Partial or full thickness tears that are not complete ruptures are generally far more common than complete ruptures (not common, but require surgery with some level of urgency). Been thoroughly researching (scr surgery)Superior capsular reconstruction. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. I see this is true of SSGtomn who has left a comment already. My question to you is why can they not try to repair the rotator cuff using a graft of somesort. Patients 80 years and over have an even higher occurrence rate of 80%. I will congratulate you on actually doing your exercises! The outcomes to be included will be range of motion, muscle strength, rotator cuff integrity, pain scores, shoulder function, patient satisfaction, and quality of life. Her MRI shows a full thickness tear of supraspinatus tendon and a tear of the majority of the infraspinatus tendon (with a few lower infraspinatus fibers still attached). Unfortunately I can't give you specific advice over the internet, without conducting a physical examination etc. make sure you do it some place where anesthesia will do an interscalene block for post op pain relief. Arthroscopic shoulder surgery may be required, or even rotator cuff tear procedures may be advised depending on the extent of the injury or damage to your supraspinatus muscle and surrounding bones, tendons, and muscles. This is just general information of course. Elderly patients; full thickness rotator cuff tear; non-surgical and surgical treatment. When a surgeon sutures 1 a healthy tendon, it holds. Some minor tears may be treated without surgery. Degeneration of the infraspinatus tendon with bursa side fraying. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. Particularly about what many people are likely to experience during the often long road to recovery. 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. left supraspinatus tendon tear,so what the process of curing? Article Google Scholar Ratte-Larouche M, Szekeres M, Sadi J, Faber KJ. Overall, it will often take 6 months or more before the shoulder is completely back to normal. Dr. Mike. Thanks for stopping by and sharing your interesting story. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. 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. It sounds like you may be putting yourself at unnecessary risk? @anonymous: Oh Tonia, I feel for you. 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. All material on this website is protected by copyright. I have not returned back. Here is some general information which I hope is useful for you: 1. Popping noises can occur for a variety of reasons, the most common of which are completely normal. I have had this problem with my shoulder/arm for about 6 months maybe. I'm not really sure how the whole army doctor situation works while you are on deployment, but I think if you have ongoing symptoms then it is worth making sure the appropriate people know. !!! Couldn't even lay down. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. This has caused thickening and abnormal signal in the supraspinatus tendon consistent with tendinopathy and/or a partial tear. working a full time job nd being a mother of three I could never fit it in my schedule but was also told by a family member that PT would not help. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. 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. There are many sub-types of SLAP tears and varying severity. Anyone want to shed a little light for a vet? 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. This may result in pain and weakness of the shoulder. An easy way to understand what I mean is to think about eating a steak. If you have a degenerative tear in one shoulder, there is a greater likelihood of a rotator cuff tear in the opposite shoulder even if you have no pain in that shoulder. 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. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. 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. This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. Full thickness tearing is characterized by the complete removal of the tendon from the bone.2 This includes large tears (35 cm) and massive tears (>5 cm).3 In the geriatric population, rotator cuff tears are a prominent clinical problem and many patients report difficulty with routine tasks of daily living. One of the most painful experiences ever. These types of tears can also be symptomatic meaning that it causes significant pain and impedes your ability to perform basic everyday tasks or asymptomatic, meaning that the tear doesnt cause significant pain, but should still be monitored by an orthopaedic surgeon since tears can grow worse over time. Your doctor may also advise a trial of physical therapy to see if that can bring relief to his symptoms. On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. I went to one orthopedic doctor and he immediately said surgery is my only option. 27. Must also have to bring the arm back with my other arm if I am lying and have the arm overheadwhich now longer will lie flat on the floor if it is overhead.It has been recommende to do ART then PRP and possibly prolotherapy. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. Data extraction will be undertaken by the primary author with verification by another author to minimize potential bias and potential errors. Thanks for sharing this detailed account with everyone. 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???? 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. Kim SH, Ha KI, Park JH, Kang JS, Oh SK, Oh I. Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years follow-up. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. The search strategy will aim to find both published and unpublished studies. If I need surgery,what is the recovry time.. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. I left out a bunch of other things that are normal. Abrisham SM, Kermani-Alghoraishi M, Ghahramani R, Jabbari L, Jomeh H, Zare M. Additive effects of low-level laser therapy with exercise on subacromial syndrome: a randomised, double-blind, controlled trial. That being said, I am scheduled for surgery on 6 Nov. For more information, please refer to our Privacy Policy. 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. muscle atrophy of supraspinatus, infraspinatus, and subscapularis muscles, 3.) 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 don't think there is a clear answer to this one. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. Some days later, I was called back to the VA so they could tell me what they found. Full thickness tears will not heal without surgery. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. I wish you a speedy and full recovery. After a formal assessment, they will be able to prescribe a course of rehabilitative exercises or recommend surgery. Schmidt CC, Jarrett CD, Brown BT. 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. Should this shoulder have an MRI? Moderate subacromial/sub deltoid bursitis. In the supraspinatus tendon, increased expression of MMP-1, MMP-9, MMP-13, and vascular endothelial growth factor was found in the full-thickness group. Good luck! I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. If the injection does give you pain relief, it may allow you a couple of months without pain to do exercises that can strengthen your rotator cuff and improve the biomechanics at your shoulder in an effort to reduce irritation of the bursa and Supraspinatus tendon. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. 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. 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. Effect sizes will be expressed as either odds ratios (for dichotomous data or weighted (or standardized) mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. Read about knee pain, especially from a torn meniscus. Any thoughts? Hope that helps. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. Rotator Cuff Tears in the. The rotator cuff is a group of four muscles and their associated tendons that originate from locations on the scapula and insert onto the humeral head. Of the eight studies included in the review, seven focused on surgical treatment and one compared the efficacy of sodium hyaluronate against corticosteroid injection. 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. As such, no conclusion on non-surgical treatments was reached. That means it becomes more like fatty tissue. There also is mild tendinosis of the infraspinatus at the footprint. 21. Let us know how you go. I have been seeing an orthopedic doctor for the past 18 months. You may have shoulder pain and arm weakness. He kind of scared me regarding the recovery for this. Rising trends in surgery for rotator cuff disease in Western Australia. This kind of tear does not heal on its own. Because most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging, people over 40 are at greater risk. Here are the causes and treatments. I've seen musicians and artists with poor shoulder function be able to perform their art as well as they did before their injury; sometimes through making some adaptations, but other times almost no adaptation was required (depending on their technique / instrument / art etc.). He did say that it can be done in the next few months and no urgent intervention required. Dr Mike, Please help me understand what options I might have in my case of job relater incident. If youve experienced acute damage or a recent shoulder injury, or are otherwise experiencing pain in your shoulder or rotator cuff area, consult your doctor and an orthopaedic surgeon as soon as possible, particularly if you work in a field, play a sport, or have a hobby that involves lots of overhead lifting and repetitive arm motions. 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. Hope that helps! What little I have done has given me improvement. 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. 14. 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. its been three months with some pt but no noticeable improvement. )amount of fluid in acromioclavicular joint and last but not least 5.) Selected studies will be critically appraised by two independent reviewers using standardized critical appraisal instruments from JBI SUMARI. 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). 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. I was very optimistic about the P.T. Could this require surgery. With complete tears, the tendon has come off (detached) from where it was attached to the bone. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. The pain is manageable if you stay on top of it with pain medication. 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. In my reports say that I have less fluid and possible tear. 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. In your opinion, do I have any other option other than surgery? There are a few options for repairing rotator cuff tears. Medicine and physiotherapy often. Injury to the rotator cuff is common and progression of injury typically begins in the supraspinatus tendon mostly as a result of an intrinsic attritional process that leads to partial and eventually full-thickness tearing. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. I have had shoulder pain for years and years. The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm (humerus bone). Thorpe A, Hurworth M, O'Sullivan P, Mitchell T, Smith A. Either way, this kind of ongoing shoulder pain is not good. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. You mentioned rotator cuff and tendonosis like they were different things. 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. Small to moderate glenohumeral joint effusion. Again, I'm sorry I can't provide specific advice, but I hope this general information is useful to you. Good luck! Thanks for stopping by and leaving a comment. I am 55 yrs. Generally speaking, for shoulder pain related to rotator cuff injuries following trauma, often the first strategy is to see whether the pain and other symptoms improve with non-surgical management approaches. However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. If not what is this indictative of. Thanks for stopping by and leaving a comment! This includes small (01 cm) and medium (13 cm) tears. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. This review will consider studies that have measured one or more of the following outcomes: This review will consider randomized controlled trials, pseudo-randomized controlled trials, quasi-experimental studies, case-control studies and cohort studies. Jacquot A, Dezaly C, Goetzmann T, Roche O, Sirveaux F, Mole D. Is rotator cuff repair appropriate in patients older than 60 years of age? 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. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. 4. 2 Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, . Injection therapy, including corticosteroids, hyaluronic acid and platelet-rich plasma. Nike shoes helped manage my plantar fasciitis. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. Supraspinatus tendon tears require specific rehabilitation of the rotator cuff and muscles that stabilize the shoulder blade. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. They decided to do a re examination of my MRI to see if there was something they were missing. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. If you have any uncertainty around the need for your sling use, please call your surgeon's office today. Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. Good luck! These are recommendations only and may not apply to every case. Thanks. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. Painters, carpenters, and others who do overhead work also have a greater chance for tears. Either way, I wish you all the best with it (and a safe deployment and return). I had periodic pain and tingling running all the way down my forearm. I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. There are several treatment options for a rotator cuff tear, and the best option is different for every person. 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. ), a shoulder x-ray may not reveal anything conclusive. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. 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! If you get a chance please let us know how you go. I do so appreciate the advice and direction you have given to myself and others through this posting. In these cases often a multidisciplinary treatment team skilled in treating whiplash can be very useful (this may include health professionals like physiotherapists, psychologists, occupational therapists and doctors). Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do. But not result in a normal shoulder. This degeneration naturally occurs as we age and in most cases is relatively painless. Thanks for the update and let us know how you go. Lots of people express feeling useless, frustrated, and angry at times. Mild AC arthropathy. @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. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. Most people who I have seen with whiplash (albeit usually from motor vehicle accidents more than falls) tend to notice a great deal of improvement over the first few weeks, but some have symptoms that persist. However, in some cases it is clear that surgery is likely to be the best option. In about 80 to 85% of patients, nonsurgical treatment relieves pain and improves function in the shoulder. Strengthening the rotator cuff is not really like going to the gym and lifting heavy weights. MRI). the defect measures approximately 1cm anterior to posterior and medial to lateral. Have been taking 800 mg Motrin tid. Many professions require repetitive or heavy overhead work (roof plasterer etc.). Starting with Physio treatment is a good idea. @anonymous: mike but not dr. mike. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. Studies have reported that, compared to older individuals, younger patients under 55 years have a higher ratio of smaller tears likely to occur from traumatic events.5,6 Patients over 60 have been found to be twice as likely to experience large rotator cuff tears and three times more likely to experience massive rotator cuff tears compared with younger patients.7,8 The prevalence of full-thickness rotator cuff tears may occur in up to 22% of all patients over 65.9 Approximately 25% of patients in their 60 s and 45% of patients in their 70 s suffer from rotator cuff tears.10 Patients 80 years and over have an even higher occurrence rate of 80%.8, Rotator cuff tear management aims to relieve pain, restore movement and improve function of the shoulder. The effect of neuromuscular electrical stimulation of the infraspinatus on shoulder external rotation force production after rotator cuff repair surgery. 2. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. Stay informed on the latest news and updates from Melbourne Arm Clinic. The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. You may have pain in the shoulder when you lift your arm, or pain that moves down your arm. Consult with your orthopaedic surgeon to determine the best solution for your case, your supraspinatus tears, any other associated injuries, and your lifestyle. There are other things your physical therapist may be able to help you with to give you some relief in the short term. @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. It will be your Godsend. 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. I am unable to carry any significant weight. Being deployed and not receiving treatment makes it difficult. Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. Shoulder function, measured by shoulder-specific scales including but not limited to ASES, Simple Shoulder Test, UCLA shoulder scoring scale. Let us know how things turn out for you. 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). The popping may or may not be related to your shoulder pain (difficult for me to say without an examination etc.) Questions: 1. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. The incident happened on Sept 25 and it is now Nov 10. Thanks for stopping by. Especially since my injury has gotten worse instead of better. Should you tell him what the other surgeons name is and what they advised. 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. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. Good luck! Don't be afraid to ask your surgeon about all your treatment options. Abstract Background: Our hypothesis was that arthroscopic repair of full-thickness supraspinatus tears achieves a rate of complete tendon healing equivalent to those reported in the literature with open or mini-open techniques. The first relates to the potential risk of a poorer outcome due to the delay; this may occur due to further damage being caused in structures that are difficult or impossible to repair etc. Efficacy of platelet-rich plasma in arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis. I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). Although very uncommon, it is possible that the report did contain an error. Good luck! 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.