I think this is a common dilemma that people face. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. Small. Good luck! its been 5 months since my partialthickness tear of mysupraspinatus the the footplate..im 56 and also have degenerative change o the acromioclavicular joint impinging on the supraspinatus at the myotendinous junctionNarrowing of the acromiohumral distancetenosynovitis of the lpng head of the bicepswill I need surgery???? What does he mean by my tendon is failing? A full thickness tear is not usually a complete rupture. After 4 months of therapy and 3 injections I am unable to lift my right arm. Click here to learn about partial thickness tears. 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. 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. Thanks for sharing. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. An exercise or physical therapy program is necessary to regain strength and improve function in the shoulder. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. Rotator cuff tendon augmentation grafts are a promising area of research. When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. Im a bodybuilder for years but I'm getting old. Mild AC arthropathy. I'm sorry I can't give you specific advice over the internet about the best option for your situation. The medical staff there did an x-ray, which did not turn anything up, and once again, were not overly concerned with my condition, but just instructed me to continue to ice pack my shoulder and take some pain medication. Either way, I wish you all the best with it (and a safe deployment and return). At 55 years of age you still have a lot of living still to do, so don't be afraid to talk openly with your doctor about the success rates for all of the options available to you, and the likely recovery times involved. She presented initially with active shoulder flexion range of motion (ROM) 0-80 . 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 instructed to ice pack my shoulder and take it easy. Visited many doctors and was always told it was nothing, the pain got unbearable and I saw yet another dr who was completely caught off guard my the loud pop my shoulder makes. Some simple tests during a physical examination should enable your doctor to determine whether your symptoms are likely to improved with a surgical repair of the tendon. It would be particularly unusual for a radiologist to see a tear that was non-existent (perhaps more likely to miss one that was hard to see than to see one that is not there). There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. Can a supraspinatus tendon tear heal itself? These tears can be painful. This can be one of the most frustrating things for people who have whiplash associated disorders. Thanks for stopping by and sharing your story. It must have been quite a knock, there is some quite serious damage there. infraspinatus tendon had full-thickness tear . Debridement involves trimming the frayed edges of the tear back to healthy tissue in order to allow it to heal itself. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. Thanks for stopping by and sharing your story. 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! HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. Thanks for posting your question. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. but can get back fairly good motion about the shoulder . Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. Couldn't even lay down. People doing repetitive work above shoulder height may find themselves at higher risk of a supraspinatus tear. Mary Kay. 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. 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. It sounds like you may have already discussed the likelihood of success with your surgeon, if not, this would be a very wise thing to do. There is synovial fluid at the glenohumeral articulation. Hope that helps. Good luck! These four muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) stabilize the glenohumeral joint, enable rotation around the joint, and provide a counterforce to . In many cases, surgery is required. 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 checked into my local VA hospital and initiated my disability claim. A full-thickness rotator cuff tear is characterized by a focal transmural tendon discontinuity, . Not too sure if this article is still active but I'll ask anyways. Good luck! Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. Edema is seen involving an intracapsular segment of biceps tendon with possible interstitial tears. Also not sure how long I should wait. An important thing to consider (as you have correctly mentioned) is that a reverse shoulder replacement is probably unlikely to restore normal shoulder function and resolve the pain if substantial soft tissue problems are still present in the tendons around the shoulder. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. A tendon is similar to a rope and you can compare the suprasinatus tendon to an inch wide . The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. How do you repair a rotator cuff tear? 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 stopping by, you have raised some very good questions. Sought 2 nd opinion 3weeks later due to the server pain. Surgical repairs can be compromised when post-operative instructions are not followed, so if you have surgery make sure you know exactly what you should and should not do! Usually getting a second opinion is not a bad option if you are not confident that the first opinion is going to lead to the best outcome for you, but I expect that may well be impossible while you are still on deployment? Unfortunately I can't give you specific advice over the internet. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. There are other things your physical therapist may be able to help you with to give you some relief in the short term. Any thoughts? If muscles of the rotator cuff are not providing adequate stability throughout the shoulder's range of motion, this can contribute to shoulder impingement and a break down of the supraspinatus tendon. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. I hope I have not waited to long for having this checked, and the only option will be surgery. Good luck! No tendon retraction or muscle belly atrophy. At approximately the 3:40 mark in the video above, there are a few exercises to help increase the range of the movement in the shoulder. The supraspinatus is part of the rotator cuff of the shoulder. Pitchers, swimmers, and tennis players are common examples. 6 months ago a different ortho diagnosed the problem as frozen shoulder and gave me a cortizone shot followed by physio therapy for few weeks. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. . 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. @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 Physician is online now Related Medical Questions 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). If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) Large. Retraction of the supraspinatus tendon medial to the glenoid. 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. ; 2. I am 55 yrs. Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. I left out a bunch of other things that are normal. It is also worth noting that whiplash associated disorders are complex. 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. I have lost about 45+% of my ROM in my right arm. From time to time tendons do rupture from a variety of causes, in your case it sounds like the surgeons description of rope fraying is a good one. Methods: Sixty-five consecutive shoulders with a chronic full-thickness supraspinatus tear were repaired arthroscopically in sixty-five patients with use of a tension-band suture technique. Many persons with partial-thickness tears will never require surgery if they undergo an appropriate physical therapy rehabilitation to address muscle imbalances. In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. 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. However it does bother me when i open the car door and my current range of left arm is restricted when i left up straight. That was July of 2011. I see this is true of SSGtomn who has left a comment already. It also allows a quick comparison between the affected shoulder and the healthy shoulder. 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. If it has been a while since the MRI, this may involve getting another one (as tendinosis can weaken the tendon, which may in turn lead to larger tears or even a complete rupture), it may also involve a trial of PT or a referral directly to an orthopedic surgeon. If in doubt call your surgeons office. I am wondering if I can recover without a surgery option. It is good that you have discussed the recovery with your surgeon already. Generally speaking, treatment options for shoulder injuries that include supraspinatus tendon tears and other findings similar to those you have reported could include surgery, or more conservative treatments like a trial of physical therapy or injections. Symptomatic full thickness rotator cuff tears can be managed surgically. What little I have done has given me improvement. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). 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. In some cases, surgery to repair the tendon is also required. 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. I am sorry I can't give you specific advice but here is some general information that may be useful to you. No, it may not be too late to get relief. In my reports say that I have less fluid and possible tear. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. 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. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). Superior subluxation of the humeral head. 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? I was very optimistic about the P.T. Some people will say that exercises didn't work for them, but it turns out actually doing the exercises (rather than just thinking about them) drastically increases the chance of them being effective! Went down a water slide on a mat head first arms supporting my body. There is some really good information in what you have said. Good luck with it either way. All rights reserved. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. I mention this, as this will often influence treatment decisions. Thank you for the info posted on this page. What does all that mean in simple layman terms? 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%. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. I wrote a previous commentsaw my orthopedic surgeon this week. MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). I have had this problem with my shoulder/arm for about 6 months maybe. This information is provided as an educational service and is not intended to serve as medical advice. Now I have these results stated above. @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. There is inhomogeneous and bulbous appearance of the distal .subscapularis tendon with tendinosis. Acute Tear If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. i was recently diagnosed via MRI that i have a supraspinatus tendon tear. Your doctor may recommend a diagnostic imaging study such as a magnetic resonance imaging (MRI) scan or ultrasound to confirm the diagnosis. Complete rehabilitation after surgery may take several months or even up to a year. Wish me luck!!! There may also be insurance implications etc. If you get a chance, drop by and let us know how you go with your recovery! The four muscles supraspinatus, infraspinatus, subscapularis and teres minor originate from the scapula (shoulder blade). However, I can just mention some general information that may be of interest. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! The radiomics model of no tears or tears achieved a high overall accuracy of 93.6%, sensitivity of 91.6%, and specificity of 95.2% for supraspinatus tendon tears. The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. However, in other cases, it may be that delaying will not reduce the chance of surgical success, but permit a trial of more conservative treatments that may eliminate the need for surgery, or strengthen muscles that provide stability to the joint to help optimize the outcome following surgery. 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