I mention this, as this will often influence treatment decisions. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. bone spurs and/or rotator cuff tears. Pain is really consistent and moderate with moments of severe. Surgical repairs of complete tendon tears from a traumatic event, like a car accident, can easily fail when surgeons instructions aren't followed. Dr. Mike. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. They loaded the muscles under three separate conditions: 1) rotator cuff . 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. I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. These include . The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. I'm experiencing the exact same pain you described, and the Army doc told me I was too young to tear a rotator cuff. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. 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 get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). My pain is mostly in the bicep area and I do not have trouble lifting the arm but bringing it back down and also bringing the lower arm down when the upper arm is at 90 degrees. All the best with it. Symptomatic full thickness rotator cuff tears can be managed surgically. Above my shoulder or behind my back without pain. A-C joint is moderately to severely degenerative. Supraspinatus is the most commonly injured rotator cuff tendon. The lack of a normal amount of synovial fluid in the joint space could potentially be a sign of adhesive capsulitis (also known as frozen shoulder) among some people. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). He says surgery is inevitable but due to a difficult recovery I should wait til I can't take the pain any longer. I also can't give you specific advice about your situation over the internet etc. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. The supraspinatus is the tendon that tends to suffer from partial tears most commonly. Good luck! If I need surgery,what is the recovry time.. 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. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. Interpretation: There is a focally retracted full thickness 1.2 x 1.2 cm tear of the supraspinatus tendon at its anterior attachment site on the humerus. On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) Sorry I can't give you specific advice over the internet, but it sounds like your shoulder specialist will be able to give you good personalized advice on Tues. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. Since most rotator cuff tendons are about as wide as three of your fingers, a small tear would be one the size of your fingernail or smaller (less than one centimeter of tendon torn) (Figure 7). Since then, my pain has gotten to the point where its starting to take effect of my day to day life. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. However, there are a variety of factors that will need to be considered. . I don't think there is a clear answer to this one. The individual shape of the bone structures (particularly the acromion) and soft tissues around the tendon will contribute to whether the tendon is able to move freely or become impinged between structures with arm elevation. Overall my subscapularis does appear intact." If you have injured your shoulder or have chronic shoulder and arm pain, it is best to see an orthopaedic surgeon. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. 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. I work construction and am self employed. 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. If your doctor does end up recommending surgery, make sure you have a good chat about what to expect after the specific surgery they are planning. I hope I have not waited to long for having this checked, and the only option will be surgery. There is fluid distending the long head of the biceps tendon sheath, representing tenosynovitis. There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described. 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. Some simple tests during a physical examination should enable your doctor to determine whether your symptoms are likely to improved with a surgical repair of the tendon. 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. I'm sorry I can't give you specific advice on your case over the internet. If they suggest surgery, ask them about what you can expect after surgery and the likely recovery time (including how long it is likely to be before you can use your arm for normal occupational or day to day activities). Either way, I wish you all the best with it (and a safe deployment and return). Because of the risk of infection and and nerve damage. I was instructed to ice pack my shoulder and take it easy. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. 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! It is also worth noting that whiplash associated disorders are complex. Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. Complete rehabilitation after surgery may take several months or even up to a year. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. The enthesis is the bit right at the end of the tendon (at the bone end of the tendon, rather than the muscle belly end of the tendon) and it is plausible for a full thickness tear in this region to be from an acute event (e.g. . Even though most tears cannot heal on their own, you can often achieve good function without surgery. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. and still end up with an unexpected problem. It seems to be a long recovery period with a great deal of physical therapy following. I had a fall at my workplace and was suffering neck and shoulder pain. If pregnant or nursing, consult with a qualified provider on an individual basis. So while the cost of surgery can be expensive, people who can't do their job one-handed may also need to consider potential loss of income as well or making alternative work arrangements. 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! It is also worth mentioning that not all PTs are created equal. MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain Hope that helps! 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 take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull. Am I destined for surgery in order to regain even 50% of what I've loss or should I try another round of prolotherapy? Overall, it will often take 6 months or more before the shoulder is completely back to normal. 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? The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. 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). 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. People doing repetitive work above shoulder height may find themselves at higher risk of a supraspinatus tear. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. Have been taking 800 mg Motrin tid. @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. 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. Good luck with it either way. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. The average duration of follow-up was twenty-nine months. I am sorry, I can't give you specific advice over the internet about whether you will need surgery or not. tendon transfer. Full thickness tears: usually categorized by size in centimeters. I served in the Navy for many years, and in April of 2010 I had a little mishap. This can be one of the most frustrating things for people who have whiplash associated disorders. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. This information is provided as an educational service and is not intended to serve as medical advice. No black and white answer for this one I'm afraid. Does a full thickness tear of the supraspinatus tendon need surgery? Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). Sought 2 nd opinion 3weeks later due to the server pain. Edema is seen involving an intracapsular segment of biceps tendon with possible interstitial tears. Strengthening the rotator cuff muscles can give relief to some people wanting to avoid surgery. The supraspinatus is one of four muscles that make up a group referred to as the rotator cuff muscles. Good luck with your next round of surgery or therapies! It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. A partial tear may require only a trimming or smoothing procedure called a dbridement. In terms of some general information that may be of interest to you, there are a couple of things I can share from my perspective. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). In my reports say that I have less fluid and possible tear. This has caused thickening and abnormal signal in the supraspinatus tendon consistent with tendinopathy and/or a partial tear. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. 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