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. So my tear went from a near full thickness tear to a full thickness tear. 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. Particularly about what many people are likely to experience during the often long road to recovery. The supraspinatus muscle provides stability to the glenohumeral joint and is a frequent source of pain and disability. A tendon is similar to a rope and you can compare the suprasinatus tendon to an inch wide . Drugs, supplements, and natural remedies may have dangerous side effects. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. I was released from the P.T. When I visit my DR. what are the thing I need to be aware for the diagnostic? Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. Good luck with it! All the best. This will help you figure out what you are deciding between. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. But shoulder exercises from now until I die. In this study, 24 patients who had full thickness supraspinatus tears and who opted to forego surgery were tracked over time. Even though most tears cannot heal on their own, you can often achieve good function without surgery. People who have partial thickness supraspinatus tendon tears following a fall or mechanical trauma often report similar symptoms to people with whiplash associated disorders (aka whiplash). 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. 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. Full thickness tears may involve only part of one tendon (usually the supraspinatus). This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. I slept in a recliner for about 2 1/2 months following surgery (I don't think I slept at all before surgery :) ). Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. Your doctor may recommend a diagnostic imaging study such as a magnetic resonance imaging (MRI) scan or ultrasound to confirm the diagnosis. After surgery, the repair must be protected from certain activities that may put healing at risk. I wrote a previous commentsaw my orthopedic surgeon this week. Those words exactly. 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. 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. Tendonosis literally means chronic pathology without inflammation (i.e. It sounds like you may be putting yourself at unnecessary risk? The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". She said she had never heard anything like that before and it was not my rotater cuff like everyone else believed. Your physician or orthopedic specialist should be able to give you specific advice about whether it is worth having an MRI in your specific case. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. 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. Bursal side: tears on the top of the tendon. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). The rotator cuff tendons attach to the head of the humerus in bony spots referred to as the greater and lesser tuberosities. Risk of infection and nerve damage are worthy of consideration for any surgery, particularly one as involved as a reverse shoulder replacement. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. 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. There are other things your physical therapist may be able to help you with to give you some relief in the short term. I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. Some minor tears may be treated without surgery. Decided to see ortho who ordered an MRi last week. They usually present as a sharp pain at the outside or front of the shoulder, particularly with arm elevation (raising the arm to the side or front). It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. The retracted margin of the tendon is at the level of the lateral and anterior margin of the anterior acromion. I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. 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. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. Medium. I'm sorry I can't provide you with specific advice, rather I only provide some general information. The recovery after surgical tendon repairs often takes longer than recovering from broken bones. There is no question that the word 'small' can be misleading regarding the amount of pain and discomfort that a supraspinatus tendon tear can cause. First, sorry for the delay in response. In full-thickness tears, surgery is indicated in many patients. Good luck with it! Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. Questions: 1. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. if your initial injury was work related. The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. Thanks for stopping by and leaving a comment. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. My arm is very weak. indications. 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 . The researchers used a custom-built shoulder testing system to measure the effects of varying loads placed on the muscles of the rotator cuff and parascapular muscles. If in doubt call your surgeons office. In many cases, surgery is required. I can't comment on the nature of care you have received, but I can say that you are not alone in this type of experience! I am sorry I can't provide you specific advice over the internet. Not too sure if this article is still active but I'll ask anyways. I've only got a couple of minutes, so I'll keep this short. I do not want a metal shoulder. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). 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. Thanks for stopping by and leaving a comment. Now I have these results stated above. Many persons with partial-thickness tears will never require surgery if they undergo an appropriate physical therapy rehabilitation to address muscle imbalances. I wish you a speedy and full recovery. I am sorry I can't give you specific advice but here is some general information that may be useful to you. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. It extends slightly into the proximal subscapularis bursa. 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. Waiting until after the delivery of your baby to re-attach the tendon may increase the chance of a poorer outcome (not to mention the difficulty nursing a newborn with only one functional arm). Thoughts on surgery? 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. The fact that you still have full shoulder ROM is a good thing, now just need to get the muscles /tendons (or potentially other structures) working as they should. This likely represents extension of an existing tear. A full rupture will require surgery (usually quite urgently). It is also very interesting to note that for those people who have persistent whiplash symptoms there is often a change in the way their brain processes sensation from the neck and shoulder region. Retraction of the supraspinatus tendon medial to the glenoid. That being said, I am scheduled for surgery on 6 Nov. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. 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. Thanks for sharing. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. Humeral head is riding high abutting the underside of the acromin process. Instantly a wave of incredible pain came over my entire arm, generating from the back of my shoulder all the way down to my hand. pain that gets worse when you lift your arm. @anonymous: Hi Hans, Thanks for stopping by and sharing your story. These muscles can be torn in a traumatic injury or simply by age-related wear and tear. 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. It seems to be a long recovery period with a great deal of physical therapy following. They may extend to become massive involving multiple tendons as shown in the figure. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). It's very good of you to reply so promptly and clearly though. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. You mention your shoulder makes a popping noise, generally speaking the sound a joint makes is not a good indicator of anything (particularly if the popping noise itself is not accompanied by pain). I'm just about at the point of desperation here. The rotator cuff exercises should not cause pain while the exercise is being performed. I have been seeing an orthopedic doctor for the past 18 months. I maybe take a few Advil a week with no loss of function at all. @anonymous: Thanks for keeping us up to date. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. (See Fig. I then took the second opinion of an orthopaedic surgeon who found a superantanaus partial tendon thickness tear and rotator cuff dysfunction through mri scan. These tears can be painful. Background: Good functional results have been reported for arthroscopic repair of rotator cuff tears, but the rate of tendon-to-bone healing is still unknown. I am wondering if I can recover without a surgery option. Even pain from a full-thickness tear can be relieved without surgery through exercises that make other muscles strong enough to pick up the slack. 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. Early diagnosis and treatment of a rotator cuff tear may prevent symptoms such as loss of strength and loss of motion from setting in. I am disappointed not to have been referred to a surgeon, but I have to admit the exercises have already helped me sleep better. 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. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. Good luck! 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. 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. No. It is plausible to sustain one or the other (or both) from a fall. Thanks for stopping by, you have raised some very good questions. There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described. Follow up not til next Wednesday. Had mild discomfort in shoulder for a few weeks in August. Between 1997 and 1999, there were 24 patients who had a complete arthroscopic . I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. 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? 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