However, I can just mention some general information that may be of interest. have got bursal thickening as well and mild thickening of. I found the information good. This will help you figure out what you are deciding between. 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 in doubt, don't be afraid to get a second opinion. 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. 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. Very much appreciated. Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. However, there are a variety of factors that will need to be considered. The use of steroid injection for treatment of a full-thickness rotator cuff tear is still controversial. Articular side: tears on the bottom of the tendon. A full thickness tear is not usually a complete rupture. I hope I have not waited to long for having this checked, and the only option will be 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? The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. All the best. 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. 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. This sounds like a difficult situation. 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. Thanks. If they suggest surgery, ask them about what you can expect after surgery and the likely recovery time (including how long it is likely to be before you can use your arm for normal occupational or day to day activities). Went down a water slide on a mat head first arms supporting my body. Patients ranged in age from twenty-nine to seventy-nine years. 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). 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 appreciate your thoughts on this matter. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. Especially since my injury has gotten worse instead of better. there is a small full thickness insertional tear identified relating to the posterior supraspinatus. 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. Don't be afraid to ask your surgeon about all your treatment options. 3. 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. 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). I served in the Navy for many years, and in April of 2010 I had a little mishap. 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. If you have any uncertainty around the need for your sling use, please call your surgeon's office today. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. but unfortunately, the results were extremely minor. This website also contains material copyrighted by third parties. People tend to expect recovery after surgery will take a few weeks. Thanks for sharing. 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. J Bone . 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). @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. Interstitial hyperintensity is seen within biceps tendon in the . 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. This is partly because rehabilitation following surgery will depend on the surgical technique used. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. is PT a good options. In the interim, physio, chiro, massage, taping were part of my pain management and ROM for all pain sites relating to MVA. I'm quite apprehensive and nervous about the surgery but more so about the recovery. It sounds like you may have already discussed the likelihood of success with your surgeon, if not, this would be a very wise thing to do. If you get a chance drop by again and let us know how you went. If you give PT a go, make sure you follow their instructions and specific techniques for the exercises they give you (most likely to strengthen your rotator cuff). Im a bodybuilder for years but I'm getting old. 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. Starting with Physio treatment is a good idea. What does he mean by my tendon is failing? I have full range of motion and only occasional soreness now and again, but can't sleep on that side. There also is mild tendinosis of the infraspinatus at the footprint. 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 also have no insurance and don't know about surgery. Re-attaching the tendon to the bone as you have described is a substantial surgery, the first months of recovery after this type of surgery are very important to ensure that the tendon does not detach / rupture and optimal recovery can occur. A complete, full thickness tear means that the tear goes all the way through the tendon. The majority of rotator cuff tears can be treated nonsurgically using one or more of these treatments: The goals of treatment are to relieve pain and restore strength to the involved shoulder. I explained of my ongoing problems since the incident, and once the claim was processed I was sent through a variety of medical departments for a full diagnostic. All material on this website is protected by copyright. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Care is taken to preserve as much of the CA as possible. Hope that helps. I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. I hope some of the general information I provided in my response to Tim's (or others) comment is useful. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. i was recently diagnosed via MRI that i have a supraspinatus tendon tear. The Physician is online now Related Medical Questions there is no focal atrophy or fatty infiltration.that is my M.R. Early diagnosis and treatment of a rotator cuff tear may prevent symptoms such as loss of strength and loss of motion from setting in. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. In addition to arm elevation, the supraspinatus muscle is critical in pulling the head of the humerus (the ball part of the ball and socket joint) into the glenoid (socket). I can reach behind my back ok. thank you for your considiration and helle from Turkey:-). So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. I'm 43 and have been suffering from shoulder issues for over a year. >5cm), depth (partial or full thickness), degree of fatty infiltration (Goutallier. Tendonosis literally means chronic pathology without inflammation (i.e. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. Basically, it creates a hole in the tendon. Sorry for the delay in response. I had an MRI done on my left shoulder last week and it turns out, to my surprise, that I have a full-thickness supraspinatus tear. When I visit my DR. what are the thing I need to be aware for the diagnostic? I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). Instead specific movements are required, these shouldn't cause pain while performing the exercise. As far as general information goes, it is also worthwhile noting that chronic pain and inflammation at a joint can lead to secondary changes (weakening muscles, changes in the way the body processes pain etc.) The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. Front view (left) and overhead view (right) of the tendons that form the rotator cuff. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. Is surgery my only option? coracoacromial ligament. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. The supraspinatus tendon is the tendon that is most commonly torn when people suffer a rotator cuff tear. @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. Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. The supraspinatus is one of four rotator cuff muscles in our shoulder. perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. Good luck! I have lost about 45+% of my ROM in my right arm. 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. I have not returned back. LOTS of heavy benching, etc. This can be one of the most frustrating things for people who have whiplash associated disorders. On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) I have a referral to a specialist and hopefully I will have some answers soon. If pregnant or nursing, consult with a qualified provider on an individual basis. If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. The supraspinatus is the tendon that tends to suffer from partial tears most commonly. Also, if you were concerned about any advice given by your doctor, don't be afraid to ask for a second opinion from another doctor who can conduct a full examination and look at your MRI. . I had surgery in Mar 2012 for decompression,near full thickness bursa tear and a near full thickness supraspinatus tear with degeneration and general multi-directional laxity of the shoulder capsule.I know the work I have preformed and physical activities over the past 20yrs haven't helped but it was an acute injury that ended it.Since surgery I have been to a physiotherapist but after a few sessions I was experiencing a spot of pain (hot spot) which the physio dismissed as surgery related pain.To make a long story short, gym didn't go well to which I was told by my physio that I was overdoing it (I followed the program to the letter) anyway a second opinion found I have got a high grade partial tear and possible partial full thickness tear and bursa thickening and bunching on adduction. I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. I just found out this week that I have Bursitis, and a tear in my Supraspinatus. and still end up with an unexpected problem. Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! After an initial diagnosis from an Orthopedic specialist, the initial course of action was a steroid injection treatment into the "affected area" and a course of physical therapy. ROM decreased. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. Thanks for stopping by, you have raised some very good questions. Muscular and tendinous structures including remaining portions of the rotator cuff are also felt to remain otherwise unremarkable in signal and morphology. Here I am 5 days post op. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. damage to the tendon without swelling). In the case of a non-retracted full thickness supraspinatus tear and acromioclavicular degeneration, surgery may well be the best option to maximize the long term outcome. 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 unable to carry any significant weight. I am in aching pain consistently. 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. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. Quick story on me: I'm 41, male, 5'11", 205. The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. Injuries are a less common cause of partial tears than aging. 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. Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). On the other hand, if surgery is inevitable or at least the most likely outcome, then the treating doctor / surgeon(s) may recommend early surgery. 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