I'll go check out some of your Lenses. She did an MRI and said it was tendonosis, and suggested PT. Your surgeon will be able to explain the potential risks and benefits (as well as if he thinks any alternatives are likely to be helpful). I am disappointed not to have been referred to a surgeon, but I have to admit the exercises have already helped me sleep better. I am sorry, this is not a nice situation to be in, but doesn't sound as though you are at the end of the line yet. However, in some cases it is clear that surgery is likely to be the best option. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. @anonymous: Thanks for sharing you story Marcia. 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). Surgery for a minor partial thickness tear will often involve a simple debridement of the tear. Thanks for stopping by and sharing your interesting story. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. Can you help me out at all? Examination otherwise demonstrates the osseous structures of the shoulder to be otherwise unremarkable in signal and morphology. I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). 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). I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. Surgical repairs can be compromised when post-operative instructions are not followed, so if you have surgery make sure you know exactly what you should and should not do! Either way, don't be afraid to ask your surgeon lots of questions (likelihood of success in your case, what will happen after surgery, recovery time-frames etc.). 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. A full-thickness tear is when the wear in the tendon goes all the way through the tendon. Thanks! Articular side: tears on the bottom of the tendon. There is synovial fluid extending into the suhacromial/subdeltoid bursa. is PT a good options. However, I went in to see my GP last week for an initial visit and have been advised to do a month of strengthening exercises. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. ( x-ray, phys ther,corticosteroid inj. Interstitial hyperintensity is seen within biceps tendon in the . In some cases, surgery to repair the tendon is also required. The supraspinatus is one of four muscles that make up a group referred to as the rotator cuff muscles. >5cm), depth (partial or full thickness), degree of fatty infiltration (Goutallier. I'm unable to say whether this has occurred in your case, however, the reason why this springs to mind is that I cannot recall ever seeing a true case of adhesive capsulitis (sometimes called frozen shoulder) that resolved in 6 weeks? 2. pain that gets worse when you lift your arm. Hi, I have had a partial supraspintus tear for 3 years now, and am wondering if it's too late to anything about it? 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). Here are a few notes/tips before you begin: Below is a demonstration of this exercise. I worked closely with a physiotherapist for a good four months and pain got worse. Had periods of pain go from the back of my shoulder down my arm like before. I had a fall at my workplace and was suffering neck and shoulder pain. If you want any further clarification just post any follow up question. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. So it would seem strange that your surgeon would expect adhesive capsulitis to resolve with 6 weeks of physical therapy, unless you had already had the condition for many months and he had started to detect improvement? 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. From a mechanical point of view the muscles and soft tissues around the shoulder do an amazing job to keep the head of the humerus (ball) in the small glenoid fossa (bony component of the socket)! 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. I plan on asking the surgeon these questions, but wanted your expert opinion. Thanks for stopping by and sharing your story with everyone! Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. This may not give immediate relief, but hopefully will show some benefit within 6 weeks. I guess my question is does this always require surgery? The results are: full thickness cuff tear 2.3 cm AP involving supra spinets and a portion of infra spinets at distal critical zone and enthesis. Risk of infection and nerve damage are worthy of consideration for any surgery, particularly one as involved as a reverse shoulder replacement. 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%. There is synovial fluid at the glenohumeral articulation. I am sorry I can't provide you specific advice over the internet. What I think is more common, is two doctors not taking the time to explain something in normal everyday language and ensuring their patients have understood whatever it is they are trying to say (so lots of people feel like they are being told different things)! Any suggestions? I left out a bunch of other things that are normal. and seemed to be doing ok with Cortisone shots. Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. So in summary Tim, I would say I feel for you buddy. pendulum), which should be undertaken ensuring correct technique). I am in aching pain consistently. Second, I am sorry to hear about your fall and subsequent shoulder pain. Further studies, like more larger cohort study or prospective study, will be needed to support our results. Twelve patients in Group 1 received an intra-substance injection into rupture area of supraspinatus tendon with Diprospan 1 cc (betamethasone disodium phosphate 2 mg and betamethasone dipropionate 5 mg) and . I have a referral to a specialist and hopefully I will have some answers soon. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. 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. They may be perfectly justified in their opinion, but if their opinion is based on one or two other specific cases that they know of (or perhaps their own bad experience), it would be a shame to miss out on receiving some potential benefit because a well meaning friend or family is not as well informed on the topic as they may think. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. Your doctor should be able to explain your options and potential expected outcomes. Anyways, my appointment for surgery on my right shoulder is in 2 weeks.. Arthroscopic.. it use to ache and ache at night but recently its not so bad. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). These types of pathology are nothing to be sneezed at and have potential to cause quite a lot of pain (which you probably know a thing or two about). Mild AC arthropathy. Thanks again Dr. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. This will help minimize strain on the back. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. @anonymous: Thanks for keeping us up to date. Humeral head is riding high abutting the underside of the acromin process. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. The majority of these tears occur amongst people over the age of 40. there is a small full thickness insertional tear identified relating to the posterior supraspinatus. 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. If you have any uncertainty around the need for your sling use, please call your surgeon's office today. I am 72, I just got the mri with same partial tear. Other symptoms of a subscapularis tear are unique to this injury. If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) Modify Sport Techniques . Quick story on me: I'm 41, male, 5'11", 205. A rotator cuff tear can be caused by an acute injury such as a fall or by normal age-related wear and tear combined with tendon degeneration. patients should expect to return to full work duty by 6-10 months after surgery. 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). I will congratulate you on actually doing your exercises! The type of repair performed is based on the findings at surgery. The radiomics model of no tears or tears achieved a high overall accuracy of 93.6%, sensitivity of 91.6%, and specificity of 95.2% for supraspinatus tendon tears. On one hand, I want the second opinion to be formulated entirely based on my case information (not on what another surgeon did or did not recommend). My question to you is why can they not try to repair the rotator cuff using a graft of somesort. Information on this topic is also available as an OrthoInfo Basics PDF Handout. That is some interesting advice you have received. Any advice would be appreciated thanks. From the information you have provided it is difficult to say whether surgery will be needed. Good luck! In active individuals who use the arm for overhead work or sports. Having pain and sub-optimal shoulder functioning while you are nursing would not be ideal. Had mild discomfort in shoulder for a few weeks in August. 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. What does he mean by my tendon is failing? When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. Thanks for stopping by, you have raised some very good questions. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. 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. Dr. Mike great info here thanks. This article describes general phases of rehabilitation following arthroscopic rotator cuff repair. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. 2. mild labral degeneration. The infraspinatus contains a subtle hypochoic region measuring 0.5cm within the tendon substance consistent concerning for an intrasubstance tear. Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. After a formal assessment, they will be able to prescribe a course of rehabilitative exercises or recommend surgery. Some minor tears may be treated without surgery. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. !!! Small to moderate glenohumeral joint effusion. coracoacromial ligament. Seek immediate help if you are experiencing a medical emergency. Tendonosis literally means chronic pathology without inflammation (i.e. At the final follow-up, the VAS, Constant, ASES, and UCLA scores were 1.1 0.9, 84.3 16.4, 88.3 17.4, and 31.1 6.0, respectively. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. @DrMikeM: Thank you Dr. Mike for answering my question. 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. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. bone spurs and/or rotator cuff tears. It must have been quite a knock, there is some quite serious damage there. The rehabilitation after surgery is likely to take time. There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. No black and white answer for this one I'm afraid. Supraspinatus full thickness tear clu801 686 subscribers Subscribe 215 Share 7.8K views 2 years ago I am just sharing my experience with recovering from a shoulder surgery to repair a. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). 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). @pawpaw911: Hi Pawpaw911, thanks for dropping by. Based on the information you have provided above, I would say there are several structures that could potentially be causing this ongoing problem, of which a supraspinatus tendon tear is one (but is difficult to speculate without a physical examination / seeing the MRI etc. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. It's very good of you to reply so promptly and clearly though. Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. With full thickness tears the entire tendon has separated or torn from the bone. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. According to Dr. Bob Burks, professor of orthopedics, 60 percent to 70 percent of patients will have some sort of tear by age 80. i'm a long distance runner and in good fitness and the shoulder problem does not bother me during running. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. By June '13 I was better in many ways than before the injury. 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. 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. For anyone contemplating surgery, buy a recliner to sleep in after surgery. . The tear of the subscapularis muscle is less common then the tear of the other rotator cuff muscles, such as the supraspinatus, infraspinatus or suprascapularis. The goal of acromioplasty is to increase the size of the subacromial space. Rotator cuff tears can also be described as being partial, or full thickness. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. Pain can also be brought on by laying on the side. LOTS of heavy benching, etc. The four muscles supraspinatus, infraspinatus, subscapularis and teres minor originate from the scapula (shoulder blade). I understand most of it but I was wondering is there supposed to be fluid in the acromioclavicular joint. 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. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. 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. Pain is really consistent and moderate with moments of severe. I was very optimistic about the P.T. While it is estimated that 65-70% of all shoulder pain involves the rotator cuff tendon, it has been estimated that 5 to 40 % of people without shoulder pain have full-thickness tears of the rotator cuff. The rotator cuff is made up of 4 muscles. If pregnant or nursing, consult with a qualified provider on an individual basis. Children are such a blessing and that time nursing your newborn is such a special and important time. have got bursal thickening as well and mild thickening of. 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. It is important the the surgical repair of the tendon is protected initially to ensure that a re-injury does not occur. Purpose: The objective of this study is to report on the complete arthroscopic repair of full-thickness tears of the supraspinatus.Type of Study: Prospective cohort study. This can occur normally over time, or with repetitive use or a re-injury. I appreciate your thoughts on this matter. The retracted margin of the tendon is at the level of the lateral and anterior margin of the anterior acromion. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. I decided to go to the local army medical hospital. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Good luck! Sorry we are unable to give specific advice over the internet, but I hope this general information is helpful! Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). Most of the time, it is accompanied by another rotator cuff muscle tear. Surgical repair can often be . Good luck! its been three months with some pt but no noticeable improvement. Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. Like Helpful Hug REPLY An important thing to consider (as you have correctly mentioned) is that a reverse shoulder replacement is probably unlikely to restore normal shoulder function and resolve the pain if substantial soft tissue problems are still present in the tendons around the shoulder. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. 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. Avoiding work above shoulder height can sometimes avoid aggravating the pain. I also can't give you specific advice about your situation over the internet etc. After an initial diagnosis from an Orthopedic specialist, the initial course of action was a steroid injection treatment into the "affected area" and a course of physical therapy. P.S. It is good that you have discussed the recovery with your surgeon already. A rotator cuff tear (RCT) is a common disorder associated with pain and dysfunction in the shoulder, the prevalence of which increases with age [].Full-thickness RCTs are present in approximately 25 % of individuals in their 60 s and 50 % of individuals in their 80 s; however, the reported incidence is lower for patients < 55 years of age (4-8 %) [1, 2].
full thickness tear of the supraspinatus tendon surgery