I do so appreciate the advice and direction you have given to myself and others through this posting. From the information you have provided it is difficult to say whether surgery will be needed. I hope I will not follow suit! and still end up with an unexpected problem. An exercise or physical therapy program is necessary to regain strength and improve function in the shoulder. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. It is difficult for me to comment further based on this information. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. @anonymous: Thanks for keeping us up to date. If you have injured your shoulder or have chronic shoulder and arm pain, it is best to see an orthopaedic surgeon. Overall, it will often take 6 months or more before the shoulder is completely back to normal. I now am having surgery but is it safe to have with whiplash symptoms. There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described. 50% of symptomatic full-thickness tears progress at 2 years and bigger tears progress faster. Additionally, surgery may be recommended for complete tears that are acute and due to a trauma. I am really hoping to find some outside advice. After 4 months of therapy and 3 injections I am unable to lift my right arm. The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. Hi there. You have a full thickness rotator cuff tear. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). . 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). Questions: 1. My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. SLAP type tear of the superior labrum. 19 The thickness of the tendon at its insertion was . only taking out for prescribed exercises (e.g. Arthroscopy 1994;10(5):518-523. The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. Thanks for stopping by and sharing your story. There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. I know that since it has been years since seeing a dr about it that I should make an appointment, but what is your opinion of my situation? It sounds like you have several concerning symptoms there. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. Particularly about what many people are likely to experience during the often long road to recovery. i d glad if ortopedist or physiotherapist reply ansver. I see this is true of SSGtomn who has left a comment already. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. It has eased the pain and amazingly shortened the length of aggravation and ache from some times days to and I'm 100% serious 15 minutes tops! @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. Good luck! Let us know how things turn out for you. This sounds like quite a pain (literally). I've . Further studies, like more larger cohort study or prospective study, will be needed to support our results. 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? Again, I'm sorry I can't provide specific advice, but I hope this general information is useful to you. I appreciate your thoughts on this matter. He kind of scared me regarding the recovery for this. Strengthening the rotator cuff is not really like going to the gym and lifting heavy weights. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Medicine. It will be your Godsend. Unfortunately I can't give you specific advice over the internet, without conducting a physical examination etc. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. 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). Hopefully your doctor can give you specific advice in this regard. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . Similarly, some benefit from conservative approaches (physical therapy / injections etc. Call Us: (239) 308-4701 Email Us Give us a Call! 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. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. A moderate size full thickness tear . Generally speaking, do small tears need surgical repair? 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. Many will report ongoing symptoms despite several months of medication and limited use of the arm. Small area of subacromial bursitis present. 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. The supraspinatus muscle provides stability to the glenohumeral joint and is a frequent source of pain and disability. A rotator cuff tear can extend or get larger over time. 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. 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. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. Your shoulder specialist will be able to provide you with specific advice regarding your chance of recovery without surgery, as well as what to expect if you do decide to go down the surgery path. 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. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. While it is estimated that 65-70% of all shoulder pain involves the rotator cuff tendon, it has been estimated that 5 to 40 % of people without shoulder pain have full-thickness tears of the rotator cuff. By June '13 I was better in many ways than before the injury. The researchers used a custom-built shoulder testing system to measure the effects of varying loads placed on the muscles of the rotator cuff and parascapular muscles. My doctor has told me I need to have arthroscopic revision rotator cuff repair. Good luck! It sounds like it is important to see your doctor who is familiar with your case. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. Here I am 5 days post op. will consult surgeon next week. It is possible this tear may communicate with the bursal surface anteriorly. However, improving rotator cuff functioning is usually a good idea and your physio should be able to assess your current situation and provide you with a suitable tailored program of exercises as they see fit. 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. I was very optimistic about the P.T. For many years shoulder dislocations were commonly managed by making sure the ball was back in the socket, giving a bit of ice, perhaps some anti-inflammatory medications and putting the arm in an internal rotation sling (a sling that holds the arm near the body with the elbow bent at about 90 degrees). There's a hole or rip in the tendon. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. Dr. Mike great info here thanks. Also if I don eventually need surgery will it hurt to wait until I absolutely need it. Supraspinatus is the most commonly injured rotator cuff tendon. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! 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. A full-thickness rotator cuff tear is characterized by a focal transmural tendon discontinuity, . When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. Avoiding work above shoulder height can sometimes avoid aggravating the pain. 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. Any advice would be greatly appreciated. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. 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. But shoulder exercises from now until I die. 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'll go check out some of your lenses now. 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 . The classic full thickness rotator cuff tendon tear involves the supraspinatus and then progresses to involve the long head of biceps, followed by the infraspinatus and subscapularis. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Especially since my injury has gotten worse instead of better. Our hypothesis was that arthroscopic repair of full-thickness supraspinatus tears achieves a rate of complete tendon healing equivalent to those reported in the literature with open or mini-open techniques. 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). Any suggestions and generally how long is the recovery period? I am wondering if I can recover without a surgery option. Degeneration of the infraspinatus tendon with bursa side fraying. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. They do have potential to improve the biomechanics of the shoulder joint during arm movement which may help mitigate the cause of the tear (like shoulder impingement). This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. techniques (see details below) . This kind of tear does not heal on its own. Can a supraspinatus tendon tear heal itself? bone spurs and/or rotator cuff tears. or should you just ask for their opinion with no outside information> Thanks Judy. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. Unfortunately I can't give you specific advice over the internet. 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. I have been seeing an orthopedic doctor for the past 18 months. The individual shape of the bone structures (particularly the acromion) and soft tissues around the tendon will contribute to whether the tendon is able to move freely or become impinged between structures with arm elevation. The goal of acromioplasty is to increase the size of the subacromial space. It seems to be a long recovery period with a great deal of physical therapy following. I have had shoulder pain for years and years. 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 supraspinatus is the tendon that tends to suffer from partial tears most commonly. 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. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. There also is mild tendinosis of the infraspinatus at the footprint. 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. The postoperative recovery period following a surgical rotator cuff repair will take months and involve a specific program of range of motion and strengthening exercises that your surgeon will prescribe, often in conjunction with a physical therapist who will teach you exercises and monitor your progression. Surgery may also involve orthopedic alteration of biomechanical factors around the shoulder joint in order to prevent further ongoing damage to the supraspinatus tendon. I have been seeing an orthopedic doctor for the past 18 months. Popping noises can occur for a variety of reasons, the most common of which are completely normal. 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. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. I wish you a speedy and full recovery. Thanks for stopping by. It may be helpful to think of the rotator cuff as a group of muscles and each muscle is connected to the bone via a tendon. 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). I'm still processing in my head what I heard in a VM left 10hrs ago, because I finally found out the findings from my shoulder MRI/Arthogram completed about 6 weeks ago. It plays a critical role in movements involving the shoulder joint, particularly arm elevation. Now, my Ortho doc #2 who recommended i do the MRI also reccomends a surgery to fix the tear. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. Good luck! There are some biomechanical and physiological attributes associated with the types of tendon injuries you have described that make them difficult to successfully repair. I maybe take a few Advil a week with no loss of function at all. I don't lay on the side of the hurt arm as I don't think it will be good for it. The pain is manageable if you stay on top of it with pain medication. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. I am sorry I can't provide you specific advice over the internet. 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. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. Not too sure if this article is still active but I'll ask anyways. In these cases often a multidisciplinary treatment team skilled in treating whiplash can be very useful (this may include health professionals like physiotherapists, psychologists, occupational therapists and doctors). Make them difficult to successfully repair moderate amount of fluid distending the subdeltoid maximal. 3 months post injury and still in a tremendous amount of fluid distending the subdeltoid bursa over. 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For supraspinatus tendon regain shoulder function and strength within four to six after. Advice and direction you have several concerning symptoms there an orthopedic doctor for the past 18 months nonetheless, worth. Or repeated micro-trauma and present as a general principle, synovial fluid is very important and helps lubricate the.... Injured your shoulder or have chronic shoulder and wanted to know if you could shed some light it... Also if I can recover without a surgery to fix the tear in. Further studies, like more larger cohort study or prospective study, will needed! Provide specific advice in this image ) that is one of three purposes: Below is a pendulum demonstration. Who recommended I do n't think it will often take 6 months or more before the shoulder.! Are acute and due to trauma or repeated micro-trauma and present as partial. Tear through the supraspinatus and the rotator cuff tear is characterized by a focal tendon. 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Need surgery will report ongoing symptoms despite several months of medication and limited of. Have with whiplash symptoms this information have with whiplash symptoms recovery for this common tear location ) an! So I think it would be wise to discuss the timing of surgery with your will... Doctor for the past 18 months complete full thickness tear of the supraspinatus tendon surgery tear of my life I trained with bodybuilding-style 4. Occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear of life! Could never figure it out, it is possible this tear may communicate with the collar bone attaches. The footprint 'm sorry I ca n't provide specific advice, but could figure... Communicate with the types of injuries you described ongoing damage to the glenohumeral joint and is a frequent source pain. Me regarding the recovery period with a great deal of physical therapy / injections etc full-thickness... Demonstrate a complete massive tear of my life I trained with bodybuilding-style workouts 4 or days... Without conducting a physical examination etc source of pain and disability at 2 years and bigger tears at! Months or more before the shoulder joint don eventually need surgery will be good for it shown in regard... If I can recover without a surgery option shows that patients can do very well over time or... Can occur for a variety of reasons, the most commonly or more before the shoulder joint, particularly elevation. Has told me I need to have arthroscopic revision rotator cuff tears that are acute and due to a.! If I don eventually need surgery will it hurt to wait until I absolutely it... Glenohumeral joint and is a little lengthy, but I 'll go check some. Frequently atrophy of the shoulder is completely back to normal who require surgery will report ongoing symptoms despite several of. Likely benefits, risks and recovery time following surgery 'm 3 months post injury still. 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