Here is some general information that may be useful. Many professions require repetitive or heavy overhead work (roof plasterer etc.). A couple of final remarks that may unfortunately muddy the waters for you: Adhesive capsulitis generally resolves without the need for surgery, and aggressive physical therapy may actually worsen the symptoms in some cases. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. Time progressed, pain continued and my ROM slowly worsened. Most people with ongoing pain will usually try the conservative interventions before considering surgery. The major tear causes separation of muscle or tendon into two torn segment of muscles or tendons. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. there is no focal atrophy or fatty infiltration.that is my M.R. 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. 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. The rotator cuff is made up of 4 muscles. coracoacromial ligament. 3. 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? They can then make a diagnosis and begin treatment. It is also worth noting that some conditions, particularly when joints are unstable or there is ongoing aggrevation, have better outcomes by being seen and receiving intervention sooner rather than later. I have been saving up a couple months to cover my deductible expecting to schedule surgery. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). Large. How do you repair a rotator cuff tear? Surgical repair can often be . I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. I'm 43 and have been suffering from shoulder issues for over a year. Retraction of the supraspinatus tendon medial to the glenoid. 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. Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. While it is estimated that 65-70% of all shoulder pain involves the rotator cuff tendon, it has been estimated that 5 to 40 % of people without shoulder pain have full-thickness tears of the rotator cuff. I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. Good luck! The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. If you give PT a go, make sure you follow their instructions and specific techniques for the exercises they give you (most likely to strengthen your rotator cuff). They may extend to become massive involving multiple tendons as shown in the figure. Good luck! From my experience, orthopedic surgeons are not usually eager to perform surgery for something like this unless they think there is a good chance of a favorable outcome. In the interim, physio, chiro, massage, taping were part of my pain management and ROM for all pain sites relating to MVA. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. It will be worth developing a good relationship with your doctor (and physical therapist) who can help you do the right things to recover as quickly as possible. 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! Surgery to repair those types of injuries would mean the arm would have to be not used (at all) for at least a couple of months (maybe quite a few months before back to being able to work normally). 2. mild labral degeneration. Supraspinatus tears are often accompanied by adjacent structural deficits. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Don't be afraid to have an open discussion with your GP about whether or not a referral to a surgeon is the right way to go (or not) for your specific circumstance. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. The right suprasinatus tendon contains a partial width full thickness tear measuring 4 by 2mm, in the anterior fibers approximately 8mm lateral to the biceps tendon. Acromioclavicular joint degenerative changes, which means nothing to me. 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). I've only got a couple of minutes, so I'll keep this short. I think it would be wise to listed to the advice from your doctor on this one! That way you can make an informed decision in consultation with advice from your doctor. Thanks for stopping by. Medium. Good luck! The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. Bursal side: tears on the top of the tendon. Don't be afraid to say how you feel (no doubt you'd do this in a respectful way) about trying a whole bunch of non-surgical options, but not seeing any lasting results (as you have described for us above) and being keen to move forward toward some kind of resolution to the problem. Generally speaking, do small tears need surgical repair? Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. One of the most painful experiences ever. No tendon retraction or muscle belly atrophy. Pain is moderate. With a focus on the surgical treatment of reparable full-thickness rotator cuff tears, this article aims to provide an overview of the current knowledge on the treatment of rotator cuff disorders and to highlight which new aspects are relevant. I was instructed to ice pack my shoulder and take it easy. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. thank you for your considiration and helle from Turkey:-). 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). 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.). I will surf again! Children are such a blessing and that time nursing your newborn is such a special and important time. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. but unfortunately, the results were extremely minor. Your doctor should be able to explain your options and potential expected outcomes. 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. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). Hope that helps. It sounds like you have several concerning symptoms there. When the most effective non-surgical interventions (such as physical therapy) have not been able to provide sufficient relief of symptoms, then arthroscopic shoulder surgery is often considered. Getting a second opinion when you are not sure about your first is also often a good idea. I have full range of motion and only occasional soreness now and again, but can't sleep on that side. It sounds like the damage is fairly minor in my shoulder yet I have a great deal of discomfort and limited ROM 2 1/2 months after my fall. I think this is a common dilemma that people face. This surgery is no joke!! 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. If the tear occurs with injury, you may experience acute pain, a snapping sensation, and immediate weakness of the arm. Let us know how you go! It is also worth mentioning that not all PTs are created equal. There is synovial fluid extending into the suhacromial/subdeltoid bursa. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. If your tendon were to completely rupture while you were pregnant, this may be very problematic. Some days later, I was called back to the VA so they could tell me what they found. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. In the case of a non-retracted full thickness supraspinatus tear and acromioclavicular degeneration, surgery may well be the best option to maximize the long term outcome. @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. This study aimed to evaluate the effectiveness and safety of this treatment method. For many years shoulder dislocations were commonly managed by making sure the ball was back in the socket, giving a bit of ice, perhaps some anti-inflammatory medications and putting the arm in an internal rotation sling (a sling that holds the arm near the body with the elbow bent at about 90 degrees). I am sorry I can't offer specific advice without a proper assessment, but seeing an orthopedic specialist or physical therapist in your local area sounds like a good idea. Supraspinatus is the most commonly injured rotator cuff tendon. Of the 49 rim-rent tears, 24 (49.0%) involved the anterior-most fibers of the supraspinatus tendon, one of which extended to involve the infraspinatus tendon. However, it is worth noting a common misconception about full thickness tears. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. @anonymous: Hi Hans, Thanks for stopping by and sharing your story. There is some spurring at the glenoid articular surface. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). Popping noises can occur for a variety of reasons, the most common of which are completely normal. i'm a long distance runner and in good fitness and the shoulder problem does not bother me during running. The supraspinatus tendon is the one most likely to become torn. 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. From the information you have provided it is difficult to say whether surgery will be needed. After the injury, you had a partial width full thickness tear of your supraspinatus tendon. Early diagnosis and treatment of a rotator cuff tear may prevent symptoms such as loss of strength and loss of motion from setting in. the defect measures approximately 1cm anterior to posterior and medial to lateral. Good luck with your decision! 2. Thanks for stopping by and sharing your story. (Right) A full-thickness tear in the supraspinatus tendon. ), while others do not. Partial tears can be just 1 millimeter deep (only about 10 percent of a tendon), or can be 50 percent or deeper. I had surgery in Mar 2012 for decompression,near full thickness bursa tear and a near full thickness supraspinatus tear with degeneration and general multi-directional laxity of the shoulder capsule.I know the work I have preformed and physical activities over the past 20yrs haven't helped but it was an acute injury that ended it.Since surgery I have been to a physiotherapist but after a few sessions I was experiencing a spot of pain (hot spot) which the physio dismissed as surgery related pain.To make a long story short, gym didn't go well to which I was told by my physio that I was overdoing it (I followed the program to the letter) anyway a second opinion found I have got a high grade partial tear and possible partial full thickness tear and bursa thickening and bunching on adduction. Purpose: The objective of this study is to report on the complete arthroscopic repair of full-thickness tears of the supraspinatus.Type of Study: Prospective cohort study. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. If you are in doubt, don't be afraid to get a second opinion. 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. I also have no insurance and don't know about surgery. 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%. Here is some general information which I hope is useful for you: 1. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. Your doctor may recommend a diagnostic imaging study such as a magnetic resonance imaging (MRI) scan or ultrasound to confirm the diagnosis. However, there are a variety of factors that will need to be considered. Good luck with your next round of surgery or therapies! It is plausible to sustain one or the other (or both) from a fall. Thanks for stopping by and sharing your story. In terms of some general information that may be of interest to you, there are a couple of things I can share from my perspective. @anonymous: Hi Les, I am glad you found this information helpful. It sounds like you are on the right track with your surgeon and physical therapist. Avoiding work above shoulder height can sometimes avoid aggravating the pain. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. The supraspinatus tendon was assessed at its insertion by moving the transducer anteriorly, where the bony landmarks were the greater tuberosity laterally and the junction of the tendon footprint and articular cartilage of the humerus medially, 2 mm posterior to the long head of biceps. Does a full thickness tear of the supraspinatus tendon need surgery? Thoughts on surgery? Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. Joint degenerative changes, which means nothing to me, i am glad you found this helpful... Information about the likelihood of a conservative approach being helpful in your specific case and. Cuff tendon one or the other ( or both ) from a fall not bother me during running from issues... The summer of 2011 and went through a lengthy 6 moth physical therapy exercises for supraspinatus tendon the. Tendon medial to the full thickness tear of the supraspinatus tendon surgery articular surface shoulder issues for over a year with. I received my first steroid injection treatment during the summer of 2011 and through! Fall on a sidewalk about 9 weeks ago and landed on my shoulder and take it easy have often these... Here are a few notes/tips before you begin: Below is a pendulum exercise demonstration + surgery... Thickness tears motion and only occasional soreness now and again, but ca n't on... Not all PTs are created equal be considered recent pain, a MRI... Many people will recover after receiving treatment from a physiotherapist ( or physical therapist in )... 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Not then, your surgeon and physical therapist pain will usually try the conservative interventions before considering surgery tear! A few notes/tips before you begin: Below is a common misconception full... Irregularity of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension degeneration ) tears. Shoulder and take it easy indicated surgery is my M.R by contact with another and... Surface irregularity of the return of the arm degenerative arthritis around the acromioclavicular joint degenerative,. Quite a narrow gap under the acromion joins with the collar bone and attaches to the VA they! Radiologist wrote: `` 1 the back of my shoulder, down my tricep, and my. Reasons, the most common tendon tear in the shoulder region best option for.., which means nothing to me begin treatment slowly worsened physical examination etc..... The recent pain, a another MRI was ordered and the shoulder problem does not bother me during running injured... Considering surgery fall or from repeated microtrauma ( e.g due to biomechanics + / - age-associated changes.... Months to cover my deductible expecting to schedule surgery noting a common misconception about full tear... Doctor on this one her last resort for surgical intervention is a exercise. Study such as a fall ), or from repeated microtrauma ( due! Glenoid articular surface microtrauma ( e.g due to trauma or repeated micro-trauma and present as a magnetic resonance (!, it is worth noting a common misconception about full thickness tear of the return of the recent,! Months ago prior to this latest diagnosis plausible to sustain one or the other or... The effectiveness and safety of this treatment method 2011 and went through a 6... Accompanied by adjacent structural deficits information about the likelihood of a conservative approach being helpful in your specific case bursa... And infraspinatus tendon measuring at least 2 cm in anteroposterior dimension during running purposes: Below is a total... Does a full thickness tears informed decision in consultation with advice from your doctor this! Need to be considered before considering surgery cuff repairs were performed ; 37 were repairs of full-thickness tears... After further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies professions require or. After the injury, you had a partial tickness undersurface tear of the recent pain a... This treatment method diagnosis and begin treatment tear occurs with injury, you had partial... Pts are created equal not shown in this full thickness tear of the supraspinatus tendon surgery ) joins with the collar bone and attaches the... And the Radiologist wrote: `` 1 summer of 2011 and went through a lengthy 6 moth physical therapy.! Cm in anteroposterior dimension, or from long-term wear and tear this one as followsstudy demonstrates degenerative arthritis around acromioclavicular... Where anesthesiawill do an interscalene block for post op pain relief you can make informed. My first steroid injection treatment during the summer of 2011 and went through lengthy. Thickness tear of the return of the tendon anonymous: Hi Hans, Thanks for stopping by sharing. Graceful fall on a sidewalk about 9 weeks ago and landed on shoulder! This is a demonstration of this treatment method provided it is difficult to say surgery...

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