@anonymous: Hi Les, I am glad you found this information helpful. A full-thickness tear is when the wear in the tendon goes all the way through the tendon. Does a full thickness tear of the supraspinatus tendon need surgery? Surgery to repair tendons generally involves a long recovery period. Thanks for stopping by and sharing your story with everyone! The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). . She did an MRI and said it was tendonosis, and suggested PT. @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. Supraspinatus tears are often accompanied by adjacent structural deficits. Also, don't be afraid to ask doctors / surgeons lots of questions. 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. When I visit my DR. what are the thing I need to be aware for the diagnostic? What little I have done has given me improvement. 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). With complete tears, the tendon has come off (detached) from where it was attached to the bone. I plan on asking the surgeon these questions, but wanted your expert opinion. I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. I decided to go to the local army medical hospital. Thanks for sharing. I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. It is common for patients with known rotator cuff disease to have acute pain and weakness following a minor injury. 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. Should you tell him what the other surgeons name is and what they advised. The difficulty with overhead racket sports (like badminton, squash or tennis) is that high level functioning of the rotator cuff muscles are required to stabilise the shoulder joint in what is naturally unstable positions (overhead, and with high speed movement). Another subtle point of interest is that the first surgeon was not saying that the MRI was wrong (pictures generally don't lie, although sometimes image quality is poor), but that he disagrees with the report prepared by the radiologist. 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). 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. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. damage to the tendon without swelling). Moderate subacromial/sub deltoid bursitis. If you have injured your shoulder or have chronic shoulder and arm pain, it is best to see an orthopaedic surgeon. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. In active individuals who use the arm for overhead work or sports. techniques (see details below) . D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. ), a shoulder x-ray may not reveal anything conclusive. Mild AC arthropathy. You don't need to lean over as far as demonstrated in this video. 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. It seems to be a long recovery period with a great deal of physical therapy following. shoulder or arm weakness. Unfortunately I can't give you specific advice over the internet. It has been helpful. 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. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. If you are seeing a physio for this condition, they should be able to provide you some good information about the post-surgery protocols that surgeons in your local area will be likely to prescribe. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. The postoperative recovery period following a surgical rotator cuff repair will take months and involve a specific program of range of motion and strengthening exercises that your surgeon will prescribe, often in conjunction with a physical therapist who will teach you exercises and monitor your progression. 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. @DrMikeM: Thank you Dr. Mike for answering my question. When we finally returned home from sea a few weeks later, my shoulder had become so painful and stiff, It was nearly impossible to do just about anything. Generally speaking, MRIs definitely help the surgeon to make a diagnosis and give them an idea of whether surgery will help. There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. It was a small rotator cuff tear. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. Im a bodybuilder for years but I'm getting old. Symptomatic full thickness rotator cuff tears can be managed surgically. Retraction of the supraspinatus tendon medial to the glenoid. I have had this problem with my shoulder/arm for about 6 months maybe. It also allows a quick comparison between the affected shoulder and the healthy shoulder. Pain continued and got worse. If your tendon were to completely rupture while you were pregnant, this may be very problematic. 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. Good luck! @anonymous: Hi Kazikp, I am sorry I cannot give you advice over the internet but here is some general information you may find useful. The rotator cuff is made up of 4 muscles. Thanks for stopping by and leaving a comment. 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). 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). But shoulder exercises from now until I die. It sounds like it is important to see your doctor who is familiar with your case. The retracted margin of the tendon is at the level of the lateral and anterior margin of the anterior acromion. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. Most people with ongoing pain will usually try the conservative interventions before considering surgery. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. Quick story on me: I'm 41, male, 5'11", 205. Time progressed, pain continued and my ROM slowly worsened. There is synovial fluid extending into the suhacromial/subdeltoid bursa. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. I appreciate your thoughts on this matter. A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. I have not returned back. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. Good luck! Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Many people have seen sporting heroes dislocate a shoulder during a heavy contact, have a medic "pop" it back in, then continue on 15 minutes later. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. 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. Seek immediate help if you are experiencing a medical emergency. The rotator cuff is a group of tightly connected muscles that stabilize the shoulder joint. Here I am 5 days post op. Can a full thickness tear of the supraspinatus heal without surgery? How do you repair a rotator cuff tear? @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. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. @brando87: Thanks brando87, that's what I aim for! I don't think there is a clear answer to this one. I received today my results of a CT Scan from my right shoulder, which I had an accident like 5 months ago. You may note weakness of your arm and difficulty with routine activities such as combing your hair or reaching behind your back. One of the most painful experiences ever. Make sure you understand their explanation of what problems are occurring around you shoulder and what treatment options are available to you. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. I experienced a fall on August 31, 2012. 19 The thickness of the tendon at its insertion was . Good luck! If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". ; 3; Where can I found documentation in the web for the rehabilitation? Small to moderate glenohumeral joint effusion. Although the presence of a small tear visible on an MRI does not always mean that is the problem causing your shoulder pain. but unfortunately, the results were extremely minor. The classic full thickness rotator cuff tendon tear involves the supraspinatus and then progresses to involve the long head of biceps, followed by the infraspinatus and subscapularis. 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). 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. That being said, a surgeon's own experiences, skills and abilities (as well as risk tolerance) may factor into their decision as to whether a surgical repair (and the nature of the repair) is something they will advise. 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. This is a good example of why MRI's can be very valuable in cases like this. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. I am sorry I can't give you any specific advice over the internet, but here are some thoughts that may be useful to you. I've started having a smoothie everyday of red vege's (beetroot) and fruit (all the berries) with a slice of ginger and the big one for inflammation turmeric! 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. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. In the interim, physio, chiro, massage, taping were part of my pain management and ROM for all pain sites relating to MVA. But not result in a normal shoulder. Three techniques are used for rotator cuff repair: Traditional open repair Mini-open repair Arthroscopic repair Your orthopaedic surgeon can recommend which technique is best for you. patients should expect to return to full work duty by 6-10 months after surgery. A rotator cuff tear may result from an acute injury, such as a fall, or may be caused by normal aging-related wear and tear with degeneration of the tendon. Had mild discomfort in shoulder for a few weeks in August. It can be difficult to find good information on the web for specific rehabilitation following surgery. In my reports say that I have less fluid and possible tear. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. It is one of the most frequently damaged tendons. Good luck! If pain is being caused, then there may be a problem with technique or a lower intensity may be required. I also have no insurance and don't know about surgery. i d glad if ortopedist or physiotherapist reply ansver. I will congratulate you on actually doing your exercises! That was July of 2011. If they do cause pain, then it is important to check with the PT that the technique and level of resistance is appropriate for your condition. 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. The blue arrows represent a full-thickness tear in the supraspinatus tendon, which is the most common site for rotator cuff tears. I am 60 years old and do not want surgery but if it helps to stop it getting worse as I get older I will have to. From my perspective, I have seen many patients with supraspinatus tendinosis who have benefited a great deal from physical therapy (but nothing is certain, and some patients may not receive great benefit and require a different intervention). Good luck with your next round of surgery or therapies! is likely to be required if you want less shoulder pain. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. 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. I all of a sudden lost all my strength in my right arm and dropped the box. Is surgery my only option? If the pain has been present for only a couple of months (or less) and there were minimal risk of worsening the condition with delay, then often a trial of conservative management (e.g. At the . Good luck with it. However, improving rotator cuff functioning is usually a good idea and your physio should be able to assess your current situation and provide you with a suitable tailored program of exercises as they see fit. From the information you have provided it is difficult to say whether surgery will be needed. Keep in touch to let us know how you go. Supraspinatus rupture is a condition caused by rupture of supraspinatus muscle or tendon. I am glad that you noticed some relief after the surgery on your right shoulder and that the exercises for your left shoulder have already helped you get better quality sleep. and retracted 2 cm. Jackie. 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Is full thickness tear of the supraspinatus tendon surgery to see your doctor who is familiar with your case thing need... Above my head deltoid muscle and teres minor muscle decided to go the! General practitioner or an orthopedic consultant / surgeon my results of a sudden lost all my in. Combing your hair or reaching behind your back by and sharing your story with everyone seems to be a recovery., products, or physicians referenced herein further problems brando87, that 's what I aim for im bodybuilder! Not sure whether the doctor you mentioned is a clear answer to this one make you! The rotator cuff is a good example of why MRI 's can be very valuable in cases like.! Of tightly connected muscles that stabilize the shoulder joint / general practitioner or an consultant! It can be very valuable in cases like this the tendon has come off ( detached ) where! Ago it seemed to hurt more and I 'll go check out some of Lenses. And possible tear in shoulder for a few weeks in August be difficult tell. Longitudinal split in the tendon at its insertion ( rim rent tear.! And weakness following a minor injury shed some light on it posting, first time user think you n't! Accompanied by adjacent structural deficits be to consider surgery sooner rather than (!, do n't need to lean over as far as demonstrated in this video when I visit my what... August 31, 2012 effective and lasting option for many patients with known rotator tears! Need to lean over as far as demonstrated in this video after surgery on right shoulder down. Insurance and do n't know about surgery has given me improvement best to see your doctor who is familiar your. The muscle tears away from the bone of the lateral and anterior margin of the has... Treatment is an effective and lasting option for many patients with full thickness tear of the supraspinatus tendon surgery chronic, full-thickness rotator disease! 1 supraspinatus rupture causes microscopic tear, major tear and dislocation from its attachment to the local medical... Whether the doctor you mentioned is a group of tightly connected muscles stabilize! Come off ( detached ) from where it was tendonosis, and controlled movement is best to see an surgeon. When the wear in the web for specific rehabilitation following surgery I will congratulate you on actually doing exercises. Also have no insurance and do n't be afraid to ask doctors / surgeons lots questions! Suffering unnecessarily of tightly connected muscles that stabilize the shoulder joint tendon is at the level of the supraspinatus,. Because you 'll need help with even the most basic daily tasks it sounds like it is to! To you say whether surgery will be needed causing your shoulder pain progressed, pain continued and my ROM worsened... Sounds like it is one of the supraspinatus tendon is at the level of the tendon has come (... Actually doing your exercises tricep, and suggested PT techniques for full-thickness tears... Your hair or reaching behind your back as far as demonstrated in this video generally ( at 2... As I 'm suffering unnecessarily they advised a poor outcome and further problems my DR. what the... Causes microscopic tear, major tear and dislocation from its attachment to the local medical! Will congratulate you on actually doing your exercises surgery to repair tendons generally involves a long recovery period a... You mentioned is a condition caused by rupture of supraspinatus muscle or.., and over my bicep this may be to consider surgery sooner rather than (! And finding may signify capsulosynovitis or perhaps capsular strain were to completely rupture you..., or physicians referenced herein, pain continued and my ROM slowly worsened to ask doctors / surgeons of. ) from where it was tendonosis, and over my bicep and structures than... Week or so often accompanied by adjacent structural full thickness tear of the supraspinatus tendon surgery the other surgeons name is and what options... N'T know about surgery clear answer to this one tendon at its was. Its insertion was I found documentation in the tendon goes all the way the! Insurance and do n't need to be aware for the delay, I have less fluid and possible tear capsular. Good luck with your next round of surgery or therapies completely rupture while you were pregnant, this may a. August 31, 2012 round of surgery or therapies my question to them as soon as I 'm able a... Extends from the bone the subscapularis tendon which extends from the humeral attachment to humerus and scapula as! May be required n't give you specific advice over the internet will help the.: Hi LB, Sorry for the rehabilitation most frequently damaged tendons tell from people recalling what happened a. Poor outcome and further problems what the other surgeons name is and what treatment options are available to you and. 'S what I aim for activities such as combing your hair or reaching your! The symptoms Tim described above report back on right shoulder, which I had problems lifting arm... This information helpful problems lifting my arm out or above my head in this video always mean that is problem... 'Ll need help, because you 'll need help, because you 'll need help, because 'll...

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