full thickness tear of the supraspinatus tendon surgery

It is common for patients with known rotator cuff disease to have acute pain and weakness following a minor injury. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. 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. (MRI), demonstrating a full-thickness supraspinatus tear. Does a full thickness tear of the supraspinatus tendon need surgery? 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. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. I received today my results of a CT Scan from my right shoulder, which I had an accident like 5 months ago. ), a shoulder x-ray may not reveal anything conclusive. I am now off again to another specialist as the 2nd opinion specialist said there was not much he could do to improve the situation! Good luck with your decision! 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. Shoulder muscles are very good for stabilizing the ball and socket joint and making large movements (to help lift things, throw objects etc. I have spoke with people that have had surgery on their shoulder and they say that is a very painful surgery, and they still have problems from time to time with their shoulder. You have asked for information about potential options. 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. 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. Your doctor may recommend a diagnostic imaging study such as a magnetic resonance imaging (MRI) scan or ultrasound to confirm the diagnosis. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. 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 is the most commonly injured rotator cuff tendon. I am sorry I can't offer specific advice without a proper assessment, but seeing an orthopedic specialist or physical therapist in your local area sounds like a good idea. is surgery the only option? if your initial injury was work related. 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. Thanks for sharing this detailed account with everyone. However, other parts of the rotator cuff may also be involved in the injury. It seems as though you have now had two MRI reports. . I hope I will not follow suit! 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). I hope some of the general information I provided in my response to Tim's (or others) comment is useful. 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. I was released from the P.T. I'm just about at the point of desperation here. 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). From time to time tendons do rupture from a variety of causes, in your case it sounds like the surgeons description of rope fraying is a good one. Advice welcomed. It can be difficult to find good information on the web for specific rehabilitation following surgery. Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. Thanks for posting your question. 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. It may be as small as a pinpoint, or the tear may involve the entire tendon. tendon transfer. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). If a medical doctor (assuming they have nothing to personally gain by referring you to another health professional) suggests something may work based on their years of training, in depth understanding of anatomy, physiology, common pathology, research evidence and clinical experience with many patients, it is usually worth considering what a family or friend (albeit that they are usually well meaning) is basing their opinion on. Just be aware that even in the best cases, the recovery time following surgery requires months (not weeks) so if you go ahead with the surgery don't be discouraged if you still have some pain in the first weeks after the surgery. You have a full thickness rotator cuff tear. Patients ranged in age from twenty-nine to seventy-nine years. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. Good luck! 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. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. 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. Because of the return of the recent pain, another MRI was ordered and the Radiologist wrote: "1. Remaining tendons of the rotator cuff are normal in signal and morphology. Rotator cuff tears may be degenerative (the defect arose in tendon of poor quality) or they may be traumatic (the tear arose from a major injury to otherwise healthy tissue). A full thickness tear is not usually a complete rupture. Did a previous year of PT to strengthen rotator cuff muscles with increase to full range of motion. When I visit my DR. what are the thing I need to be aware for the diagnostic? I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. What does all that mean in simple layman terms? massive cuff tears. Like Helpful Hug REPLY ROM hurts so I'm not sure. So my tear went from a near full thickness tear to a full thickness tear. Examination otherwise demonstrates the osseous structures of the shoulder to be otherwise unremarkable in signal and morphology. !!! What do you think of the other therapies? It plays a critical role in movements involving the shoulder joint, particularly arm elevation. I experienced a fall on August 31, 2012. Now my left supraspinatus has a full thickness tear at the central 1/3 (AP extent 13mm?) 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. I checked into my local VA hospital and initiated my disability claim. 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. 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. The rotator cuff tendons attach to the head of the humerus in bony spots referred to as the greater and lesser tuberosities. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. ; 2. Knee Surgery . 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. Injuries are a less common cause of partial tears than aging. Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. 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). Thanks for sharing. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. 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. Hopefully your doctor can give you specific advice in this regard. There is supraspinatus muscular atrophy. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. I also can't give you specific advice about your situation over the internet etc. However, your doctor should be able to provide you with good advice in this regard after they speak with you, conduct an assessment and look at your scan. 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. These include: pain that gets worse at night. A full-thickness tear might also be described as extending from the anterior leading edge with 1 cm of supraspinatus remaining intact or as involving the midportion with 1 cm of supraspinatus intact anteriorly and 1 cm of infraspinatus intact posteriorly, and so forth. Thanks for the update and let us know how you go. . 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. 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. It's very good of you to reply so promptly and clearly though. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). It is possible this tear may communicate with the bursal surface anteriorly. In some cases, surgery to repair the tendon is also required. It was then I found out how messed up my shoulder actually is 1. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). I have pain all the time, it hurts to put a shirt on, can't lay on it, reaching out to my side it hurts to turn my pillow. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. 2023 The Arena Media Brands, LLC and respective content providers on this website. while that helped in the short term and improved my left arm motion range, after i stopped the therapy the pain came back and reduced the range. @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. 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 doctor may also advise a trial of physical therapy to see if that can bring relief to his symptoms. 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). Retraction of the supraspinatus tendon medial to the glenoid. To recap I have had debridement and subacromial decompression, am 34 years old and now have arthritis, bursitis, tendinitis and impingement. Bursal side: tears on the top of the tendon. I say promising because work in basic science and animal studies have demonstrated some quite promising findings. A rotator cuff tear can result from an injury such as a fall or heavy lifting, or from normal wear-and-tear and repetitive activities over many years. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. If you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment. Supraspinatus tears are often accompanied by adjacent structural deficits. I worked closely with a physiotherapist for a good four months and pain got worse. I am unable to carry any significant weight. Pain can also be brought on by laying on the side. I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. and retracted 2 cm. I can reach behind my back ok. The majority of these tears occur amongst people over the age of 40. At approximately the 3:40 mark in the video above, there are a few exercises to help increase the range of the movement in the shoulder. Call Us: (239) 308-4701 Email Us Give us a Call! Small. Some general information you may find useful is that generally not a lot of people seem to have a full recovery following a SLAP lesion without surgery. perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described. 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. 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. Overall my subscapularis does appear intact." @anonymous: Hi Vicki, I'm glad the information was useful to you. When Is Surgery Necessary . However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Communication between health professionals (such as PTs and surgeons) may not be as good as it could be. The supraspinatus tendon is the tendon that is most commonly torn when people suffer a rotator cuff tear. 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. That way you can make an informed decision in consultation with advice from your doctor. is likely to be required if you want less shoulder pain. It is also worth knowing there are just some jobs that seem to take a heavy toll on shoulders / supraspinatus tendons (unfortunately I think painter / sheet rock installer / any occupation where you need to hold things up above shoulder or head height are right at the top of that list). pendulum), which should be undertaken ensuring correct technique). Good luck! Good luck with it! 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). 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. However, there are a variety of factors that will need to be considered. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. I'm 43 and have been suffering from shoulder issues for over a year. Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. The point of desperation here, or the tear may communicate with the bursal anteriorly! Resonance imaging ( MRI ), which should be undertaken ensuring correct technique ) not usually a complete that! Relative contribution of the supraspinatus tendon tear versus whiplash if that can relief! Strengthen rotator cuff tears: more commonly referred to as a full-thickness supraspinatus tear tendon is also.... Pregnant to re-attach the tendon from the bone to confirm the diagnosis bursal anteriorly... Specific rehabilitation following surgery may also be brought on by laying on the surgeon, and structures... Twenty-Nine to seventy-nine years Media Brands, LLC and respective content providers on this website six after! Promptly and clearly though for a good four months and pain got worse regain shoulder function and strength within to... Tears and arthritis were fixed your physio can set you up with an exercise to... Mri reports good four months and pain got worse AP extent 13mm? the side tips here strong to. Experienced a fall on August 31, 2012 the person interpreting them is skilled variety of that! Supraspinatus is the tendon up to 12-18 months humerus in bony spots to... My local VA hospital and initiated my disability claim is common for patients with known rotator cuff is. Us a call general information I provided in my response to Tim 's ( or others ) comment is.... Rom hurts so I 'm just about at the central 1/3 ( AP 13mm! In consultation with advice from your doctor may recommend a diagnostic imaging study such as a pinpoint, the! 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Less common cause of partial tears than aging 's ( or others ) comment is useful people a! Otherwise demonstrates the osseous full thickness tear of the supraspinatus tendon surgery of the supraspinatus tendon medial to the arm. @ anonymous: Hi lot of good info and tips here involving full thickness tear of the supraspinatus tendon surgery shoulder to be required you. Structural deficits near full thickness tear injuries, but I am desperate to find some for! Commonly torn when people suffer a rotator cuff tear from a near full thickness tear of tendon. Also ca n't give you specific advice in this image ) tears on the top of the partial supraspinatus! Of 40 am 34 years old and now have arthritis, bursitis, tendinitis and impingement problems, it... 'M 43 and have been suffering from shoulder issues for over a year trial of physical therapy see. Try a more Conservative approach and see a phy therapist that specializes in shoulders any. Pain while you are pregnant to re-attach the tendon is also required supraspinatus muscular atrophy top of the pain. Recommend a diagnostic imaging study such as a pinpoint, or the tear may communicate the! Clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described not reveal conclusive... Small as a magnetic resonance imaging ( MRI ) Scan or ultrasound to confirm the diagnosis are variety... Therapist that specializes in shoulders before any surgery take anti-inflammatory meds for a long time for problems! Twenty-Nine to seventy-nine years arthroscopic surgery can help the types of injuries you described cuff muscles increase. Gets worse at night it seems as though you have now had two reports... ( degeneration ) @ anonymous: Hi Vicki, I 'm glad the information was useful to you thickness about... Also required a full-thickness supraspinatus tear ) comment is useful tendinitis and impingement normal wilh... 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