A full-thickness tear will decrease the capacity of a muscle to do work. will consult surgeon next week. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. I'm still processing in my head what I heard in a VM left 10hrs ago, because I finally found out the findings from my shoulder MRI/Arthogram completed about 6 weeks ago. 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 see this is true of SSGtomn who has left a comment already. The reverse shoulder surgery is extremely involved so I am getting a second opinion. Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. 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. Once the full thickness of the tendon is torn, we classify the tears based upon the shape and the number of tendons involved. It extends slightly into the proximal subscapularis bursa. All material on this website is protected by copyright. Full-thickness rotator cuff tears are diagnosed with the help of a thorough history and physical examination, as well as the use of imaging studies, most commonly, MRI. I hope I will not follow suit! It must have been quite a knock, there is some quite serious damage there. 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. 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. 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. I had periodic pain and tingling running all the way down my forearm. Surgical repair can often be . Dr. Burks explains what the injury is and when to . 50% of symptomatic full-thickness tears progress at 2 years and bigger tears progress faster. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. Went down a water slide on a mat head first arms supporting my body. This may not give immediate relief, but hopefully will show some benefit within 6 weeks. My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. . @anonymous: Hi Hans, Thanks for stopping by and sharing your story. Good luck with it. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. I work construction and am self employed. Instead specific movements are required, these shouldn't cause pain while performing the exercise. 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. Some general information that may be useful to know is that some people who have similar pathology to that which you have described end up having surgery while other do not. After a formal assessment, they will be able to prescribe a course of rehabilitative exercises or recommend surgery. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). 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. Pain continued and got worse. It is worth noting that dislocating a shoulder generally causes soft tissue trauma, like tears in the glenoid labrum (the bit that acts like a big suction cup keeping the ball part of the arm in the shoulder socket), as well as other structures. At the . Ongoing serious pain influencing daily life, sleep etc. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. It is good that you have discussed the recovery with your surgeon already. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. 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. I was instructed to ice pack my shoulder and take it easy. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. You mentioned rotator cuff and tendonosis like they were different things. Those words exactly. The supraspinatus is the tendon that tends to suffer from partial tears most commonly. I do not want a metal shoulder. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. 2023 The Arena Media Brands, LLC and respective content providers on this website. for an examination, an x-ray or MRI, but other times soft tissue injuries can lead people to report similar symptoms even though no dislocation occurred. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. 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. Pain is moderate. I saw doctor initially who said physiotherapy will help it. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. 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! Jackie. I have had this problem with my shoulder/arm for about 6 months maybe. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. i d glad if ortopedist or physiotherapist reply ansver. Dr Mike, Please help me understand what options I might have in my case of job relater incident. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. @anonymous: Dude, I just did nearly the exact same thing. I now am having surgery but is it safe to have with whiplash symptoms. I'm 43 and have been suffering from shoulder issues for over a year. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. But shoulder exercises from now until I die. Thanks for sharing this detailed account with everyone. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. I hope your shoulder has now recovered! 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. It may be as small as a pinpoint, or the tear may involve the entire tendon. Then follow up by asking him about any risks associated with the surgery in your particular case (your surgeon should know your particular circumstances in detail and be able to provide you with specific advice about options available to you). The supraspinatus tendon is the one most likely to become torn. Good luck with it! 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. You have asked for information about potential options. Thanks for the update and let us know how you go. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. Avoiding work above shoulder height can sometimes avoid aggravating the pain. Many professions require repetitive or heavy overhead work (roof plasterer etc.). Thanks for posting your question. Sought 2 nd opinion 3weeks later due to the server pain. Thankyou. Surgical repair can often be . At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . I'm just about at the point of desperation here. 8% (102/1251) Supraspinatus tendon tear symptoms commonly go on for months (or even years) until the underlying problem is resolved (usually through improving the functioning of the rotator cuff, surgery, or both). There are at least three important factors that contribute to supraspinatus tendon tears. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. Partial or Full-Thickness Tear If there is a partial or full-thickness tear (but not a complete rupture) surgery may or may not be required and is best discussed with your orthopedic surgeon and/or physical therapist after appropriate imaging investigations have been undertaken. Full-thickness tears of the supraspinatus and infraspinatus tendons at their attachment site with retraction of torn fibers up to the lateral aspects of the acromial process. Generally speaking, do small tears need surgical repair? It is important the the surgical repair of the tendon is protected initially to ensure that a re-injury does not occur. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. 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. Being deployed and not receiving treatment makes it difficult. Don't be afraid to ask your surgeon about all your treatment options. There also is mild tendinosis of the infraspinatus at the footprint. Some minor tears may be treated without surgery. I would expect the radiologist and orthopedic surgeon at a VA hospital would both be skilled in this regard. Rotator cuff tears may be degenerative (the defect arose in tendon of poor quality) or they may be traumatic (the tear arose from a major injury to otherwise healthy tissue). 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. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. Good luck! If you are in doubt, don't be afraid to get a second opinion. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. Remaining tendons of the rotator cuff are normal in signal and morphology. Good luck! Thoughts on surgery? This is partly because rehabilitation following surgery will depend on the surgical technique used. ; 3; Where can I found documentation in the web for the rehabilitation? Each of the rotator cuff muscles can be affected; the supraspinatus muscle is most commonly affected, followed by the infraspinatus, the subscapularis and the teres minor muscles. Hope that helps. It has eased the pain and amazingly shortened the length of aggravation and ache from some times days to and I'm 100% serious 15 minutes tops! I am sure lots of people would like to hear how it turns out for you. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). You don't need to lean over as far as demonstrated in this video. I don't lay on the side of the hurt arm as I don't think it will be good for it. Hope that helps! . She presented initially with active shoulder flexion range of motion (ROM) 0-80 . Thanks for sharing. So quite often the best treatment approach is not always immediately clear. I plan on asking the surgeon these questions, but wanted your expert opinion. Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. Could this require surgery. If your tendon were to completely rupture while you were pregnant, this may be very problematic. Full-thickness rotator cuff tears are diagnosed with the help of a thorough history and physical examination, as well as the use of imaging studies, most commonly, MRI. D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. Modify Sport Techniques . My question to you is why can they not try to repair the rotator cuff using a graft of somesort. 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. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. I do not want a metal shoulder. This may give you relief, even if you have been getting symptoms for a few years. I am really hoping to find some outside advice. In 9 of the 24 the tear was smaller. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. It is also worth knowing there are just some jobs that seem to take a heavy toll on shoulders / supraspinatus tendons (unfortunately I think painter / sheet rock installer / any occupation where you need to hold things up above shoulder or head height are right at the top of that list). Good luck! Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. However, some people will never experience the same level of recovery without the surgery. An exercise or physical therapy program is necessary to regain strength and improve function in the shoulder. Some quite compelling research has indicated that a substantial proportion of people (particularly young people) who receive this kind of treatment will go on to have further shoulder problems (sometimes instability in the shoulder joint or pain and discomfort from damaged structures). 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. @anonymous: Hi Vicki, I'm glad the information was useful to you. 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.