There are two categories of supraspinatus tears, degenerative and acute. Sorry for the delay in response. Over-the-counter medication, such as aspirin, ibuprofen, or naproxen, may relieve the pain. If surgery is not indicated, your doctor should be able to refer you to a physical therapist who will likely assess your shoulder movement and be able to provide you with a tailored program to help strengthen your rotator cuff. Generally speaking, do small tears need surgical repair? This surgical method is a simple and effective Surgery to repair those types of injuries would mean the arm would have to be not used (at all) for at least a couple of months (maybe quite a few months before back to being able to work normally). Overall function increased by 47.67% from pre-op to post-op3. All material on this website is protected by copyright. On the other hand, physical therapy can often help supraspinatus tendon tears but sometimes they do need surgery in order for a suitable recovery to occur. make sure you do it some place where anesthesia will do an interscalene block for post op pain relief. The supraspinatous is one of the 4 muscles that make u. Avoiding work above shoulder height can sometimes avoid aggravating the pain. A significant amount of these occur in the supraspinatus muscle, although other areas of the rotator cuff may be involved. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. Not too sure if this article is still active but I'll ask anyways. Rotator cuff tendon augmentation grafts are a promising area of research. In layman terms, I would say this means your supraspinatus tendon has probably been irritated for quite a while, and has a small tear near where it attaches to the bone (but tendon is currently still attached). I am glad that you noticed some relief after the surgery on your right shoulder and that the exercises for your left shoulder have already helped you get better quality sleep. This will help minimize strain on the back. The classic full thickness rotator cuff tendon tear involves the supraspinatus and then progresses to involve the long head of biceps, followed by the infraspinatus and subscapularis. The rotator cuff exercises should not cause pain while the exercise is being performed. I have a second opinion on Monday. prospective, randomised trial in 103 patients with a mean four-year follow-up. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! There are several video examples to accompany the written explanation. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm (humerus bone). Jung HJ, Sim GB, Bae KH, Kekatpure AL, Chun JM, Jeon IH. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. I have a referral to a specialist and hopefully I will have some answers soon. but can get back fairly good motion about the shoulder . Is surgery my only option? This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. !!! The choice of, and response to, rotator cuff tear treatment may vary with age due to differences in etiology and pathogenesis. Men over forty are the most likely to have degenerative supraspinatus tears. Studies that include patients under 60, provided they report the results separately for patients aged 60 and over, will also be included in the review. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). I will surf again! Good luck! This sounds like quite a pain (literally). 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. )full thickness tear of supraspinatus and infraspinatus tendons both have retracted past glenoid process 2.) Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. An updated systematic review is now needed to identify the best treatment approach for full thickness rotator cuff tears in the elderly. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. Thanks. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. 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. 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 ]. Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. Also, don't be afraid to ask doctors / surgeons lots of questions. (Right) A full-thickness tear in the supraspinatus tendon. The reverse shoulder surgery is extremely involved so I am getting a second opinion. My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. It sounds like it is important to see your doctor who is familiar with your case. By June '13 I was better in many ways than before the injury. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. To be as specific as I can, It feels like someone shoved a knife right into the top of my shoulder blade and right down inside my shoulder. How do you repair a rotator cuff tear? 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. This will inform the development of a search strategy which will be tailored for each information source. Where required, authors of papers will be contacted to request for missing or additional data. Rest, pain relievers and physical therapy can help. The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. Although very uncommon, it is possible that the report did contain an error. It must have been quite a knock, there is some quite serious damage there. Statistical tests for funnel plot asymmetry (Egger test, Begg test, Harbord test) will be performed, where appropriate. This includes small (01 cm) and medium (13 cm) tears. An acute tear of the supraspinatus muscle can occur alongside injuries like shoulder dislocation, clavicle fractures, or other rotator cuff injuries that can happen as the result of things like a fall on your outstretched arm or attempting to lift something too heavy; plus there are a variety of sports where the athletes are prone to shoulder damage like baseball, basketball, rugby, AFL Football, and tennis. is surgery the only option? Don't be afraid to have an open discussion with your GP about whether or not a referral to a surgeon is the right way to go (or not) for your specific circumstance. Any advice would be greatly appreciated. Quality of life, measured using any validated instrument. An orthopedic surgeon will be able to provide you with all the information you need regarding surgery, however, regarding exercises to return to badminton it might be wise to see a physical therapist (also known as physiotherapist) who specialises in sports injuries and rehabilitation. I here is incidental note made that the teres minor muscle is prominently atrophic. @anonymous: Hi Elania, Thanks for stopping by and sharing. 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. Pain continued and got worse. In my reports say that I have less fluid and possible tear. I would expect the radiologist and orthopedic surgeon at a VA hospital would both be skilled in this regard. These injections usually include an anti-inflammatory that can last for a couple months delivered directly to the problem area(s) and a local anesthetic that will work for the first few days until the anti-inflammatory starts to give relief. Getting a second opinion when you are not sure about your first is also often a good idea. I can reach behind my back ok. that can be just as difficult to resolve as any structural injury. I also have no insurance and don't know about surgery. It extends slightly into the proximal subscapularis bursa. To recap I have had debridement and subacromial decompression, am 34 years old and now have arthritis, bursitis, tendinitis and impingement. labra are not evaluated 4. Depending on the severity of your shoulder tear and other injuries, your age, general health, and lifestyle, it might be possible to alleviate the pain and minimize the issues resulting from a supraspinatus year through a combination of non-invasive tactics like medication and physiotherapy. I now am having surgery but is it safe to have with whiplash symptoms. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Treatment options, tips, knee surgery info, and medical videos are included. 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. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). 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. It would be particularly unusual for a radiologist to see a tear that was non-existent (perhaps more likely to miss one that was hard to see than to see one that is not there). 5. Its often accompanied by other tears in the muscles that make up the rotator cuff. It sounds like you are not following your surgeons instructions! Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. I hope I have not waited to long for having this checked, and the only option will be surgery. He says that my tendon is failing. 9. 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. In planning your treatment, your doctor will consider: There is no evidence of better results from surgery performed near the time of injury versus later on. If pregnant or nursing, consult with a qualified provider on an individual basis. Reinold MM, Macrina LC, Wilk KE, Dugas JR, Cain EL, Andrews JR. It sounds like the damage is fairly minor in my shoulder yet I have a great deal of discomfort and limited ROM 2 1/2 months after my fall. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. Rotator cuff tear management aims to relieve pain, restore movement and improve function of the shoulder. Thorpe A, Hurworth M, O'Sullivan P, Mitchell T, Smith A. 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. I had surgery in Mar 2012 for decompression,near full thickness bursa tear and a near full thickness supraspinatus tear with degeneration and general multi-directional laxity of the shoulder capsule.I know the work I have preformed and physical activities over the past 20yrs haven't helped but it was an acute injury that ended it.Since surgery I have been to a physiotherapist but after a few sessions I was experiencing a spot of pain (hot spot) which the physio dismissed as surgery related pain.To make a long story short, gym didn't go well to which I was told by my physio that I was overdoing it (I followed the program to the letter) anyway a second opinion found I have got a high grade partial tear and possible partial full thickness tear and bursa thickening and bunching on adduction. The search for unpublished studies will include: ProQuest Dissertations and Theses, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, ANZCTR and ICTRP. Thank you. Those words exactly. pain that increases with shoulder use. Although overuse tears caused by sports activity or overhead work also occur in younger people, most tears in young adults are caused by a traumatic injury, like a fall. I can reach behind my back ok. I am not aware of any studies that have shown rotator cuff exercises impair healing in supraspinatus tendons that have a partial thickness tear. It is one of the four rotator cuff muscles. I'm sorry I can't give you specific advice on your case 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)! Available from. 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? It is certainly worth discussing a more conservative approach, such as seeing a physical therapist that specializes in shoulders, with your orthopedic surgeon; particularly if you feel you have noticed improvements previously. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. Also now taking Tylenol 500 with5 hydrocodone. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. I was released from the P.T. I'm sure it is no surprise to you, but when someone is experiencing worsening pain with conventional conservative management like physical therapy this is also not a good sign for a speedy recovery without surgery. Management of rotator cuff tears can broadly be divided into surgical and non-surgical treatment.8 Surgical treatments include arthroscopic repairs, open repairs, mini open repairs, tendon reconstruction and reverse shoulder arthroplasty.11-15 Non-surgical treatments consist of physiotherapy or injection. Without seeing the scan or conducting a physical examination, I can only offer some general comments in response. After 4 months of therapy and 3 injections I am unable to lift my right arm. 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. is PT a good options. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. Any advice would be appreciated thanks. The purpose of this study was to compare clinical outcome measures at least 1 year postoperatively between patients who had completion of a high-grade partial thickness supraspinatus tear to a full-thickness tear (PT) and those who had an isolated full-thickness supraspinatus tear (FT). It is the most common tendon to be damaged in the shoulder. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. @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. 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. 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. It is also worth mentioning that when surgeons send patients for PT and don't hear from them for a while, they may well have just assumed everything went well and there is no more problem (or they have so many patients that they haven't given it much thought). 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. ; 3; Where can I found documentation in the web for the rehabilitation? Construction work and other high-risk physical jobs can also increase the likelihood of experiencing this type of injury. It is not possible for me to give you any specific advice over the internet etc., but here are some general thoughts. Above my shoulder or behind my back without pain. The chief advantage of nonsurgical treatment is that it avoids the major risks of surgery, such as: The disadvantages of nonsurgical treatment are: Your doctor may recommend surgery if your pain does not improve with nonsurgical methods. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! 2. My arm is very weak. 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. Subcortical reactive changes superiorly and laterally at the humeral head are present. So in summary Tim, I would say I feel for you buddy. Visited many doctors and was always told it was nothing, the pain got unbearable and I saw yet another dr who was completely caught off guard my the loud pop my shoulder makes. 16. The main action of the supraspinatus muscle is to abduct the shoulder joint (lift your arm out sideways and upwards). (Right)A full-thickness tear in the supraspinatus tendon. Second, I am sorry to hear about your fall and subsequent shoulder pain. Mary Kay. Of course, all these options should involve regular check-ups with your orthopaedic surgeon in order to make sure the problem isnt getting worse. I am worried I will not improve my ROM this time. Here is some general information which I hope is useful for you: 1. When I visit my DR. what are the thing I need to be aware for the diagnostic? Your arm is kept in your shoulder socket by the rotator cuff. Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. It sounds like you may be putting yourself at unnecessary risk? Article Google Scholar Ratte-Larouche M, Szekeres M, Sadi J, Faber KJ. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). Several factors contribute to degenerative, or chronic, rotator cuff tears. Some things to consider when you are discussing your options with a surgeon is the length of recovery time following surgery (likely to be months), consider time to return to work (also consider whether it it possible for you to return to light duties at work). You may be trying to access this site from a secured browser on the server. Here I am 5 days post op. The tendon will usually retract if a full rupture has occurred. The review will exclude studies which include patients with concomitant shoulder conditions such as osteoarthritis, fractures, osteonecrosis, instability, and additional intra-articular pathology or acromion morphology, as these conditions may necessitate intervention/s that may be different from patients who have rotator cuff tear only. I did PT around December for a month, twice a week. That is some interesting advice you have received. 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 some biomechanical and physiological attributes associated with the types of tendon injuries you have described that make them difficult to successfully repair. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. The tendon that seems to be most commonly affected is the supraspinatus, although it could also easily be either infraspinatus, long head of biceps, subscapularis or teres minor tendons. When one or more of the rotator cuff tendons is torn, the tendon becomes partially or completely detached from the head of the humerus. I guess my question is does this always require surgery? I appreciate your thoughts on this matter. 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. However, you would need to discuss this with your surgeon who will also be able to take a detailed history and conduct a full examination etc. I have had this problem with my shoulder/arm for about 6 months maybe. Advice welcomed. Downie BK, Miller BS. Yes, surgery can be painful initially, but your surgeon should be able to tell you the likelihood of a successful outcome of surgery based on your specific circumstances. Any thoughts? We will also discuss surgical interventions for tendon injuries. will consult surgeon next week. Rotator cuff tear is the term commonly used by the general public to describe any detachment or tear of the tendons that connect that connect or attach the muscle from your shoulder to the head of the humerus.

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