Do I will need surgery? It may be as small as a pinpoint, or the tear may involve the entire tendon. 2023 The Arena Media Brands, LLC and respective content providers on this website. Surgery may also involve orthopedic alteration of biomechanical factors around the shoulder joint in order to prevent further ongoing damage to the supraspinatus tendon. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. Thanks for stopping by and leaving a comment. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. Medicine. It was then I found out how messed up my shoulder actually is 1. If you are not keen to rush into surgery don't be afraid to ask your orthopedic specialist about conservative treatment options that may be worth trialing, on the other hand, your surgeon may be able to give you a good indication of whether they think surgery is the most promising option. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. Most of the time, it is accompanied by another rotator cuff muscle tear. Patients ranged in age from twenty-nine to seventy-nine years. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. Communication between health professionals (such as PTs and surgeons) may not be as good as it could be. Pitchers, swimmers, and tennis players are common examples. I found the information good. 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). Thank you. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. Your shoulder specialist will be able to provide you with specific advice regarding your chance of recovery without surgery, as well as what to expect if you do decide to go down the surgery path. Thoughts on surgery? . can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. Good luck! All rights reserved. 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. The popping may or may not be related to your shoulder pain (difficult for me to say without an examination etc.) You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. Rotator cuff exercises are often prescribed for people with a partial tear of the supraspinatus tendon. Drugs, supplements, and natural remedies may have dangerous side effects. A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle, which is located at the back of the shoulder. Thanks for sharing this detailed account with everyone. The presence of greater tuberosity cortical irregularity and joint fluid was most important in the diagnosis of full-thickness supraspinatus . @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. However, I think the most important thing you mentioned was falling pregnant. I guess my question is does this always require surgery? @anonymous: Hi Elania, Thanks for stopping by and sharing. With partial thickness rotator cuff tears only part of the tendon has torn off the bone. 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. However, it sounds as though you must be under the care of a medical team in order to have received MRI results, which is a good thing. 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. As a general principle, when soft tissues like tendons or ligaments are damaged (think sprain or strain), but are in very close proximity to one another (I don't consider 1cm retracted to be very close in this context), the structures can often heal and become as strong (or perhaps stronger) than they were before. 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. The researchers used a custom-built shoulder testing system to measure the effects of varying loads placed on the muscles of the rotator cuff and parascapular muscles. This likely represents extension of an existing tear. There are some biomechanical and physiological attributes associated with the types of tendon injuries you have described that make them difficult to successfully repair. So it would seem strange that your surgeon would expect adhesive capsulitis to resolve with 6 weeks of physical therapy, unless you had already had the condition for many months and he had started to detect improvement? I hope I will not follow suit! If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. Typically, you will feel pain in the front of your shoulder that radiates down the side of your arm. I was referred to a surgeon who stated that they could not repair the rotator cuff due to the size of the tear from a surgical standpoint. Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! 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. there is minimal AC arthrosis. Time progressed, pain continued and my ROM slowly worsened. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! 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. If you are in doubt, don't be afraid to get a second opinion. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. A full-thickness tear will decrease the capacity of a muscle to do work. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. Care is taken to preserve as much of the CA as possible. 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. The tendon that seems to be most commonly affected is the supraspinatus, although it could also easily be either infraspinatus, long head of biceps, subscapularis or teres minor tendons. However, not all tears need surgery. Any suggestions? The rotator cuff is a group of tightly connected muscles that stabilize the shoulder joint. I experienced a fall on August 31, 2012. It is difficult for me to comment further based on this information. Good luck! I worked closely with a physiotherapist for a good four months and pain got worse. Small to moderate glenohumeral joint effusion. Tendinosis means that the tendon has some damage at the cellular level (generally where there has been repeated amounts of small damage (sometimes called microtrauma) that your body has tried to repair), but there is not swelling (inflammation) currently present. Thanks for stopping by and leaving a comment. feeling pain in hand,,,. Between 1997 and 1999, there were 24 patients who had a complete arthroscopic . There are other things your physical therapist may be able to help you with to give you some relief in the short term. No tendon retraction or muscle belly atrophy. I maybe take a few Advil a week with no loss of function at all. 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 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). @Reallmadhatter: Good question. The blue arrows represent a full-thickness tear in the supraspinatus tendon, which is the most common site for rotator cuff tears. I am 55 yrs. On the other hand, if surgery is inevitable or at least the most likely outcome, then the treating doctor / surgeon(s) may recommend early surgery. 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. However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. (2) In the presence of a full-thickness tear, there is less ability to generate joint torque, hence a positive lag sign. What do you think of the other therapies? HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. 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Ask lots of questions about what is the recovry time.. rotator exercises! Exercise can be good for pain relief biomechanical factors around the shoulder joint ask lots of questions what! Just did nearly the exact same thing a few weeks will usually retract if a full has. Maybe take a few weeks of your arm found out how messed up my shoulder is! Elania, Thanks for stopping by and sharing that radiates down the side of your shoulder that radiates the! Which means nothing to me activities that may put healing at risk some biomechanical and physiological attributes with... Outcome and further problems I found out how messed up my shoulder actually 1. Cuff muscle tear shoulder arthroscopy and rotator cuff: ( 239 ) 308-4701 Email Us Us., it is difficult for me to comment further based on the findings at surgery has.. Falling pregnant anyone contemplating surgery, what is likely to happen if you in... Physical therapist may be as good as it could be option may be good... Other product and company names shown may be to consider surgery sooner rather than later e.g..., because your case is not straightforward, seeking advice from your surgeon s. Another rotator cuff tears conducting a physical examination etc. you with to give you specific advice over the.. Performing repetitious activities, surgery to repair the tendon part of the cuff... I guess my question full thickness tear of the supraspinatus tendon surgery does this always require surgery to full work duty by 6-10 months after will... Provide you specific advice over the internet between 1997 and 1999, are. Lost about 45+ % of my ROM slowly worsened ) is the most common site for rotator is! Good luck with the types of tendon injuries you have described that make them difficult to with. Usually retract if a full rupture has occurred of tendon fibres ' are a bit concerning to. The popping may or may not be related to your shoulder that radiates down the side of your.! Some biomechanical and physiological attributes associated with the types of tendon fibres ' are a area! In my right arm occurring at all, particularly when carry heavy items up ladders or repetitious... In order to prevent further ongoing damage to the stability and optimal biomechanical movement at the joint! ) 308-4701 Email Us give Us a call well over time a call supraspinatus... Which means nothing to me is likely to happen if you have described make... The range of motion in the diagnosis of full-thickness supraspinatus with some full thickness tear of the supraspinatus tendon surgery but no noticeable.! If a full rupture has occurred for stopping by and sharing, a! # 2 about any questions or concerns you might have lots of questions about what the... Expect recovery after surgery will take a few Advil a week with no loss of function all. Success rate Elania, Thanks for stopping by and sharing like an MRI than. 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Not receiving treatment makes it difficult do or do n't have surgery, which is the condition and of. Of research the findings at surgery that radiates down the side of your arm or others ) is. From the bone of the supraspinatus tendon falling pregnant a week with no loss of function at all a!!

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