), while others do not. If you are in doubt, don't be afraid to get a second opinion. I mention this, as this will often influence treatment decisions. The supraspinatus is part of the rotator cuff of the shoulder. So while the cost of surgery can be expensive, people who can't do their job one-handed may also need to consider potential loss of income as well or making alternative work arrangements. Medicine. Medium. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. 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). The rehabilitation after surgery is likely to take time. Sometimes in cases like this your surgeon may want to try an injection. Medicine and physiotherapy often help in reducing pain but the effect is temporary. Patients ranged in age from twenty-nine to seventy-nine years. The four muscles supraspinatus, infraspinatus, subscapularis and teres minor originate from the scapula (shoulder blade). The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). 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. D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. In my reports say that I have less fluid and possible tear. MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain If, however, you are active or use your arm for overhead work or sports, surgery is most often recommended because many tears will not heal without surgery. With partial thickness rotator cuff tears only part of the tendon has torn off the bone. Let us know how you go! Good luck! This sounds like a difficult situation. I am really hoping to find some outside advice. Thoughts on surgery? As you have correctly identified, there is quite a long recovery period following surgical repairs of rotator cuff injuries, but on the other hand, there is a pretty good success rate among people who follow the post-operative instructions. Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. I sleep fine as it does not hurt to lay on my back. I am 55 yrs. If in doubt call your surgeons office. I'm 43 and have been suffering from shoulder issues for over a year. If you have concerns, you could ask the surgeon when you next see him whether he thinks your symptoms are from the tendon tear and rotator cuff dysfunction or whiplash? Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. In active individuals who use the arm for overhead work or sports. He kind of scared me regarding the recovery for this. Any advice would be greatly appreciated. The tear in his supraspinatus tendon may be torn across its full thickness (but probably not completely ruptured which would require it be torn across it's full thickness and the entire width of tendon). No black and white answer for this one I'm afraid. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. 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. Ongoing serious pain influencing daily life, sleep etc. 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). OpenStax College (CC 3.0) via Wikimedia Commons. Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? I sleep fine as it does not hurt to lay on my back. I have noticed these types of shoulder pathology often occur among people who work (or have worked) in jobs that are physically demanding on the shoulders (or have a recreation / sporting background that may have contributed to shoulder girdle degeneration). Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. It was then I found out how messed up my shoulder actually is 1. (2) In the presence of a full-thickness tear, there is less ability to generate joint torque, hence a positive lag sign. On the other hand, if your surgeon thought your tendon would be able to endure pregnancy and nursing your baby without the need for strong medications or the need for surgery, then this may influence your decision on timing for surgery etc. Should you tell him what the other surgeons name is and what they advised. It was sometime in the early months of 2011 that I was sent off to have an MRI done. i'm a long distance runner and in good fitness and the shoulder problem does not bother me during running. I am in aching pain consistently. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). It has been helpful. Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. ), but not so good with the finer movements (better performed by the muscles in the forearm and hand). So first off, I should say that I have certainly seen situations where a small supraspinatus tear has been surgically repaired, only for a worsening of symptoms to occur after further pathology (such as other rotator cuff tendon tears) either develop or become easier to detect on imaging (e.g. 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 . A rotator cuff tear can result from an injury such as a fall or heavy lifting, or from normal wear-and-tear and repetitive activities over many years. The process of recovery is different depending on a number of factors including the cause, severity and location of the tear, the biomechanics of the affected shoulder, the age of the individual just to name a few. I wish you a speedy and full recovery. However, it is worth noting a common misconception about full thickness tears. A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle, which is located at the back of the shoulder. They can then make a diagnosis and begin treatment. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). Seek immediate help if you are experiencing a medical emergency. I was instructed to ice pack my shoulder and take it easy. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. my MRI result come out that supraspinant tendom has partial tear. 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. 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. With complete tears, the tendon has come off (detached) from where it was attached to the bone. Basically, it creates a hole in the tendon. A partial tear may require only a trimming or smoothing procedure called a dbridement. Good luck! There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. Hi, I have had a partial supraspintus tear for 3 years now, and am wondering if it's too late to anything about it? For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. Productive acromioclavicular joint changes are associated with an anterolaterally down sloping type II acromial configuration. Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. I did this as instructed, but, to little improvement. If your tendon were to completely rupture while you were pregnant, this may be very problematic. X-rays are often not very useful in diagnosing shoulder injuries. It is difficult for me to comment further based on this information. Good luck! Exercise is important for many reasons (not the least of which are physical and mental health benefits). Can a supraspinatus tendon tear heal itself? (MRI), demonstrating a full-thickness supraspinatus tear. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. bone spurs and/or rotator cuff tears. As mentioned in the video, the aim of these resistance band exercises is not to increase your range of movement but to instead strengthen the rotator cuff muscles which will help protect the soft tissue structures around the shoulder in the long term. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. Like Helpful Hug REPLY In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. I also have no insurance and don't know about surgery. It may take a while to overcome your shoulder pain, and you may even need to modify the types of activities you do, but working hard to be able to return to exercise is definitely a worthwhile goal. 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. I think these are promising approaches for the types of pathology you described. If a medical doctor (assuming they have nothing to personally gain by referring you to another health professional) suggests something may work based on their years of training, in depth understanding of anatomy, physiology, common pathology, research evidence and clinical experience with many patients, it is usually worth considering what a family or friend (albeit that they are usually well meaning) is basing their opinion on. 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 appreciate your thoughts on this matter. The Physician is online now Related Medical Questions (See Fig. muscle atrophy of supraspinatus, infraspinatus, and subscapularis muscles, 3.) I don't lay on the side of the hurt arm as I don't think it will be good for it. Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. When you speak to your doctor and discuss your plan for treatment, make sure you discuss any relevant work / sport related activities so you both know what to expect. It usually develops alongside other rotator cuff muscle tears, which may be result of trauma or repeated micro-trauma. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. This may give you relief, even if you have been getting symptoms for a few years. Three techniques are used for rotator cuff repair: Your orthopaedic surgeon can recommend which technique is best for you. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). Being deployed and not receiving treatment makes it difficult. What we often don't see is the subsequent shoulder surgery and months of rehabilitation (sometimes in the off-season) to repair the damaged structures. @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. Good luck! Mild AC arthropathy. Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. It sounds like it is important to see your doctor who is familiar with your case. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). There may also be insurance implications etc. 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. Thanks for stopping by and sharing your story. She did an MRI and said it was tendonosis, and suggested PT. I am worried I will not improve my ROM this time. I have not returned back. 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. An orthopedic surgeon will be able to provide you with all the information you need regarding surgery, however, regarding exercises to return to badminton it might be wise to see a physical therapist (also known as physiotherapist) who specialises in sports injuries and rehabilitation. Symptomatic full thickness rotator cuff tears can be managed surgically. @DrMikeM: Thank you Dr. Mike for answering my question. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. 4. 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. Unfortunately I can't give you specific advice over the internet. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. I don't lay on the side of the hurt arm as I don't think it will be good for it. Good luck with it. It is also worth noting that whiplash associated disorders are complex. A full rupture will require surgery (usually quite urgently). 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. LOTS of heavy benching, etc. What may be useful is for me to share some of my experiences and give you some questions to think about and discuss with your doctor. Now I have these results stated above. 2. mild labral degeneration. Heuberer et al 15 used the knotless cinch-bridge technique for supraspinatus tears. Thanks for stopping by and leaving a comment. @anonymous: Hi Bobby, Thanks for stopping by and leaving a comment. The rotator cuff is a group of tightly connected muscles that stabilize the shoulder joint. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. The supraspinatus is the tendon that tends to suffer from partial tears most commonly. However, not all tears need surgery. Can a full thickness tear of the supraspinatus heal without surgery? @anonymous: Hi Donald, I'm sorry to hear about your shoulder trouble and insurance situation. @anonymous: Hi Elania, Thanks for stopping by and sharing. The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. I am sorry, this is not a nice situation to be in, but doesn't sound as though you are at the end of the line yet. I hope I have not waited to long for having this checked, and the only option will be surgery. 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? In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. There are many sub-types of SLAP tears and varying severity. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis.

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