Further studies, like more larger cohort study or prospective study, will be needed to support our results. my ROM did increase a very small amount, but my pain and discomfort never went away. Good luck! @Reallmadhatter: Good question. @brando87: Thanks brando87, that's what I aim for! The presence of greater tuberosity cortical irregularity and joint fluid was most important in the diagnosis of full-thickness supraspinatus . It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) Hi, I have had a partial supraspintus tear for 3 years now, and am wondering if it's too late to anything about it? 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. Although very uncommon, it is possible that the report did contain an error. 2. mild labral degeneration. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full Reallmadhatter Mar 14, 2013 @ 3:44 pm. Dr. Mike great info here thanks. For anyone contemplating surgery, buy a recliner to sleep in after surgery. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. It plays a critical role in movements involving the shoulder joint, particularly arm elevation. However, some people will never experience the same level of recovery without the surgery. 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. What does all that mean in simple layman terms? Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. A full-thickness rotator cuff tear is characterized by a focal transmural tendon discontinuity, . This level of degradation is not particularly common for someone so young, but does happen from time to time and may well lead to a complete rupture. Having pain and sub-optimal shoulder functioning while you are nursing would not be ideal. 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! Not all the time, but it was intermittent. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. will consult surgeon next week. Make sure you understand their explanation of what problems are occurring around you shoulder and what treatment options are available to you. The supraspinatus is one of four rotator cuff muscles in our shoulder. J Bone . However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. 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. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. and still end up with an unexpected problem. Thanks for stopping by and leaving a comment! Good luck! The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. Usually getting a second opinion is not a bad option if you are not confident that the first opinion is going to lead to the best outcome for you, but I expect that may well be impossible while you are still on deployment? In some cases, surgery to repair the tendon is also required. the defect measures approximately 1cm anterior to posterior and medial to lateral. There are some biomechanical and physiological attributes associated with the types of tendon injuries you have described that make them difficult to successfully repair. 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. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. Mary Kay. Thanks to my hubby for finding this site. If the pain has been present for only a couple of months (or less) and there were minimal risk of worsening the condition with delay, then often a trial of conservative management (e.g. This sounds like a difficult situation. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. 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. 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. 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. Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. 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. Very much appreciated. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. but can get back fairly good motion about the shoulder . The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. Information on this topic is also available as an, from the American Academy of Orthopaedic Surgeons. Thank you for the info posted on this page. 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). 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 have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. 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. The supraspinatus is part of the rotator cuff of the shoulder. @anonymous: Hi Les, I am glad you found this information helpful. 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. I then went to see another orthopaedic surgeon who said I have whiplash. Good luck! ,Been dealing with shoulder pain for about nine months now and thought I'd share my experience with you and other readers. Do I will need surgery? 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? It may be as small as a pinpoint, or the tear may involve the entire tendon. Your surgeon will be able to explain the potential risks and benefits (as well as if he thinks any alternatives are likely to be helpful). Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. 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. I'm only 38 and am not willing to give up everything I love doing and from what I read there are many more options available. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . 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. These types of pathology are nothing to be sneezed at and have potential to cause quite a lot of pain (which you probably know a thing or two about). I think it would be wise to listed to the advice from your doctor on this one! 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 . It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) I was instructed to ice pack my shoulder and take it easy. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. Supraspinatus tears are often accompanied by adjacent structural deficits. Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. The rotator cuff tendons attach to the head of the humerus in bony spots referred to as the greater and lesser tuberosities. if applied to the common anterior supraspinatus tendon tear, the term full thickness means that if the tear is viewed . This may result in pain and weakness of the shoulder. I don't think there is a clear answer to this one. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. 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. All the best with it. 19 The thickness of the tendon at its insertion was . Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. Arthroscopy 1993;9(2): 195-200. Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. The rotator cuff is made up of 4 muscles. Thanks for stopping by and sharing your story. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. ( x-ray, phys ther,corticosteroid inj. Either way, don't be afraid to ask your surgeon lots of questions (likelihood of success in your case, what will happen after surgery, recovery time-frames etc.). I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. There is synovial fluid at the glenohumeral articulation. (See Fig. Three kids will no doubt also be keeping you busy and missing out sleep because of your shoulder pain doesn't sound like much fun. but unfortunately, the results were extremely minor. 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. Should this shoulder have an MRI? 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. There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. Let us know how you go! P.S. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. I plan on asking the surgeon these questions, but wanted your expert opinion. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. If you have any uncertainty around the need for your sling use, please call your surgeon's office today. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. 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. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. It allows a provider to assess the structures of your shoulder during movement. I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). infraspinatus tendon had full-thickness tear . 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. Good luck! . Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. If you have only seen your family physician or general practitioner so far it would be a good idea to ask them about a referral to an orthopedic specialist who primarily treats patients with shoulder conditions. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. 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). So quite often the best treatment approach is not always immediately clear. there is a small full thickness insertional tear identified relating to the posterior supraspinatus. If muscles of the rotator cuff are not providing adequate stability throughout the shoulder's range of motion, this can contribute to shoulder impingement and a break down of the supraspinatus tendon. 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full thickness tear of the supraspinatus tendon surgery