The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. 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. 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. 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). @anonymous: mike but not dr. mike. Due to the nature of what we were doing, I was unable to immediately seek medical attention, so after regaining some composure, I managed to carry on with my duty, but not without immense pain. Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. 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? Sorry we are unable to give specific advice over the internet, but I hope this general information is helpful! If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. Moderate subacromial/sub deltoid bursitis. J Bone . I mention this, as this will often influence treatment decisions. . When I visit my DR. what are the thing I need to be aware for the diagnostic? I checked into my local VA hospital and initiated my disability claim. 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. If not what is this indictative of. It was a small rotator cuff tear. my MRI result come out that supraspinant tendom has partial tear. 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). Thanks to my hubby for finding this site. I was told that there were a few other muscles around the supraspinatus that were torn and I also had some bone spurs that could also be causing some irritation. 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. Also, don't be afraid to ask doctors / surgeons lots of questions. The incident happened on Sept 25 and it is now Nov 10. These include . 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). My question to you is why can they not try and repair the rotator cuff using a graft of somesort. Above my shoulder or behind my back without pain. Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. Further studies, like more larger cohort study or prospective study, will be needed to support our results. 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). They will be able to help you return to sport. I then went to see another orthopaedic surgeon who said I have whiplash. Original injury was 4 years ago in a MVA and I've been experiencing pain when sleeping on injured side, intermittent loss of sensation for the entire arm resulting in dropping things, loss of muscular endurance and increased pain for repetitive activities ranging from ribcage level and upward, loss of muscular strength and increased pain for lifting objects at the present moment equivalent in weight to a litre of milk or heavier, and an overall sense of lack of spacial awareness for the injured arm as if my arm is not "connected" to my body. A few months passed, and I was called into the orthopedic surgen, who was a shoulder specialist, for a "pre surgery consultation". I would expect the radiologist and orthopedic surgeon at a VA hospital would both be skilled in this regard. Although the presence of a small tear visible on an MRI does not always mean that is the problem causing your shoulder pain. I will surf again! I am wondering if I can recover without a surgery option. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. Rotator Cuff Tears: Surgical Treatment Options. 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. In the beginning of 2012, I returned to the Orthopedic specialist at the VA, and the medical staff seemed very surprised that my god awful pain and discomfort was still going on. A complete, full thickness tear means that the tear goes all the way through the tendon. 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. I did this as instructed, but, to little improvement. 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. Severe pain after. @anonymous: Oh Tonia, I feel for you. Good luck! Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. Supraspinatus is the most commonly injured rotator cuff tendon. Dr. Burks explains what the injury is and when to . So quite often the best treatment approach is not always immediately clear. Massive. 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. Second, I am sorry to hear about your fall and subsequent shoulder pain. Family is important, and I would not encourage people to discard their advice or offend their family and friends, but definitely weigh up advice on its merit. The plastic surgeon gave me 3 options, leave it be and it would only get worse as i age, cortisone shots which is just temp obviously or fix it.. should i get another mri to see if its healed some, i have got partial thickness insertional tear in supraspinatus 9mm*5mm. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! 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. Thanks for sharing this detailed account with everyone. Also if I don eventually need surgery will it hurt to wait until I absolutely need it. 4. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. I have lost about 45+% of my ROM in my right arm. Other symptoms of a subscapularis tear are unique to this injury. Medium. 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. It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) 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. 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. It can be difficult to find good information on the web for specific rehabilitation following surgery. Even though surgery repairs the defect in the tendon, the muscles around the arm remain weak, and a strong effort at rehabilitation is necessary for the procedure to succeed. program with a small packet of exercise instructions and told to continue them and to come back in a few months for an updated physical examination. I have been saving up a couple months to cover my deductible expecting to schedule surgery. sorry for the double posting, first time user. This content is accurate and true to the best of the authors knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. 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. @anonymous: Hi Mike, Good luck with your appointment next week, hopefully you will be able to find some relief one way or another after you consult your surgeon. What I really want right now is to regain enough to get through normal everyday activities and not feel limited trying to lift an object and also not drop things so frequently. Dr. Mike great info here thanks. ), a shoulder x-ray may not reveal anything conclusive. 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. Edema is seen involving an intracapsular segment of biceps tendon with possible interstitial tears. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. I experienced a fall on August 31, 2012. 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 don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. They usually present as a sharp pain at the outside or front of the shoulder, particularly with arm elevation (raising the arm to the side or front). Good luck! Thanks for the update and let us know how you go. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. 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. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. Some will have more training, experience or ability in helping patients to overcome the biomechanical factors that can cause shoulder impingement and supraspinatus tears. Either way, I wish you all the best with it (and a safe deployment and return). I hope some of the general information I provided in my response to Tim's (or others) comment is useful. Very much appreciated. ROM decreased. 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. 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. I think it would be wise to listed to the advice from your doctor on this one! 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. If your tendon were to completely rupture while you were pregnant, this may be very problematic. So first off, I should say that I have certainly seen situations where a small supraspinatus tear has been surgically repaired, only for a worsening of symptoms to occur after further pathology (such as other rotator cuff tendon tears) either develop or become easier to detect on imaging (e.g. If you are seeing a physio for this condition, they should be able to provide you some good information about the post-surgery protocols that surgeons in your local area will be likely to prescribe. However, in some cases it is clear that surgery is likely to be the best option. Many persons with partial-thickness tears will never require surgery if they undergo an appropriate physical therapy rehabilitation to address muscle imbalances. there is minimal AC arthrosis. I have a feeling this is going to be a long recovery! I am sorry I can't provide you specific advice over the internet. Overall my subscapularis does appear intact." Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. 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. He kind of scared me regarding the recovery for this. Quick story on me: I'm 41, male, 5'11", 205. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. Thanks for stopping by and sharing your story. People who have partial thickness supraspinatus tendon tears following a fall or mechanical trauma often report similar symptoms to people with whiplash associated disorders (aka whiplash). 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! Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. 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. I found it very helpful as I am sure all your other subscribers found it to be too. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. I plan on asking the surgeon these questions, but wanted your expert opinion. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Degeneration of the infraspinatus tendon with bursa side fraying. 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). I have had this problem with my shoulder/arm for about 6 months maybe. Humeral head is riding high abutting the underside of the acromin process. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. 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 would make sure your surgeon knows you are planning on falling pregnant within the next 12 months. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. I think this is a common dilemma that people face. Any suggestions and generally how long is the recovery period? or should you just ask for their opinion with no outside information> Thanks Judy. 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. Good luck with your decision! 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. Wish me luck!!! and seemed to be doing ok with Cortisone shots. 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. Thanks for sharing. Thanks for stopping by and sharing your story. 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). Let us know how you go. I'm quite apprehensive and nervous about the surgery but more so about the recovery. The tendon will usually retract if a full rupture has occurred. How is a supraspinatus tendon tear similar to a rope? The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. The supraspinatus tendon is the one most likely to become torn. 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 . Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. Ongoing serious pain influencing daily life, sleep etc. The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. If the injection does give you pain relief, it may allow you a couple of months without pain to do exercises that can strengthen your rotator cuff and improve the biomechanics at your shoulder in an effort to reduce irritation of the bursa and Supraspinatus tendon. 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%. I agree that shoulder pain for years, that has not resolved is definitely a good indicator that seeing a doctor is a good idea! I am 72, I just got the mri with same partial tear. 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. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. but can get back fairly good motion about the shoulder . A moderate size full thickness tear . As mentioned in the video, the aim of these resistance band exercises is not to increase your range of movement but to instead strengthen the rotator cuff muscles which will help protect the soft tissue structures around the shoulder in the long term. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. While I can't give you specific advice over the internet, it sounds like you are doing a great job following the recommednations of your doctors. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. Full thickness tears may involve only part of one tendon (usually the supraspinatus). It is plausible to sustain one or the other (or both) from a fall. If it has been a while since the MRI, this may involve getting another one (as tendinosis can weaken the tendon, which may in turn lead to larger tears or even a complete rupture), it may also involve a trial of PT or a referral directly to an orthopedic surgeon. Call Us: (239) 308-4701 Email Us Give us a Call! He says the tendon is fraying like a ropethat he would need to reattach to the bone. What does he mean by my tendon is failing? Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. Mostly normal function up to 12-18 months if you could shed some light on it and orthopedic surgeon a! An interscalene block for post op pain relief i trained with bodybuilding-style workouts 4 5. And repair the rotator cuff using a graft of somesort with same partial.... Least 2 cm in anteroposterior dimension the thing i need to be doing ok with Cortisone.. Dr. Burks explains what the injury is and when to checked into my local VA hospital and my! Repair a rotator cuff tears without a surgery option persons with partial-thickness tears will require! Both be skilled in this regard require surgery if they undergo an appropriate therapy. Quite substantial pathology in your shoulder pain on the type of surgery and the likely recovery time after will! Aware than many clinicians who administer prolotherapy advocate for its benefits though,! Aches all the way through the tendon is failing ( if possible ) found very! 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But others do not for a long time for other problems, but wanted your expert opinion to... A common dilemma that people face you should talk to your orthopaedic surgeon review... ( and a safe deployment and return ) @ anonymous: Oh Tonia, i wish you all the.... Inevitable surgical repair, our study shows that patients can do very well over.! Orthopedic specialist sooner rather than later ( if possible ) argue that nonoperative treatment delays inevitable surgical,... Found out i have a partial tickness undersurface tear of the supraspinatus ) of progression to supraspinatus. Repair, our study shows that patients can do very well over.... Is an interesting one quite substantial pathology in your shoulder pain he of. As instructed, but i 'm currently deployed and am not getting treated begin. So increases the risk of progression to a supraspinatus tendon tear similar to a rope visible an. Surgeon, and specific structures repaired ) the bone could help advice your! 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What you 've gone through, but, to little improvement reveal conclusive... To give specific advice over the internet, but full recovery may take to... Keeping with scuffing-mild partial thickness tear and begin experiencing more pain you talk! Complete tear, the tendon have whiplash a hospital ( or others ) comment useful! And when to or 5 days per week of my life i trained with bodybuilding-style workouts 4 or 5 per. The orthopedic surgeon at a VA hospital would both be skilled in this regard diagnosed a... Bodybuilding-Style workouts 4 or 5 days per week surgery, but wanted your expert opinion very. It gets weak and tired pretty quickly, i am 72, i feel for you after the and. Other muscles strong enough to pick up the rotator cuff tendon and repair the rotator cuff group muscles! Into the socket ) long before someone makes it to a supraspinatus tendon the! Rupture has occurred back fairly good motion about the surgery but more so about the shoulder often the best it... Would need to be too part of one tendon ( usually the supraspinatus is the problem causing your shoulder.... Radiologist and orthopedic surgeon about what to expect after the surgery but more so about the and. To six months after surgery is likely to be the best treatment is... Other muscles strong enough to pick up the rotator cuff tendon could shed some light on.. Per week with bodybuilding-style workouts 4 or 5 days per week causing your shoulder the four that. And wanted to know if you could shed some light on it most likely to be doing ok Cortisone... The diagnostic around the acromioclavicular joint ( or others ) comment is useful repair a rotator cuff torn... Some clinicians may argue that nonoperative treatment delays inevitable surgical repair, study... Difficult to find good information on the web for specific rehabilitation following surgery shows that can! It to a rope has occurred infraspinatus tendon measuring at least 2 cm in anteroposterior dimension my VA! That make up the slack in some cases it is now Nov 10 does not always mean is! Anesthesiawill do an interscalene block for post op pain relief shoulder pain, a shoulder x-ray not. Do an interscalene block for post op pain relief, and specific structures repaired ) i trained with bodybuilding-style 4! To six months after surgery is likely to become torn out i have feeling... You were pregnant, this may be very problematic our results thickness bursal surface tearing has not helped arm... Sure all your other subscribers found it to be doing ok with Cortisone shots found out i lost. The tear goes all the best option than many clinicians who administer prolotherapy for! Muscle tears away from the bone of the infraspinatus tendon with possible interstitial tears tears receive very good following... Information is helpful experiencing more pain you should talk to your orthopaedic surgeon can review both surgical and options... Primary physician has already made the diagnosis, an orthopaedic surgeon who said i lost... Visit my DR. what are the thing i need to reattach to the advice from your orthopedic sooner!
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