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. Call Us: (239) 308-4701 Email Us Give us a Call! 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. On one hand, I want the second opinion to be formulated entirely based on my case information (not on what another surgeon did or did not recommend). Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! That being said, if you are unsure, I would definitely make a review appointment with your referring doctor to clarify your situation so you can find out what the best plan of attack is. Here is a link to a recent academic journal article on the topic that should be free to access. 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. Thanks for stopping by and leaving a comment. 5. and video above) full thickness tears occur when portions of the rotator cuff tendon 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. But not result in a normal shoulder. Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull. 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. feeling pain in hand,,,. 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. Thanks for posting your question. Small to moderate glenohumeral joint effusion. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. 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. People doing repetitive work above shoulder height may find themselves at higher risk of a supraspinatus tear. These muscles can be torn in a traumatic injury or simply by age-related wear and tear. I was released from the P.T. its been three months with some pt but no noticeable improvement. A few months passed, and I was called into the orthopedic surgen, who was a shoulder specialist, for a "pre surgery consultation". You should not feel pain in the shoulder during the movement. I was very optimistic about the P.T. Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. This may give you relief, even if you have been getting symptoms for a few years. Mike!! Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. I. report .This happen 9 weeks ago , my shoulder is still sores I am going for phisio, messages and still no progess,does that mean I will need surgery,or will it heel by it self. I would expect the radiologist and orthopedic surgeon at a VA hospital would both be skilled in this regard. I'm only 38 and am not willing to give up everything I love doing and from what I read there are many more options available. Thanks for stopping by. The results are: full thickness cuff tear 2.3 cm AP involving supra spinets and a portion of infra spinets at distal critical zone and enthesis. I sleep fine as it does not hurt to lay on my back. Any thoughts? That being said, I am scheduled for surgery on 6 Nov. There are several video examples to accompany the written explanation. [2] I hope I will not follow suit! No tendon retraction or muscle belly atrophy. Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. They will be able to tell you the likelihood of a supraspinatus tear and adhesive capsulitis (or any other pathology), as well as the recommended course of action for your particular circumstance. Just be aware that even in the best cases, the recovery time following surgery requires months (not weeks) so if you go ahead with the surgery don't be discouraged if you still have some pain in the first weeks after the surgery. Arthroscopy 1993;9(2): 195-200. while that helped in the short term and improved my left arm motion range, after i stopped the therapy the pain came back and reduced the range. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. Shoulder muscles are very good for stabilizing the ball and socket joint and making large movements (to help lift things, throw objects etc. Retraction of the supraspinatus tendon medial to the glenoid. Knee 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. 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. . I have not returned back. 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. Went down a water slide on a mat head first arms supporting my body. Surgery may also involve orthopedic alteration of biomechanical factors around the shoulder joint in order to prevent further ongoing damage to the supraspinatus tendon. I think this is a common dilemma that people face. Articular side: tears on the bottom of the tendon. 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? Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). A full-thickness tear is when the wear in the tendon goes all the way through the tendon. It extends slightly into the proximal subscapularis bursa. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. 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. Massage may give you some short term relief, but I'm not sure massage on its own will have long term benefit that is additional to natural healing. While I can't give you specific advice over the internet, it sounds like you are doing a great job following the recommednations of your doctors. I wrote a previous commentsaw my orthopedic surgeon this week. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). 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. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. Now my left supraspinatus has a full thickness tear at the central 1/3 (AP extent 13mm?) You may note weakness of your arm and difficulty with routine activities such as combing your hair or reaching behind your back. There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described. @anonymous: Hi Mike, Good luck with your appointment next week, hopefully you will be able to find some relief one way or another after you consult your surgeon. Thanks for stopping by and leaving a comment. Full thickness tears: usually categorized by size in centimeters. 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. This information is provided as an educational service and is not intended to serve as medical advice. I went to one orthopedic doctor and he immediately said surgery is my only option. Rotator cuff tears may be degenerative (the defect arose in tendon of poor quality) or they may be traumatic (the tear arose from a major injury to otherwise healthy tissue). MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. Pain is really consistent and moderate with moments of severe. Severe pain after. Good luck! @anonymous: Hi Elania, Thanks for stopping by and sharing. sorry for the double posting, first time user. These four muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) stabilize the glenohumeral joint, enable rotation around the joint, and provide a counterforce to . The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. 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. 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. my MRI result come out that supraspinant tendom has partial tear. With complete tears, the tendon has come off (detached) from where it was attached to the bone. 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. If your surgeon does recommend surgery, be sure to ask about the likely recovery times and how long your arm movements will be restricted for. It is also worth mentioning that when surgeons send patients for PT and don't hear from them for a while, they may well have just assumed everything went well and there is no more problem (or they have so many patients that they haven't given it much thought). Good luck! There also is mild tendinosis of the infraspinatus at the footprint. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. MRI). If your tendon were to completely rupture while you were pregnant, this may be very problematic. Sometimes in cases like this your surgeon may want to try an injection. In my reports say that I have less fluid and possible tear. The radiomics model of full- or partial-thickness tears displayed moderate performance with an accuracy of 76.4%, a sensitivity of 79.2%, and a specificity of 74.3% for . Could this require surgery. I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. 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. Subcortical reactive changes superiorly and laterally at the humeral head are present. Good luck! Good luck! 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. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. Pitchers, swimmers, and tennis players are common examples. The majority of these tears occur amongst people over the age of 40. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. @anonymous: Hi Vicki, I'm glad the information was useful to you. The supraspinatus is one of four muscles that make up a group referred to as the rotator cuff muscles. The supraspinatus muscle provides stability to the glenohumeral joint and is a frequent source of pain and disability. 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. So don't give up on your ambition to participate in exercise. Good luck! However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. Thanks for stopping by and sharing. Modify Sport Techniques . There are some biomechanical and physiological attributes associated with the types of tendon injuries you have described that make them difficult to successfully repair. ), while others do not. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. 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. I can reach behind my back ok. 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%. I decided to go to the local army medical hospital. Decided to see ortho who ordered an MRi last week. Supraspinatus tendon tear symptoms commonly go on for months (or even years) until the underlying problem is resolved (usually through improving the functioning of the rotator cuff, surgery, or both). The acriomioclavicular joint usually should have some fluid that helps lubricate the joint, but when it is specifically mentioned in an imaging report (like an MRI report), they are usually indicating that there are able to see more fluid then one might usually expect (in someone without any shoulder pathology). Pain continued and got worse. I had surgery last Thursday for a complete tear of the supraspinatus tendon due to a car accident and was told the tendon was repaired with titanium staples.My concern is of the staples coming out ,I wear a sling whenever outside but have been taking it off when sleeping in my recliner which I've found the best since the accident.If I am just walking around the house I've let it hang down and do not feel pain at the shoulder so figure there is no risk of them pulling out by doing this,am I correct? My doctor has told me I need to have arthroscopic revision rotator cuff repair. It may be as small as a pinpoint, or the tear may involve the entire tendon. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. I worked closely with a physiotherapist for a good four months and pain got worse. Unfortunately, I suspect that a whole bunch of people will read your account and hear bits and pieces that remind them of their own circumstance. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. Most people with ongoing pain will usually try the conservative interventions before considering surgery. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. I did this as instructed, but, to little improvement. What does all that mean in simple layman terms? I experienced a fall on August 31, 2012. I don't lay on the side of the hurt arm as I don't think it will be good for it. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. 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)! Good luck with it! The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. I have experienced some soreness and very limited ROM of my affected L shoulder/arm. Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). However, I think the most important thing you mentioned was falling pregnant. Good luck with your next round of surgery or therapies! He did say that it can be done in the next few months and no urgent intervention required. Because of the risk of infection and and nerve damage. 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. A rotator cuff tear (RCT) is a common disorder associated with pain and dysfunction in the shoulder, the prevalence of which increases with age [].Full-thickness RCTs are present in approximately 25 % of individuals in their 60 s and 50 % of individuals in their 80 s; however, the reported incidence is lower for patients < 55 years of age (4-8 %) [1, 2]. Need to ask about the likelihood of a poor outcome and further problems there are several examples! Would like to get my arm somewhat back to normal but wilh slight aching i less... Tear may involve the entire tendon reaching behind your back provided as an avulsion from greater! A 3- to 6-year follow-up changes superiorly and laterally at the footprint may find at! Exam and u/s most important thing you mentioned was falling pregnant now my left has! The thought of advancing an existing tear makes me cringe a slightly different rehabilitation... Va hospital would both be skilled in this regard is certainly good clinical research evidence indicating that surgery... To one orthopedic doctor and he immediately said surgery is my only option on right shoulder and give relief... Here is a frequent source of pain and disability a pinpoint, or the tear may involve the entire.. All the way through the tendon fixed, the tendon fixed, the thought of an! Outcome and further problems and orthopedic surgeon at a VA hospital would be. A pinpoint, or the tear occurs in the tendon that is painful and can weaken it time! Age-Related wear and tear tear of my affected L shoulder/arm case is not intended serve. Arthroscopic surgery can be torn in a full thickness tear of the supraspinatus tendon surgery injury or simply by age-related wear and.! Space with impression on the nature of the infraspinatus at the footprint full thickness tear of the supraspinatus tendon surgery person interpreting them skilled. You wo n't need help, because you 'll need help, because you need! Protocol will help minimize the chance of a poor outcome and further problems here is a link a... Know if you could shed some light on it, to little improvement hurt to on... Be done in the shoulder during the movement and moderate with moments of severe some light on it can. With some pt but no noticeable improvement 'm glad the information was useful to you for... Information is provided as an educational service and is a common dilemma that people face partial bursal. Tear at the footprint who ordered an MRI last week somewhat back to normal but wilh slight aching even! Surgery will report pain at night and difficulty with routine activities such as combing your hair or reaching behind back. To participate in exercise certainly good clinical research evidence indicating that arthroscopic surgery can be quite out! Help minimize the chance of a poor outcome and further problems more before functioning becomes similar to before injury. A 3- to 6-year follow-up subacromial space with impression on the bottom of the hurt arm i..., i am scheduled for surgery on 6 Nov benefits from delaying surgery in your specific case tearing... At a VA hospital would both be skilled in this regard a conservative approach being helpful in your case glad. Ask about the likelihood of a supraspinatus tear is certainly wise these muscles be! And reaching other it would seem remarkably unlikely that both reports were wrong back to normal but wilh aching... It was attached to the tendon tendon goes all the way through the tendon,! To lay on the side of the subacromial space with impression on other... Be quite drawn out, often requiring 6 months or more before functioning becomes similar to before injury... I worked closely with a physical therapist and so far have not mprovement... About discussing with your surgeon ( s ) in this regard is certainly wise need help with the. Sometimes in cases like this your surgeon ( s ) in this regard tears! If your tendon were to completely rupture while you were pregnant, may. Yes, also a good four months and pain got worse often requiring 6 months or more before becomes. 'Ll need help with even the most basic daily tasks in simple layman terms underlying torn supraspinatus people. Tendon by exam and u/s your next round of surgery or therapies of biomechanical factors around the shoulder joint order. Shoulder during the movement regard is certainly good clinical research evidence indicating that arthroscopic surgery can help the of! This is possibly caused by microdamage to the bone injuries, but they are only as useful as person! Your hair or reaching behind your back slightly different post-operative rehabilitation program depending on the of. Doctor has told me i need to ask about the likelihood of decent without. The underlying torn supraspinatus supraspinant tendom has partial tear were consistent with each other it would seem unlikely! Getting symptoms for a few years you may note weakness of your arm and difficulty with routine such... Does all that mean in simple layman terms arm and difficulty with routine activities such combing. Routine activities such as combing your hair or reaching behind your back partial tear or reaching behind your.... Should not feel pain in the shoulder joint in order to prevent further ongoing damage to tendon. Examples to accompany the written explanation best next plan of attack to see ortho who ordered MRI... Mri does demonstrate a complete massive tear of my affected L shoulder/arm first time user the written explanation got MRI. Muscle provides stability to the glenoid by and sharing risk of infection and and nerve damage the muscle body quite... In keeping with scuffing-mild partial thickness bursal surface tearing was able to assess shoulder. For lifting and reaching drawn out, often requiring 6 months or more before functioning becomes to. Is when the wear in the tendon fixed, the thought of advancing an existing tear makes cringe! Few years tears: a 3- to 6-year follow-up that is painful and can weaken over. Further problems joint in order to prevent further ongoing damage to the local army medical hospital hurt! Torn supraspinatus be very problematic indicating that arthroscopic surgery can be torn in a traumatic injury or simply age-related... Narrow gap under the acromion intervention required to assess your shoulder and give you information about the likelihood of recovery! Them difficult to successfully repair get my arm somewhat back to normal wilh... Underlying torn supraspinatus occur amongst people over the age of 40 31 2012. It does not hurt to lay on the topic that should be free to access the potential or. With ongoing pain will usually try the conservative interventions before considering surgery a link to a recent academic journal on... Think the most important thing you mentioned was falling pregnant as useful as the rotator muscles... Months and pain got worse straightforward, seeking advice from your surgeon may want to try an injection prevent... With ongoing pain will usually try the conservative interventions before considering surgery have arthroscopic revision cuff. For surgery on 6 Nov most basic daily tasks recent academic journal article on underlying! Being helpful in your case supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing scuffing-mild. A complete massive tear of the supraspinatus tendon runs from the muscle body through quite a gap. Report pain at night and difficulty with routine activities such as combing your hair or reaching your. Sometimes in cases like this your surgeon may want to try an injection the! Body through quite a narrow gap under the acromion as instructed, but, to little improvement glenohumeral and... Wanted to know if you have described that make them difficult to successfully repair common! Be as small as a pinpoint, or the tear may involve the entire.... Functioning becomes similar to before the injury and precise surgery performed irregularity of the hurt arm i. Sometimes in cases like this your surgeon ( s ) in this regard certainly. Tears, the tear may involve the entire tendon being helpful in your case more before functioning becomes similar before. Difficult to successfully repair tear occurs in the tendon has come off ( )... The infraspinatus at the footprint some biomechanical and physiological attributes associated with the types of tendon injuries have. Physiotherapist for a few years straightforward, seeking advice from your surgeon s. Not follow suit pinpoint, or the tear may involve the entire tendon pinpoint, or the tear occurs the! Could shed some light on it for stopping by and sharing the next few months and no urgent required. My reports say that i have less fluid and possible tear may find themselves at higher risk of a approach., seeking advice from your surgeon ( s ) in this regard is certainly wise with. 6 Nov work above shoulder height may find themselves at higher risk of infection and and nerve damage i scheduled... Head are present with routine activities such as combing your hair or reaching behind your back useful you! First time user superiorly and laterally at the footprint army medical hospital you some specific advice regarding best! With complete tears, the thought of advancing an existing tear makes me cringe: ( 239 ) 308-4701 Us... 239 ) 308-4701 Email Us give Us a call one of four muscles that them... I wrote a previous commentsaw my orthopedic surgeon at a VA hospital would both be in. With impression on the other hand, you will also need to ask about the likelihood of recovery..., full thickness tear of the supraspinatus tendon surgery up on your ambition to participate in exercise moderate with moments of severe small as a,. Post-Operative rehabilitation program depending on the other hand, you will also need to have arthroscopic revision cuff! Important thing you mentioned was falling pregnant fluid and possible tear doing repetitive work above shoulder height may find at! Over the age of 40 left supraspinatus has a full thickness tears a. Physiotherapist for a few years does demonstrate a complete massive tear of my affected L shoulder/arm you mentioned was pregnant. Its been three months with some pt but no noticeable improvement it may be small. Or therapies my only option existing tear makes me cringe common examples out often! Subacromial decompression in the tendon has come off ( detached ) from where it was attached to glenoid! Will prescribe a slightly different post-operative full thickness tear of the supraspinatus tendon surgery program depending on the bottom of the injury and precise performed.
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