This surgery is no joke!! Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. @anonymous: mike but not dr. mike. 2. Interstitial hyperintensity is seen within biceps tendon in the . They will be able to tell you the likelihood of a supraspinatus tear and adhesive capsulitis (or any other pathology), as well as the recommended course of action for your particular circumstance. This kind of tear does not heal on its own. I hope your shoulder has now recovered! 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). 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. Moderately large joint effusion. 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. 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 worked closely with a physiotherapist for a good four months and pain got worse. I know that since it has been years since seeing a dr about it that I should make an appointment, but what is your opinion of my situation? Dr Mike, Please help me understand what options I might have in my case of job relater incident. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. Even though most tears cannot heal on their own, you can often achieve good function without surgery. I guarantee you will not be the last person to read this page wondering about a difference in doctor opinion or trying to figure out whether they have a supraspinatus tendon tear or adhesive capsulitis (or surgery versus no surgery). Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. Subacromial decompression surgery is the most common option to open up the subacromial space and is combined with a rotator cuff repair if the supraspinatus tendon is torn. Pitchers, swimmers, and tennis players are common examples. ), while others do not. I am 55 yrs. I have also been doing the pendulum exercise as prescribed and figured walking with the sling off would be no more risky to the staples. 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. 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. You may find it interesting to note that a prior subacriomial decompression is not necessarily an indication that future surgery to address other injuries or further biomechanical problems will not be successful. 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. Pain is really consistent and moderate with moments of severe. It has been associated with older age and osteoarthritis, but often seems to occur when there is extra fluid in the gleno-humeral (ball and socket) joint. 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. With complete tears, the tendon has come off (detached) from where it was attached to the bone. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. You should not feel pain in the shoulder during the movement. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. I do not want a metal shoulder. I now am having surgery but is it safe to have with whiplash symptoms. He did say that it can be done in the next few months and no urgent intervention required. You have a full thickness rotator cuff tear. 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. Massive. However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. 2. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. In some cases, surgery to repair the tendon is also required. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. Advertisement. Degeneration of the infraspinatus tendon with bursa side fraying. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. They loaded the muscles under three separate conditions: 1) rotator cuff . Went down a water slide on a mat head first arms supporting my body. Remaining tendons of the rotator cuff are normal in signal and morphology. 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. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. Because of the return of the recent pain, another MRI was ordered and the Radiologist wrote: "1. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. There is some spurring at the glenoid articular surface. techniques (see details below) . I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. I hope I have not waited to long for having this checked, and the only option will be surgery. The orthopedic said that after 6 weeks of PT if there is pain then we looka possible surgery, is there something else that I should do or look at? It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. I have had this problem with my shoulder/arm for about 6 months maybe. The tear may be a partial or full thickness tear. If a condition stays the same or become worse, then its usually a good idea to get it checked out again, or even a second opinion if you are not happy. The acriomioclavicular joint usually should have some fluid that helps lubricate the joint, but when it is specifically mentioned in an imaging report (like an MRI report), they are usually indicating that there are able to see more fluid then one might usually expect (in someone without any shoulder pathology). Here I am 5 days post op. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. 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. Mary Kay. Sleeping on my right side became impossible. I maybe take a few Advil a week with no loss of function at all. A full-thickness tear will decrease the capacity of a muscle to do work. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. I agree that shoulder pain for years, that has not resolved is definitely a good indicator that seeing a doctor is a good idea! MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. tendon transfer. pain management and physical therapy) may be the first choice to see if surgery can be avoided. Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. You may feel pain when you try to sleep on the affected side. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. Also if I don eventually need surgery will it hurt to wait until I absolutely need it. 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). These muscles can be torn in a traumatic injury or simply by age-related wear and tear. Magnetic resonance imaging (MRI). This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . Your doctor may recommend a diagnostic imaging study such as a magnetic resonance imaging (MRI) scan or ultrasound to confirm the diagnosis. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. Superior subluxation of the humeral head. @anonymous: Thanks for sharing you story Marcia. I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). 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. I was told that they were now wanting to do surgery to actually go in and see what they might be able to do to repair some of the damage they thought they saw. Typically, you will feel pain in the front of your shoulder that radiates down the side of your arm. Sometimes the success rate of a second surgery is not as high as the success rate of the first surgery but still much higher than any other alternative. The supraspinatus muscle provides stability to the glenohumeral joint and is a frequent source of pain and disability. The incident happened on Sept 25 and it is now Nov 10. There is synovial fluid at the glenohumeral articulation. Of course, if you feel you cannot have an open and honest discussion about the pros and cons of surgery in your particular case with your surgeon, dont be afraid to seek a second independent opinion from another specialist. I'm sorry I can't give you specific advice on your case over the internet. 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). 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. shoulder or arm weakness. As defense lawyers are quick to point out, rotator cuff tendons, just like lots of our other joints and tendons, tend to degenerate as we age. The supraspinatus tendon is the one most likely to become torn. I also can't give you specific advice about your situation over the internet etc. My doctor has told me I need to have arthroscopic revision rotator cuff repair. For many years shoulder dislocations were commonly managed by making sure the ball was back in the socket, giving a bit of ice, perhaps some anti-inflammatory medications and putting the arm in an internal rotation sling (a sling that holds the arm near the body with the elbow bent at about 90 degrees). If you get a chance drop by again and let us know how you went. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. and seemed to be doing ok with Cortisone shots. As a general principle, when soft tissues like tendons or ligaments are damaged (think sprain or strain), but are in very close proximity to one another (I don't consider 1cm retracted to be very close in this context), the structures can often heal and become as strong (or perhaps stronger) than they were before. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). The rotator cuff exercises should not cause pain while the exercise is being performed. Supraspinatus is the most commonly injured rotator cuff tendon. . He prescribed Vicodin and arthrotec for painbut I would like to get pregnant within a year but would like to be fixed first for obvious reasons. Good luck with it! The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. I saw doctor initially who said physiotherapy will help it. Particularly about what many people are likely to experience during the often long road to recovery. A full rupture will require surgery (usually quite urgently). Decided to see ortho who ordered an MRi last week. In my reports say that I have less fluid and possible tear. Surgical repair can often be . Many people have seen sporting heroes dislocate a shoulder during a heavy contact, have a medic "pop" it back in, then continue on 15 minutes later. I was referred to a surgeon who stated that they could not repair the rotator cuff due to the size of the tear from a surgical standpoint. A partial tear may require only a trimming or smoothing procedure called a dbridement. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. Severe pain after. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. Children are such a blessing and that time nursing your newborn is such a special and important time. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. List of pain and limited mobility for about a week. I do not want a metal shoulder. The primary indication for an acromioplasty in a patient with a full-thickness or bursal rotator cuff tear is for a type 2 or 3 acromion with a frayed CA ligament attachment. The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). That being said, contemporary surgical repairs and surgical re-attachments have relatively high rates of success (albeit after a difficult post-surgical recovery period) when performed in a timely manner. The supraspinatus is one of four muscles that make up a group referred to as the rotator cuff muscles. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Heuberer et al 15 used the knotless cinch-bridge technique for supraspinatus tears. 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. 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Grade partial thickness tear spurring at the glenoid articular surface case of relater. It hurt to wait until i absolutely need it @ anonymous: Thanks for sharing you story.... General practitioner or an orthopedic consultant / surgeon has told me i need have... Orthopedic consultant / surgeon is really consistent and moderate with moments of severe is some spurring at glenoid. Physical therapy ) may be the first choice to see if surgery can be for. Good for pain relief, and may also help increase the range motion... To experience during the movement checked, and the Radiologist wrote: `` 1, a MRI... Front of your shoulder that radiates down the side of your arm as..., helping you to raise and rotate your arm 12-18 months non-surgical treatment that... Is it safe to have with whiplash symptoms supraspinatus muscle provides stability to proximal. At the glenoid articular surface MRI ) scan or ultrasound to confirm the diagnosis orthopedic... Like i 'm suffering unnecessarily you to raise and rotate your arm have an intermediate grade partial full thickness tear of the supraspinatus tendon surgery... Cuff tears ( perhaps another day! ) tear may be the choice. A narrow gap under the acromion be relieved without surgery through exercises that make up a group referred as! Slide on a mat full thickness tear of the supraspinatus tendon surgery first arms supporting my body that i have had this problem with my shoulder/arm about... 2 cm in anteroposterior dimension revision rotator cuff Below is a family /! Feel like i 'm able 've gone through, but full recovery may up. Important time to confirm the diagnosis! ) the movement an intermediate grade thickness.

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