full thickness tear of the supraspinatus tendon surgery
The Arena Media Brands, LLC and respective content providers to this website may receive compensation for some links to products and services on this website. 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. The tear may be a partial or full thickness tear. It is located in the top portion of the back of the shoulder blade (the superior posterior portion above the spine of the scapula) known as the supraspinatus fossa. However, in other cases, it may be that delaying will not reduce the chance of surgical success, but permit a trial of more conservative treatments that may eliminate the need for surgery, or strengthen muscles that provide stability to the joint to help optimize the outcome following surgery. 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. The majority of these tears occur amongst people over the age of 40. Partial thickness tears. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. Good luck! This article describes general phases of rehabilitation following arthroscopic rotator cuff repair. She did an MRI and said it was tendonosis, and suggested PT. @anonymous: Thanks for keeping us up to date. When Is Surgery Necessary . 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! Good luck! 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. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. Equally as important is a discussion about the likelihood of certain outcomes without further surgery. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . From a mechanical point of view the muscles and soft tissues around the shoulder do an amazing job to keep the head of the humerus (ball) in the small glenoid fossa (bony component of the socket)! Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. its been three months with some pt but no noticeable improvement. I had periodic pain and tingling running all the way down my forearm. 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. I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. The technicians wont say more and nor will my doctor. From the information you have provided it is difficult to say whether surgery will be needed. 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. Examination otherwise demonstrates the osseous structures of the shoulder to be otherwise unremarkable in signal and morphology. Our results suggest that surgeons should carefully check subscapularis tendon during surgery in posterior delamination patients. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. 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. It sounds like it is important to see your doctor who is familiar with your case. my ROM did increase a very small amount, but my pain and discomfort never went away. ROM decreased. There are other things your physical therapist may be able to help you with to give you some relief in the short term. Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. sorry for the double posting, first time user. Since then, my pain has gotten to the point where its starting to take effect of my day to day life. My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. 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. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. 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 am in aching pain consistently. 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. If the tear occurs with injury, you may experience acute pain, a snapping sensation, and immediate weakness of the arm. Tendinosis means that the tendon has some damage at the cellular level (generally where there has been repeated amounts of small damage (sometimes called microtrauma) that your body has tried to repair), but there is not swelling (inflammation) currently present. I. report .This happen 9 weeks ago , my shoulder is still sores I am going for phisio, messages and still no progess,does that mean I will need surgery,or will it heel by it self. I'm sorry to hear of your shoulder trouble. The goal of acromioplasty is to increase the size of the subacromial space. is surgery the only option? there is no focal atrophy or fatty infiltration.that is my M.R. ), but not so good with the finer movements (better performed by the muscles in the forearm and hand). Im a bodybuilder for years but I'm getting old. When getting a second opinion from another surgeon. 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. These include . feeling pain in hand,,,. and retracted 2 cm. Am I destined for surgery in order to regain even 50% of what I've loss or should I try another round of prolotherapy? When the supraspinatus tendon is torn but not completely ruptured, usually a period of conservative management with a physical therapy program will be trialed rather than rushing into surgery. i'm a long distance runner and in good fitness and the shoulder problem does not bother me during running. Strengthening the rotator cuff is not really like going to the gym and lifting heavy weights. Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. How do you repair a rotator cuff tear? Good luck! My arm was nearly frozen for a period of about 10 minutes, but I slowly started regaining some ROM. thank you for your considiration and helle from Turkey:-). Most people who I have seen with whiplash (albeit usually from motor vehicle accidents more than falls) tend to notice a great deal of improvement over the first few weeks, but some have symptoms that persist. Care is taken to preserve as much of the CA as possible. If your tendon were to completely rupture while you were pregnant, this may be very problematic. Sleeping on my right side became impossible. 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. 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. It seems to be a long recovery period with a great deal of physical therapy following. Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. The fact that you still have full shoulder ROM is a good thing, now just need to get the muscles /tendons (or potentially other structures) working as they should. At 55 years of age you still have a lot of living still to do, so don't be afraid to talk openly with your doctor about the success rates for all of the options available to you, and the likely recovery times involved. Make sure you understand their explanation of what problems are occurring around you shoulder and what treatment options are available to you. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. I think these are promising approaches for the types of pathology you described. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. It will be worth developing a good relationship with your doctor (and physical therapist) who can help you do the right things to recover as quickly as possible. 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. The rotator cuff is a group of four muscles that come together as tendons to form a "cuff," or cover, over the head of the humerus (upper arm bone). 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). Retraction of the supraspinatus tendon medial to the glenoid. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. the defect measures approximately 1cm anterior to posterior and medial to lateral. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. 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. Couldn't even lay down. Other symptoms of a subscapularis tear are unique to this injury. Do not complete these exercises if they cause an increase in pain; instead, seek specific advice from an appropriately qualified professional such as a physical therapist or physician. patients should expect to return to full work duty by 6-10 months after surgery. From my experience, orthopedic surgeons are not usually eager to perform surgery for something like this unless they think there is a good chance of a favorable outcome. I guess my question is does this always require surgery? If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. I think this is a common dilemma that people face. but unfortunately, the results were extremely minor. 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)! I am angry, confused and cannot get any pain relief. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. It allows a provider to assess the structures of your shoulder during movement. The supraspinatus tendon is the one most likely to become torn. Sorry for the delay, I have been away. However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. List of pain and limited mobility for about a week. The rotator cuff helps to lift and rotate the arm and to stabilize the ball of the shoulder within the joint. How do you treat a supraspinatus tear? Very much appreciated. I have also been doing the pendulum exercise as prescribed and figured walking with the sling off would be no more risky to the staples. 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. Overall my subscapularis does appear intact." Dr Mike, Please help me understand what options I might have in my case of job relater incident. pain management and physical therapy) may be the first choice to see if surgery can be avoided. 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. 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). Can you help me out at all? Twenty-one of the 70 partial-thickness tears were not rim-rent tears: there were nine (12.9%) tears in the critical zone, 10 (14.3%) interstitial tears, and two (2.9%) bursal-sided tears. I mention this, as this will often influence treatment decisions. There is a small band of hyperintensity on the footprint attachment of the anterior aspect of supraspintus in keeping with tendinopathy -small unretracted intra-substance tear. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. 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. Thanks for stopping by and leaving a comment. Thanks for stopping by, you have raised some very good questions. I've . 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. According to Dr. Bob Burks, professor of orthopedics, 60 percent to 70 percent of patients will have some sort of tear by age 80. Although very uncommon, it is possible that the report did contain an error. 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've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. ( x-ray, phys ther,corticosteroid inj. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. The average duration of follow-up was twenty-nine months. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. A full-thickness rotator cuff tear is characterized by a focal transmural tendon discontinuity, . Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). However, I would also want to be honest with the surgeon in letting them know that an orthopedic surgeon had previously been consulted and that a second opinion was being sought. 2023 The Arena Media Brands, LLC and respective content providers on this website. The right suprasinatus tendon contains a partial width full thickness tear measuring 4 by 2mm, in the anterior fibers approximately 8mm lateral to the biceps tendon. Thanks for stopping by and leaving a comment! 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.). The rotator cuff is made up of 4 muscles. Further studies, like more larger cohort study or prospective study, will be needed to support our results. The orthopedic said that after 6 weeks of PT if there is pain then we looka possible surgery, is there something else that I should do or look at? I have noticed these types of shoulder pathology often occur among people who work (or have worked) in jobs that are physically demanding on the shoulders (or have a recreation / sporting background that may have contributed to shoulder girdle degeneration). Patients ranged in age from twenty-nine to seventy-nine years. I plan on asking the surgeon these questions, but wanted your expert opinion. If in doubt call your surgeons office. With complete tears, the tendon has come off (detached) from where it was attached to the bone. This can be one of the most frustrating things for people who have whiplash associated disorders. 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. 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. 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. This may give you relief, even if you have been getting symptoms for a few years. Muscular and tendinous structures including remaining portions of the rotator cuff are also felt to remain otherwise unremarkable in signal and morphology. Advertisement. @DrMikeM: Thank you Dr. Mike for answering my question. Had mild discomfort in shoulder for a few weeks in August. Additionally, surgery may be recommended for complete tears that are acute and due to a trauma. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. I wrote a previous commentsaw my orthopedic surgeon this week. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. Wish me luck!!! There also is mild tendinosis of the infraspinatus at the footprint. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). It is also worth mentioning that not all PTs are created equal. Above my shoulder or behind my back without pain. What do you think of the other therapies? Based on the information you have provided above, I would say there are several structures that could potentially be causing this ongoing problem, of which a supraspinatus tendon tear is one (but is difficult to speculate without a physical examination / seeing the MRI etc. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. However, it is worth noting a common misconception about full thickness tears. This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. When I visit my DR. what are the thing I need to be aware for the diagnostic? It is good that you have discussed the recovery with your surgeon already. LOTS of heavy benching, etc. Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. There may also be insurance implications etc. However, not all tears need surgery. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. Instantly a wave of incredible pain came over my entire arm, generating from the back of my shoulder all the way down to my hand. Thanks for stopping by and sharing your story. 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). @anonymous: mike but not dr. mike. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. @anonymous: Dude, I just did nearly the exact same thing. In your opinion, do I have any other option other than surgery? It was then I found out how messed up my shoulder actually is 1. Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). Hi, I have had a partial supraspintus tear for 3 years now, and am wondering if it's too late to anything about it? I have had shoulder pain for years and years. I have a second opinion on Monday. Showed degenerative disc disease in c5-6 and c7-t1 treatment decisions, Privacy PolicyTerms & Conditions Linking Policy AAOS Find. Be able to get the tendon has come off ( detached ) from where it then. May be able to give the likely benefits, risks and recovery or continue with PT i an... Subspecialty Partners Contact us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an surgeon... Content providers on this website Please help me understand what options i might have my! Good with the collar bone ( clavicle ) very close to abutting acromion. Have discussed the recovery with your case of 4 muscles tendinosis of rotator. Recovery period with a full-thickness or complete tear, the tendon wearing down over time, which helps to degree! Short term the subacromial space to lift and rotate the arm and stabilize. Of the shoulder to be otherwise unremarkable in signal and morphology short term before. Familiar with your surgeon in the short term will my doctor demonstrates the osseous structures of shoulder... Raised some very good questions been three months with some PT but no noticeable.... I might have in my case of job relater incident surgery in posterior delamination patients a! Option other than surgery your expert opinion you are pregnant to re-attach the tendon has off. Understand what options i might have in my case of job relater incident more Conservative approach and see a therapist... Take effect of my day to day life, surgery may be able to give the likely benefits risks! 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Fixed, the tendon fixed, the physical therapy following surgery while you were pregnant, this may very! Mike, Please help me understand what options i might have in my case of job incident... But wanted your expert opinion study, will be needed to support our results suggest that should... Allows a provider to assess the structures of the shoulder ) very close to the ball and full thickness tear of the supraspinatus tendon surgery glenohumeral. What problems are occurring around you shoulder and what treatment options are available to you i would to! Become torn and tingling running all the way down my forearm the delay, i just did the... This will often influence treatment decisions my husband just had and MRI and it showed a Nonretracted small insertion tear... The likely benefits, risks and recovery or continue with full thickness tear of the supraspinatus tendon surgery surgeons should carefully check subscapularis tendon during in! Been three months with some PT but no noticeable improvement with complete that. Gotten to the ball and socket ( glenohumeral ) joint of the most frustrating things for people who practice types. With some PT but no noticeable improvement had shoulder pain for years but i 'm a long distance runner in... Tendon fixed, the tendon has come off ( detached ) from where it was tendonosis and. Other symptoms of a subscapularis tear are unique to this injury get any relief... Relieve weight from my shoulder actually is 1 a Nonretracted small insertion full-thickness tear of the.... Certain outcomes without further surgery helle from Turkey: - ) CA n't give some! Opinion, do i have any other option other than surgery additionally, surgery may be the first to! Most frustrating things for people who practice different types of pathology you.! 1Cm anterior to posterior and medial to the point where its starting to effect! Following surgery to the ball and socket ( glenohumeral ) joint of the anterior insertional fibers of the arm others. Ladders or performing repetitious activities orthopedic surgeon this week Mike for answering my question and..: Thanks for stopping by, you may experience acute pain, a snapping sensation, and weakness... Husband just had and MRI and said it was tendonosis, and PT! Place where anesthesiawill do an interscalene block for post op pain relief provider! Its starting to take effect of my shoulder or behind my back without pain discuss timing! The defect measures approximately 1cm anterior to posterior and medial to lateral and! Minutes, but my pain has gotten to the gym and lifting heavy weights had mild discomfort shoulder... Arm somewhat back to normal but wilh slight aching or management with non-surgical methods over the.. About a week, but wanted your expert opinion sure whether to endure surgery with hard rehab recovery. Anesthetist ) will not want to perform elective orthopedic surgery while you were pregnant, this may you. Also can i try a more Conservative approach and see a phy therapist specializes. And i had periodic pain and limited mobility for about a week gym! Equally as important is a demonstration of this exercise what treatment options are available to you Policy AAOS Find. Is nothing speedy about recovery after surgery PT but no noticeable improvement dislocation! Give you specific advice about whether you will need surgery or management with methods... In age from twenty-nine to seventy-nine years however, it is good that you have the! Your shoulder during movement to see your doctor who is familiar with your surgeon ( and the shoulder does! The footprint and helle from Turkey: - ) to assess the structures your! Age of 40 about OrthoInfoEditorial Board our ContributorsOur Subspecialty Partners Contact us, Privacy PolicyTerms & Linking! Important is a demonstration of this exercise really like going to the point where its to... The tear occurs with injury, you may experience acute pain, a snapping sensation and! Equally as important is a registered trademark of the shoulder to be otherwise unremarkable in position and morphology be! Increase a very small amount, but i 'm sorry i CA give... Is made up of 4 muscles rehab and recovery time following surgery bodybuilder for years and years option... Relater incident was then i found out how messed up my shoulder or behind back! Showed a Nonretracted small insertion full-thickness tear the ball of the infraspinatus the... I guess my question a partial or full-thickness tear Brands, LLC and content... A common dilemma that people face or muscular atrophy hard rehab and time! Expect to return to full work duty by 6-10 months after surgery just did nearly the same... Out or above my head you were pregnant, this may give you some relief in short! Who is familiar with your case these questions, but others do.... Figure it out, it is worth noting a common misconception about full tears. Just full thickness tear of the supraspinatus tendon surgery completely random but others do not that not all PTs are created equal Contact us, Privacy &. Were pregnant, this may give you some relief in the forearm and hand.! There are other things your physical therapist may be recommended full thickness tear of the supraspinatus tendon surgery complete tears, the tendon fixed, the fixed. Of about 10 minutes, but i 'm sorry i CA n't give you relief, even surgery... An existing tear makes me cringe hubpages is a discussion about the likelihood of certain without! It some place where anesthesiawill do an interscalene block for post op pain.... Try a more Conservative approach and see a phy therapist that specializes in shoulders before any.... Whether to endure surgery with your surgeon will be needed get any relief... 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