have got bursal thickening as well and mild thickening of. There are two categories of supraspinatus tears, degenerative and acute. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. I just received my MRI report which states : supraspinatus tendon is thickened and immediate in signal, with a small 3mm (transverse) x 3mm (AP) full thickness footplate tear. It is best to stick within the range of movement indicated on the video rather than try to rotate your arm too far out to the side and potentially aggravate already inflamed rotator cuff tendons. Elderly patients; full thickness rotator cuff tear; non-surgical and surgical treatment. People who play baseball, tennis, and similar sports with a lot of overhead or overarm motions as well people in trades like painting, carpentry, plumbing, and other construction work that involves a lot of overhead motion are also more prone to degenerative tears of the supraspinatus and the other tendons that make up your shoulder joint. Gumina S, Carbone S, Campagna V, Candela V, Sacchetti FM, Giannicola G. The impact of aging on rotator cuff tear size. It is difficult for me to comment further based on this information. The main action of the supraspinatus muscle is to abduct the shoulder joint (lift your arm out sideways and upwards). Shoulder dislocation, shoulder instability, and shoulder subluxation can all coexist or happen as the result of a partial or full thickness shoulder supraspinatus tear, particularly when these tears occur as a result of trauma to the shoulder joint or acute injury. The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. (Right) A full-thickness tear in the supraspinatus tendon. 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. Some general information you may find useful is that generally not a lot of people seem to have a full recovery following a SLAP lesion without surgery. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. I also have no insurance and don't know about surgery. I wish you a speedy and full recovery. 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. is PT a good options. My doctor has told me I need to have arthroscopic revision rotator cuff repair. So my tear went from a near full thickness tear to a full thickness tear. You may be trying to access this site from a secured browser on the server. A full thickness tear of the supraspinatus. I left out a bunch of other things that are normal. your express consent. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. 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. 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. Drugs, supplements, and natural remedies may have dangerous side effects. 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). Because of the risk of infection and and nerve damage. In general terms of the types of MRI findings you have described, a combination of these types of pathology could require surgery; particularly if symptoms persisted after trying non-surgical interventions. I am in aching pain consistently. Your doctor will test your range of motion by having you move your arm in different directions. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. Massage may give you some short term relief, but I'm not sure massage on its own will have long term benefit that is additional to natural healing. Data will be extracted from papers included in the review using standardized data extraction tools in JBI SUMARI.26 The data extracted will include specific details about the populations, interventions, study methods and outcomes of significance to the review question and objectives. 4. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. @anonymous: Hi Kazikp, I am sorry I cannot give you advice over the internet but here is some general information you may find useful. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. Moraiti C, Valle P, Maqdes A, Boughebri O, Dib C, Giakas G, et al. It can be difficult to find good information on the web for specific rehabilitation following surgery. These are recommendations only and may not apply to every case. Second, I am sorry to hear about your fall and subsequent shoulder pain. I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. muscle atrophy of supraspinatus, infraspinatus, and subscapularis muscles, 3.) @DrMikeM: wheather arthoscopy surgry ll help for my injury sir ?what type of surgery needed for dis type of injuries sir.ortho doc told Do exercise for 2 weeks aftr tat if it not improved ll do arthoscopic surgery sir Due to a fall and resulting shoulder pain my doctor prescribed to have an MRI, the findings were; moderate tendinitis in the supraspinatus. Thank you. Athletes are especially vulnerable to overuse tears, particularly tennis players and baseball pitchers. You may still be able to return to most or all of the things you enjoy it just may not be in the next 6 to 9 months though. Rotator Cuff Tears: Surgical Treatment Options, Rotator Cuff Tears: Frequently Asked Questions, Shoulder Impingement/Rotator Cuff Tendinitis. Muscular and tendinous structures including remaining portions of the rotator cuff are also felt to remain otherwise unremarkable in signal and morphology. The initial keywords include rotator cuff tear, full-thickness tear, elderly, conservative treatment and surgery: This review is to contribute to the completion of the Master of Clinical Science degree at The University of Adelaide, Adelaide, South Australia, for MN. Some studies suggest that young patients with traumatic tears may be best managed with surgery while many atraumatic rotator cuff tears, which is common in older patients, may be amenable to a non-surgical treatment.4 In addition, compared to younger patients (<50), rotator cuff tears in older patients (>70) are characterized by greater retraction in the frontal plane and greater fatty infiltration.6 A study showed that only 82.5% of rotator cuff tear patients older than 70 who exhibited these features had supraspinatus involvement and underwent arthroscopic rotator cuff repair achieved complete healing, compared to 95% in patients under 50. Management of Rotator Cuff Tears. I'll go check out some of your lenses now. Efficacy of platelet-rich plasma in arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis. @DrMikeM: Thank you Dr. Mike for answering my question. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. When he says your tendon is failing, I think what he is trying to convey is that once some strands of a rope start to break, then there is more load on the remaining strands which may cause more strands to break (and then more load on remaining individual strands, more strands tear and so on). It is interesting that you are not experiencing a lot of discomfort with a very large tear, but this sometimes happens and can lead to difficulty in diagnosing the exact structural damage that is causing the condition. It is certainly worth discussing a more conservative approach, such as seeing a physical therapist that specializes in shoulders, with your orthopedic surgeon; particularly if you feel you have noticed improvements previously. I would make sure your surgeon knows you are planning on falling pregnant within the next 12 months. Tears that develop slowly due to overuse may also cause pain and arm weakness. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. Time progressed, pain continued and my ROM slowly worsened. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. @anonymous: Dude, I just did nearly the exact same thing. pendulum), which should be undertaken ensuring correct technique). Your message has been successfully sent to your colleague. However, I can just mention some general information that may be of interest. Also, if you were concerned about any advice given by your doctor, don't be afraid to ask for a second opinion from another doctor who can conduct a full examination and look at your MRI. The bursa allows the rotator cuff tendons to glide freely when you move your arm. Once the full thickness of the tendon is torn, we classify the tears based upon the shape and the number of tendons involved. You can live with a damaged rotator cuff for some time, especially the tearing is minimal and you can manage the pain with activity modification. Rotator cuff exercises are often prescribed for people with a partial tear of the supraspinatus tendon. As such, no conclusion on non-surgical treatments was reached. 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. but unfortunately, the results were extremely minor. 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. twice, second time relief only lasted 5 minutes) finally local doc ordered M.R.I. Please try after some time. Went to an orthopedic surgeon who said I had frozen shoulder and injected the capsule with cortisone and told me to return in 3 months. I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) Three kids will no doubt also be keeping you busy and missing out sleep because of your shoulder pain doesn't sound like much fun. Good luck! Pain continued and got worse. HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. An acute tear of the supraspinatus muscle can occur alongside injuries like shoulder dislocation, clavicle fractures, or other rotator cuff injuries that can happen as the result of things like a fall on your outstretched arm or attempting to lift something too heavy; plus there are a variety of sports where the athletes are prone to shoulder damage like baseball, basketball, rugby, AFL Football, and tennis. Players involved in sports requiring fast throwing actions (baseball) or overhead hitting (volleyball, tennis) may also sustain a traumatic injury to their rotator cuff and the supraspinatus tendon in particular. Some people need surgery to reattach a torn rotator cuff. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. I was in a car accident about 18 months ago with damage to my left side of my body, stated with my fingers, to my leg and lastly my arm. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. RCTs in older patients are predominantly attributed to degenerative tears. Dr. Mike great info here thanks. Thanks for stopping by and leaving a comment. This will inform the development of a search strategy which will be tailored for each information source. The supraspinatus is part of the rotator cuff of the shoulder. Good luck! Additional surgical techniques not found in the previous systematic review have been added to this review. The results of the search will be reported in full in the final report and presented in a PRISMA flow diagram. I hope some of the general information I provided in my response to Tim's (or others) comment is useful. The close proximity of the supraspinatus tendon to the acromion-clavicular arch is a common contributing factor in supraspinatus tears, particularly when the tendon becomes impinged between these bone structures with activities that require arm elevation. I saw doctor initially who said physiotherapy will help it. 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. The supraspinatus tendon is located on the back of your shoulder and helps your arm to move throughout its full range of motion and helps with power and strength. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. I say promising because work in basic science and animal studies have demonstrated some quite promising findings. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. It is located in the top portion of the back of the shoulder blade (the superior posterior portion above the spine of the scapula) known as the supraspinatus fossa. I have pain all the time, it hurts to put a shirt on, can't lay on it, reaching out to my side it hurts to turn my pillow. I'm sorry I can't give you specific advice on your case over the internet. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. Full-thickness rotator cuff tear | Radiology Reference Article 14. 10. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. 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). It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) Old age is also a major factor in supraspinatus tears; in fact, over 50% of people over seventy years old have a supraspinatus tear when they pass. Consult with your orthopaedic surgeon to determine the best solution for your case, your supraspinatus tears, any other associated injuries, and your lifestyle. )amount of fluid in acromioclavicular joint and last but not least 5.) thank you for your considiration and helle from Turkey:-). There are other things your physical therapist may be able to help you with to give you some relief in the short term. It seems as though you have now had two MRI reports. Treatment options, tips, knee surgery info, and medical videos are included. 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. 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. Garofalo R, Flanagin B, Castagna A, Calvisi V, Krishnan SG. It sounds as though you know a little bit about your shoulder situation already, so I won't re-state details about the anatomy that is affected. Modify Sport Techniques . Lol. I have a feeling this is going to be a long recovery! I'm only 38 and am not willing to give up everything I love doing and from what I read there are many more options available. If you do have surgery, this would mean you couldn't work on usual duties for several months (recovery time-frames are something worth discussing with your doctor). I found the information good. Lazarides AL, Alentorn-Geli E, Choi JH, Stuart JJ, Lo IK, Garrigues GE, et al. I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. 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). These tears can be painful. 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. 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'll go check out some of your Lenses. 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? Generally speaking, do small tears need surgical repair? Good luck! Studies published from 2010 up to present will be included, as the review conducted by Downie, B. et al. @anonymous: Thanks for keeping us up to date. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. Some people will recover quickly without any treatment, other people will recover after commencing non-surgical interventions (such as physical therapy and rotator cuff exercises and / or receiving a steroid injection), while others will still have pain after many months and may require surgery. Indirect signs on MRI are - subdeltoid bursal effusion, particularly if anterior, medial dislocation of biceps, fluid along biceps tendon . If you want any further clarification just post any follow up question. It would be much wiser to follow your surgeons instructions (which usually involve keeping arm in sling for 6+ weeks depending on surgery / surgeon etc. Rotator Cuff Tears - OrthoInfo - AAOS Dr. Raymond Wittstadt answered Hand Surgery 38 years experience Rotator Cuff Tear: If you are 31 and have a full thickness tear of your suprspinatous tendon, you have a problem. As I think you already suspect, an MRI is likely to have greater diagnostic accuracy for ruling out (or in) the involvement of other structures in your shoulder, such as the long head of Biceps Brachi. Physical examinations, imaging tests like X-rays, magnetic resonance imaging (MRIs), and ultrasound scans are all used to diagnose supraspinatus tears. 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%. What does he mean by my tendon is failing? Had mild discomfort in shoulder for a few weeks in August. I just had an MRI I have a tiny, focal intratendon tear of the supraspinatus fibers at the humeral insertion measuring 2mm with minor impingement changes are noted in the greater tuberosity of the humerus. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. Your orthopaedic surgeon will discuss with you the best procedure to meet your individual health needs. Geary MB, Elfar JC. 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). Here are the best Nike shoes for heel pain when you have this uncomfortable condition. Painters, carpenters, and others who do overhead work also have a greater chance for tears. My arm was nearly frozen for a period of about 10 minutes, but I slowly started regaining some ROM. A rotator cuff tear is a common cause of shoulder pain and disability among adults. Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. What happens to patients when we do not repair their cuff tears? Five Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. Original injury was 4 years ago in a MVA and I've been experiencing pain when sleeping on injured side, intermittent loss of sensation for the entire arm resulting in dropping things, loss of muscular endurance and increased pain for repetitive activities ranging from ribcage level and upward, loss of muscular strength and increased pain for lifting objects at the present moment equivalent in weight to a litre of milk or heavier, and an overall sense of lack of spacial awareness for the injured arm as if my arm is not "connected" to my body. This will help you figure out what you are deciding between. It's also a new procedure to deal with this problem. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. Please try again soon. Over-the-counter medication, such as aspirin, ibuprofen, or naproxen, may relieve the pain. Good luck with it. 2. mild labral degeneration. A rotator cuff tear can get larger over time. Some days later, I was called back to the VA so they could tell me what they found. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. ( x-ray, phys ther,corticosteroid inj. Physiotherapy interventions typically consist of stretching and strengthening exercises but can also include electrotherapy and other physical modalities such as ultrasound, moist heat and laser therapy.16-19 Treatment by injections in recent studies often involves corticosteroids, hyaluronic acid and platelet-rich plasma.20-22 The literature suggests that the majority of patients begin with non-surgical treatment and if pain persists or improvement in function is less than optimal, surgery is considered. but can get back fairly good motion about the shoulder . Thanks! I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. Rest, pain relievers and physical therapy can help. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. Although very uncommon, it is possible that the report did contain an error. Full thickness tear of supraspinatus tendon treatment Mild AC arthropathy. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. Deciding to have surgery is never an easy decision and you may require some time to recover, but if your shoulder joint issues such as supraspinatus tear are having a significant negative impact on your life, surgery and the associated downtime and physiotherapy may very well be worth it. sir i am a shuttle badminton player.. i got injury on my shoulder .. doc told to tke MRI scan.. after taking MRI scan these are the final impressions.. 1.partial tear in the supraspinatus tendon at the level of insertion in the greater tubersity for a length of about 15mm with intact insertion, 2 partial tear in the anterior superior labrum. I was instructed to ice pack my shoulder and take it easy. No black and white answer for this one I'm afraid. 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). The reference list of all studies selected for critical appraisal will be screened for additional studies. My best wishes go to all of them. Thanks for stopping by and sharing your story. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. When getting a second opinion from another surgeon. 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. The review will exclude studies which include patients with concomitant shoulder conditions such as osteoarthritis, fractures, osteonecrosis, instability, and additional intra-articular pathology or acromion morphology, as these conditions may necessitate intervention/s that may be different from patients who have rotator cuff tear only. This article will discuss the nature of tendon injuries in the hand, how to know if, in fact, a tendon has been severed, and some tips on how to avoid such injuries. I have spoke with people that have had surgery on their shoulder and they say that is a very painful surgery, and they still have problems from time to time with their shoulder. Your orthopedic specialist will be able to give you advice about the best option for your circumstances. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. An Overview of a Supraspinatus Tendon Tear. OpenStax College (CC 3.0) via Wikimedia Commons. 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.