It is plausible to sustain one or the other (or both) from a fall. 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. Heterogeneity will be assessed statistically using the standard chi-squared and I-squared tests. Sorry for the delay in response. A degenerative tear is the opposite instead of a single catastrophic episode or trauma to the shoulder, these tears are the result of damage and wear on the joint slowly over time. Your future self will thank you! There are several video examples to accompany the written explanation. I guarantee you will not be the last person to read this page wondering about a difference in doctor opinion or trying to figure out whether they have a supraspinatus tendon tear or adhesive capsulitis (or surgery versus no surgery). Remember that you are not aiming for speed; slow, steady, and controlled movement is best. 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. Treatment of rotator cuff tears in older individuals: a systematic review. Effects of Rotator Cuff Pathology and Physical Therapy on In Vivo Shoulder Motion and Clinical Outcomes in Patients With a Symptomatic Full-Thickness Rotator Cuff Tear. Management of full thickness rotator cuff tears in the : JBI All rights reserved. It has been associated with older age and osteoarthritis, but often seems to occur when there is extra fluid in the gleno-humeral (ball and socket) joint. This study included patients with a repairable full-thickness tear of the supraspinatus tendon size < 5 cm. As such, no conclusion on non-surgical treatments was reached. Family is important, and I would not encourage people to discard their advice or offend their family and friends, but definitely weigh up advice on its merit. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. After 4 months of therapy and 3 injections I am unable to lift my right arm. I am sorry I can't give you any specific advice over the internet, but here are some thoughts that may be useful to you. These types of injuries seem quite common for people who work in construction and are often associated with doing work above shoulder height. I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. From the description of your MRI report it sounds like your shoulder must have been quite painful and inflamed at the time (perhaps it still is)! This may include things like having a lesser ability to detect hot versus cold on their skin in the neck region, they may also genuinely feel pain to what would usually be non-painful stimulus. Read More I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. Decided to see ortho who ordered an MRi last week. Thanks for stopping by and sharing your story with everyone! Shoulder function, measured by shoulder-specific scales including but not limited to ASES, Simple Shoulder Test, UCLA shoulder scoring scale. They will check to see whether it is tender in any area or whether there is a deformity. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). It was then I found out how messed up my shoulder actually is 1. Early treatment can prevent your symptoms from getting worse. An easy way to understand what I mean is to think about eating a steak. Tendontobone healing after repairing fullthickness rotator cuff tear I did PT around December for a month, twice a week. For full thickness tears and more major tears (or if the tear involves more than one tendon) or there is significant damage to the tendon, various surgical procedures may be required. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. Patients 80 years and over have an even higher occurrence rate of 80%. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. It extends slightly into the proximal subscapularis bursa. Because of the return of the recent pain, another MRI was ordered and the Radiologist wrote: "1. They will be able to tell you the likelihood of a supraspinatus tear and adhesive capsulitis (or any other pathology), as well as the recommended course of action for your particular circumstance. Treatment options, tips, knee surgery info, and medical videos are included. 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. On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) It is difficult for me to comment further based on this information. A systematic review in 2012 set out to identify which treatment, surgical or non-surgical, provided the best results for elderly patients with full-thickness rotator cuff tears.25 The reviewers concluded there could be improved outcomes with surgical patients; however, heterogeneity of the studies and risk of bias made it difficult to make a definitive conclusion on the best treatment approach. Medicine and physiotherapy often. Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. sorry for the double posting, first time user. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. 12. Mild AC arthropathy. Thanks for stopping by and leaving a comment. I am sure lots of people would like to hear how it turns out for you. If you have concerns, you could ask the surgeon when you next see him whether he thinks your symptoms are from the tendon tear and rotator cuff dysfunction or whiplash? 6. working a full time job nd being a mother of three I could never fit it in my schedule but was also told by a family member that PT would not help. That being said, a surgeon's own experiences, skills and abilities (as well as risk tolerance) may factor into their decision as to whether a surgical repair (and the nature of the repair) is something they will advise. In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. FULL THICKNESS / COMPLETE SUPRASPINATUS TEAR TREATMENT - YouTube Supraspinatus Tear - Physiopedia You can partially or fully tear your supraspinatus muscle, and remember that these sorts of tears can be symptomatic (meaning they cause supraspinatus pain and inhibit your range of motion and ability to perform everyday tasks) or asymptomatic, meaning the tear is present but it not currently causing you pain or otherwise causing problems in your life. Supraspinatus Tear - Symptoms, Causes, Treatment & Rehabilitation I think these are promising approaches for the types of pathology you described. The review will exclude studies which include patients with concomitant shoulder conditions such as osteoarthritis, fractures, osteonecrosis, instability, and additional intra-articular pathology or acromion morphology, as these conditions may necessitate intervention/s that may be different from patients who have rotator cuff tear only. Good luck! Now, my Ortho doc #2 who recommended i do the MRI also reccomends a surgery to fix the tear. Good luck! 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. A-C joint is moderately to severely degenerative. Hi there. You mention your shoulder makes a popping noise, generally speaking the sound a joint makes is not a good indicator of anything (particularly if the popping noise itself is not accompanied by pain). Full-thickness rotator cuff tear | Radiology Reference Article If your doctor does end up recommending surgery, make sure you have a good chat about what to expect after the specific surgery they are planning. Cai YZ, Zhang C, Lin XJ. 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. It will also get you back to your normal routine quicker. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. Your arm is kept in your shoulder socket by the rotator cuff. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. I think it would be wise to listed to the advice from your doctor on this one! The goal of any treatment is to reduce pain and restore function. Surgery may be recommended sooner rather than later for younger patients, particularly those whove experienced acute trauma. Good luck! I have a second opinion on Monday. MRI). A supraspinatus tendon tear can be full thickness (meaning that the entire muscle is affected) or partial thickness (or an incomplete tear). I have been seeing an orthopedic doctor for the past 18 months. 13. Supraspinatus is the most commonly injured rotator cuff tendon. It seems as though you have now had two MRI reports. twice, second time relief only lasted 5 minutes) finally local doc ordered M.R.I. Modify Sport Techniques . Unless the shoulder is actually dislocated at the time of the x-ray, or there is a noticeable bone abnormality (chipped or broken bone, bone spur that is visible on x-ray etc. I wish you a speedy and full recovery. I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. The upregulation of these genes in the full-thickness group was consistent with enhanced synovial inflammation, greater vascular ingrowth, and the loss of collagen organization in both . All material on this website is protected by copyright. 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). However, in some cases it is clear that surgery is likely to be the best option. Search for Similar Articles 2023 Melbourne Arm Clinic. Original injury was 4 years ago in a MVA and I've been experiencing pain when sleeping on injured side, intermittent loss of sensation for the entire arm resulting in dropping things, loss of muscular endurance and increased pain for repetitive activities ranging from ribcage level and upward, loss of muscular strength and increased pain for lifting objects at the present moment equivalent in weight to a litre of milk or heavier, and an overall sense of lack of spacial awareness for the injured arm as if my arm is not "connected" to my body. The supraspinatus is part of the rotator cuff of the shoulder. Went to an orthopedic surgeon who said I had frozen shoulder and injected the capsule with cortisone and told me to return in 3 months. is surgery the only option? damage to the tendon without swelling). Joanna Briggs Institute. If in doubt call your surgeons office. Subcortical reactive changes superiorly and laterally at the humeral head are present. Sorry for the delay, I have been away. 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? and seemed to be doing ok with Cortisone shots. while that helped in the short term and improved my left arm motion range, after i stopped the therapy the pain came back and reduced the range. Rotator Cuff Tears - OrthoInfo - AAOS that can be just as difficult to resolve as any structural injury. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. ( x-ray, phys ther,corticosteroid inj. only taking out for prescribed exercises (e.g. The supraspinatous is one of the 4 muscles that make u. if your initial injury was work related. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. 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). Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. muscle atrophy of supraspinatus, infraspinatus, and subscapularis muscles, 3.) The size of the tear may increase over time. If youre going to have surgery to repair a full or partial thickness tear, you should keep in mind that youre going to have some significant recovery time where you wont be able to use the affected arm as usual. 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. I was told that they were now wanting to do surgery to actually go in and see what they might be able to do to repair some of the damage they thought they saw. Several factors contribute to degenerative, or chronic, rotator cuff tears. Does a full thickness tear of the supraspinatus tendon need surgery I am 72, I just got the mri with same partial tear. Fig.1 Normal rotator cuff attachment around the humeral head Fig. Lol. If you want any further clarification just post any follow up question. Selected studies will be critically appraised by two independent reviewers using standardized critical appraisal instruments from JBI SUMARI. The pain and weakness in the shoulder may make routine activities, such as combing your hair or reaching behind your back, more difficult. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Similarly, some benefit from conservative approaches (physical therapy / injections etc. It was a small rotator cuff tear. I'm 43 and have been suffering from shoulder issues for over a year. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. The tendon that seems to be most commonly affected is the supraspinatus, although it could also easily be either infraspinatus, long head of biceps, subscapularis or teres minor tendons. I am 55 yrs. The acriomioclavicular joint usually should have some fluid that helps lubricate the joint, but when it is specifically mentioned in an imaging report (like an MRI report), they are usually indicating that there are able to see more fluid then one might usually expect (in someone without any shoulder pathology). I am sorry I can't give you specific advice but here is some general information that may be useful to you. I don't lay on the side of the hurt arm as I don't think it will be good for it. Is It a Full-Thickness or a Partial-Thickness Tear of the Rotator Cuff? In general terms of the types of MRI findings you have described, a combination of these types of pathology could require surgery; particularly if symptoms persisted after trying non-surgical interventions. I worked closely with a physiotherapist for a good four months and pain got worse. Good luck! If youve experienced acute damage or a recent shoulder injury, or are otherwise experiencing pain in your shoulder or rotator cuff area, consult your doctor and an orthopaedic surgeon as soon as possible, particularly if you work in a field, play a sport, or have a hobby that involves lots of overhead lifting and repetitive arm motions. You mentioned rotator cuff and tendonosis like they were different things. Management of rotator cuff tears can broadly be divided into surgical and non-surgical treatment.8 Surgical treatments include arthroscopic repairs, open repairs, mini open repairs, tendon reconstruction and reverse shoulder arthroplasty.11-15 Non-surgical treatments consist of physiotherapy or injection. Baumer TG, Chan D, Mende V, Dischler J, Zauel R, van Holsbeeck M, et al. make sure you do it some place where anesthesia will do an interscalene block for post op pain relief. What little I have done has given me improvement. 3 Supraspinatus tear of the rotator cuff Fig. Thanks again Dr. 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. Full-thickness rotator cuff tear prevalence and correlation with function and co-morbidities in patients sixty-five years and older. The results are: full thickness cuff tear 2.3 cm AP involving supra spinets and a portion of infra spinets at distal critical zone and enthesis. Overall function increased by 47.67% from pre-op to post-op3. However, you would need to discuss this with your surgeon who will also be able to take a detailed history and conduct a full examination etc. My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. If not what is this indictative of. Good luck! Either way, I wish you all the best with it (and a safe deployment and return). This review will include studies which examined the effectiveness of non-surgical and/or surgical treatment. Not all the time, but it was intermittent. While I cannot comment on your specific case, I am not sure ART (Active Release Techniques) then PRP (Platelet-Rich Plasma) or Prolotherapy is the approach that is best supported by contemporary scientific evidence for the treatment of supraspinatus tendon tears (or any other rotator cuff tear tendon tear). What does a "full thickness tear of the supraspinatus tendon" mean? This is what a tear or rupture of the tendon connected to the supraspinatus muscle (which is part of the rotator cuff of the shoulder) is called. Rest, pain relievers and physical therapy can help. Had periods of pain go from the back of my shoulder down my arm like before. He says the tendon is fraying like a ropethat he would need to reattach to the bone. In about 80 to 85% of patients, nonsurgical treatment relieves pain and improves function in the shoulder. I appreciate your thoughts on this matter. This sounds like a difficult situation. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Partial thickness tearing is where only a portion of the tendon is torn and part of the tendon is still attached to the humeral head. 2. mild labral degeneration. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. pain while . left supraspinatus tendon tear,so what the process of curing? Generally speaking, MRIs definitely help the surgeon to make a diagnosis and give them an idea of whether surgery will help. Thanks for stopping by and sharing your interesting story. @brando87: Thanks brando87, that's what I aim for! Unfortunately, I suspect that a whole bunch of people will read your account and hear bits and pieces that remind them of their own circumstance. There are a few interesting things worth noting here. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010. Good luck! Should you tell him what the other surgeons name is and what they advised. Acute tears of the tendons in your shoulder occur due to sports or similar activities, along with more general wear and tear on the tendon depending on your age or lifestyle. Surgical repairs of complete tendon tears from a traumatic event, like a car accident, can easily fail when surgeons instructions aren't followed. 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. 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. @anonymous: Thanks for keeping us up to date. I then took the second opinion of an orthopaedic surgeon who found a superantanaus partial tendon thickness tear and rotator cuff dysfunction through mri scan. You are also right that many people often don't understand that you are not 'putting on an act'. Don't be afraid to have an open discussion with your GP about whether or not a referral to a surgeon is the right way to go (or not) for your specific circumstance. Not too sure if this article is still active but I'll ask anyways. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. Surgical repairs can be compromised when post-operative instructions are not followed, so if you have surgery make sure you know exactly what you should and should not do! Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. 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. 26. feeling pain in hand,,,. Is surgery my only option? 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. If the tendon has been completely ruptured (no longer attached), then surgery will definitely be required with some level of urgency for the tendon to be successfully reattached. but unfortunately, the results were extremely minor. Partial tears can be just 1 millimeter deep (only about 10 percent of a tendon), or can be 50 percent or deeper. Went down a water slide on a mat head first arms supporting my body. I am really concerned about success rates for revision surgery. 3. This can be one of the most frustrating things for people who have whiplash associated disorders. Most of the time, it is accompanied by another rotator cuff muscle tear. 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. If they do cause pain, then it is important to check with the PT that the technique and level of resistance is appropriate for your condition. That is some interesting advice you have received. I am sorry, this is not a nice situation to be in, but doesn't sound as though you are at the end of the line yet. @anonymous: Hi Mike, Good luck with your appointment next week, hopefully you will be able to find some relief one way or another after you consult your surgeon. 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.). @anonymous: Oh Tonia, I feel for you. No black and white answer for this one I'm afraid. have got bursal thickening as well and mild thickening of. Indirect signs on MRI are - subdeltoid bursal effusion, particularly if anterior, medial dislocation of biceps, fluid along biceps tendon . Your doctor may also advise a trial of physical therapy to see if that can bring relief to his symptoms. Supraspinatus Tear Causes & Treatment - Melbourne Arm Clinic 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. Over time, the pain may become more noticeable at rest and no longer goes away with medications. @anonymous: Hi Elania, Thanks for stopping by and sharing. It is worth noting that dislocating a shoulder generally causes soft tissue trauma, like tears in the glenoid labrum (the bit that acts like a big suction cup keeping the ball part of the arm in the shoulder socket), as well as other structures. Here is a link to a recent academic journal article on the topic that should be free to access. Where required, authors of papers will be contacted to request for missing or additional data. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. Either way, this kind of ongoing shoulder pain is not good. I'm sorry I can't provide you with specific advice, rather I only provide some general information. I can reach behind my back ok. In most rotator cuff tears, the tendon is torn away from the bone. No, it may not be too late to get relief. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. This review will consider studies that have measured one or more of the following outcomes: This review will consider randomized controlled trials, pseudo-randomized controlled trials, quasi-experimental studies, case-control studies and cohort studies. Does the reverse shoulder arthroplasty and deltoid repair be a possible option of treatment? Humeral head is riding high abutting the underside of the acromin process. Could this require surgery. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. Let us know how you go! I sleep fine as it does not hurt to lay on my back. Efficacy of platelet-rich plasma in arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis. Available from. Small area of subacromial bursitis present. @anonymous: Thanks for sharing you story Marcia. Although very uncommon, it is possible that the report did contain an error. Conclusion: Lengthening of the supraspinatus occurs with surgery, altering the length-tension relationship of the muscle, which can compromise muscle function and lead to inferior surgical outcomes. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. i was recently diagnosed via MRI that i have a supraspinatus tendon tear. You have asked for information about potential options. )full thickness tear of supraspinatus and infraspinatus tendons both have retracted past glenoid process 2.) It is one of the four rotator cuff muscles. Its often accompanied by other tears in the muscles that make up the rotator cuff. I am disappointed not to have been referred to a surgeon, but I have to admit the exercises have already helped me sleep better. People who have partial thickness supraspinatus tendon tears following a fall or mechanical trauma often report similar symptoms to people with whiplash associated disorders (aka whiplash). and retracted 2 cm. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. Full thickness tearing is characterized by the complete removal of the tendon from the bone.2 This includes large tears (35 cm) and massive tears (>5 cm).3 In the geriatric population, rotator cuff tears are a prominent clinical problem and many patients report difficulty with routine tasks of daily living. Repair of Rotator Cuff Tears - UW Orthopaedics and Sports Medicine substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great.