MRI). 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. I do not want a metal shoulder. I then went to see another orthopaedic surgeon who said I have whiplash. . From the information you have provided it is difficult to say whether surgery will be needed. I've seen musicians and artists with poor shoulder function be able to perform their art as well as they did before their injury; sometimes through making some adaptations, but other times almost no adaptation was required (depending on their technique / instrument / art etc.). First, sorry for the delay in response. Here is some general information which I hope is useful for you: 1. It is interesting that you are not experiencing a lot of discomfort with a very large tear, but this sometimes happens and can lead to difficulty in diagnosing the exact structural damage that is causing the condition. Did a previous year of PT to strengthen rotator cuff muscles with increase to full range of motion. The specific post-surgery rehabilitation is often differs between surgeons in different regions (depending on the specific techniques they use). 5. and video above) full thickness tears occur when portions of the rotator cuff tendon Jackie. When Is Surgery Necessary . Remember that you are not aiming for speed; slow, steady, and controlled movement is best. 3. 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. With partial thickness rotator cuff tears only part of the tendon has torn off the bone. 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. A supraspinatus tear is the most common malady of the shoulder that appears in my orthopedic practice. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. @anonymous: Dude, I just did nearly the exact same thing. Crossref, Medline, Google Scholar; 35 Ellman H, Kay SP, Wirth M. Arthroscopic treatment of full-thickness rotator cuff tears: 2- to 7-year follow-up study. and seemed to be doing ok with Cortisone shots. Severe pain after. It is difficult to know whether your husband will need surgery based on this information alone. Good luck! Like Helpful Hug REPLY only taking out for prescribed exercises (e.g. Many people have seen sporting heroes dislocate a shoulder during a heavy contact, have a medic "pop" it back in, then continue on 15 minutes later. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. The Physician is online now Related Medical Questions Good luck! Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. I would make sure your surgeon knows you are planning on falling pregnant within the next 12 months. Good Luck to all the other guys, especially the deployed guy, my son has just returned. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). Thanks for the update and let us know how you go. After the injury, you had a partial width full thickness tear of your supraspinatus tendon. 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. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. Full-thickness tears of the supraspinatus and infraspinatus tendons at their attachment site with retraction of torn fibers up to the lateral aspects of the acromial process. 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. Some people will recover quickly without any treatment, other people will recover after commencing non-surgical interventions (such as physical therapy and rotator cuff exercises and / or receiving a steroid injection), while others will still have pain after many months and may require surgery. If tendon tears (including small tears) have not responded to conservative (non-surgical) treatments or recovered naturally after a few months, then surgery is often considered. Communication between health professionals (such as PTs and surgeons) may not be as good as it could be. This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. Unfortunately I can't give you specific advice over the internet. Not all the time, but it was intermittent. 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. He did say that it can be done in the next few months and no urgent intervention required. This may result in pain and weakness of the shoulder. These muscles can be torn in a traumatic injury or simply by age-related wear and tear. In active individuals who use the arm for overhead work or sports. It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) When you speak to your doctor and discuss your plan for treatment, make sure you discuss any relevant work / sport related activities so you both know what to expect. Symptomatic full thickness rotator cuff tears can be managed surgically. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. 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. Had mild discomfort in shoulder for a few weeks in August. On the other hand, if your surgeon thought your tendon would be able to endure pregnancy and nursing your baby without the need for strong medications or the need for surgery, then this may influence your decision on timing for surgery etc. I can reach behind my back ok. After 4 months of therapy and 3 injections I am unable to lift my right arm. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. If you have injured your shoulder or have chronic shoulder and arm pain, it is best to see an orthopaedic surgeon. . MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain Although I probably wouldn't be forthcoming with the name of the first surgeon or advice given unless the surgeon actually asked about this directly. If you are seeing the orthopedic surgeon it is a good idea to tell them about therapies you have received and about your persistent pain. 2. This kind of tear does not heal on its own. Now I have these results stated above. This article describes general phases of rehabilitation following arthroscopic rotator cuff repair. 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. Supraspinatus is the most commonly injured rotator cuff tendon. Went down a water slide on a mat head first arms supporting my body. But shoulder exercises from now until I die. There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. If your tendon were to completely rupture while you were pregnant, this may be very problematic. Wish me luck!!! 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. 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. It sounds like you have several concerning symptoms there. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. In many cases, surgery is required. Care is taken to preserve as much of the CA as possible. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). The retracted margin of the tendon is at the level of the lateral and anterior margin of the anterior acromion. With full thickness tears the entire tendon has separated or torn from the bone. there is minimal AC arthrosis. I am really hoping to find some outside advice. Further studies, like more larger cohort study or prospective study, will be needed to support our results. 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. If you are not keen to rush into surgery don't be afraid to ask your orthopedic specialist about conservative treatment options that may be worth trialing, on the other hand, your surgeon may be able to give you a good indication of whether they think surgery is the most promising option. Here is a link to a recent academic journal article on the topic that should be free to access. I had an arthogram-MRI which showed a 4 mm near full thickness u-shaped tear involving the supraspinatus tendon anteriorly near but not actually at the numeral attachment. techniques (see details below) . Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). The goal of acromioplasty is to increase the size of the subacromial space. Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. A rotator cuff tear may result from an acute injury, such as a fall, or may be caused by normal aging-related wear and tear with degeneration of the tendon. Rotator Cuff and Shoulder Conditioning Program, Rotator Cuff Tears: Frequently Asked Questions, Rotator Cuff and Shoulder Rehabilitation Exercises. Surgical repairs of complete tendon tears from a traumatic event, like a car accident, can easily fail when surgeons instructions aren't followed. It sounds as though you know a little bit about your shoulder situation already, so I won't re-state details about the anatomy that is affected. 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? 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). @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. Productive acromioclavicular joint changes are associated with an anterolaterally down sloping type II acromial configuration. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. 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. or should you just ask for their opinion with no outside information> Thanks Judy. The rehabilitation after surgery is likely to take time. 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. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). . 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. As another rule of thumb, if you are getting mixed opinions from non-specialist doctors, it is often a good idea to refer you to a specialist (who will have most likely have seen your condition ever other day and have plenty of experience treating it). There is compromise of the subacromial space with impression on the underlying torn supraspinatus. Massage may give you some short term relief, but I'm not sure massage on its own will have long term benefit that is additional to natural healing. If the nearly complete tear were to become a complete tear, this would require surgery (ideally quite quickly) to re-attach the tendon otherwise the functioning of the supraspinatus muscle (it elevates the upper arm) would be lost. Does a full thickness tear of the supraspinatus tendon need surgery? Thanks for stopping by and sharing your story with everyone! You may find it interesting to note that a prior subacriomial decompression is not necessarily an indication that future surgery to address other injuries or further biomechanical problems will not be successful. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. She presented initially with active shoulder flexion range of motion (ROM) 0-80 . This information is provided as an educational service and is not intended to serve as medical advice. However, other parts of the rotator cuff may also be involved in the injury. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). (MRI), demonstrating a full-thickness supraspinatus tear. Our results suggest that surgeons should carefully check subscapularis tendon during surgery in posterior delamination patients. He prescribed Vicodin and arthrotec for painbut I would like to get pregnant within a year but would like to be fixed first for obvious reasons. Good luck! Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. 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. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. I am unable to carry any significant weight. When the most effective non-surgical interventions (such as physical therapy) have not been able to provide sufficient relief of symptoms, then arthroscopic shoulder surgery is often considered. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. With a focus on the surgical treatment of reparable full-thickness rotator cuff tears, this article aims to provide an overview of the current knowledge on the treatment of rotator cuff disorders and to highlight which new aspects are relevant. Either way, I wish you all the best with it (and a safe deployment and return). Since then, my pain has gotten to the point where its starting to take effect of my day to day life. @DrMikeM: Dr Mike - as you rightly say I must wait to learn the actual facts of my case - and I have an appointment soon so I will learn then I hope. I am in aching pain consistently. Basically, it creates a hole in the tendon. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. @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. 4. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. As I think you already suspect, an MRI is likely to have greater diagnostic accuracy for ruling out (or in) the involvement of other structures in your shoulder, such as the long head of Biceps Brachi. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! They can then make a diagnosis and begin treatment. Equally as important is a discussion about the likelihood of certain outcomes without further surgery. Ongoing serious pain influencing daily life, sleep etc. 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. 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. my MRI result come out that supraspinant tendom has partial tear. 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. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. but can get back fairly good motion about the shoulder . labra are not evaluated 4. 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. Supraspinatus tear can be caused by lifting something too heavy, falling on your arm, or dislocating your shoulder. These tears can be painful. First, when I speak to patients that have received conflicting opinions from surgeons often the problem is not necessarily a difference in medical knowledge between their surgeons, but a difference in communication ability or time taken to ensure their message was understood correctly (sometimes one of the doctors has not explained things as well as they could have or spent enough time ensuring that their explanation was clear and has been understood as it was intended). When I went in, he told me that after looking at my MRI, he did not think that anything was necessary, and instead wanted me to go back into physical therapy and continue to get steroid injection treatments. Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. I can't comment on the nature of care you have received, but I can say that you are not alone in this type of experience! I have always found the anatomy of the shoulder to be very interesting. 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. Because of the risk of infection and and nerve damage. Patients ranged in age from twenty-nine to seventy-nine years. I have been saving up a couple months to cover my deductible expecting to schedule surgery. Mike!! 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. ), a shoulder x-ray may not reveal anything conclusive. As you have correctly identified, there is quite a long recovery period following surgical repairs of rotator cuff injuries, but on the other hand, there is a pretty good success rate among people who follow the post-operative instructions. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. It will be your Godsend. Many persons with partial-thickness tears will never require surgery if they undergo an appropriate physical therapy rehabilitation to address muscle imbalances. 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