It allows a provider to assess the structures of your shoulder during movement. Without seeing the scan or conducting a physical examination, I can only offer some general comments in response. 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). However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Any suggestions? Needless to say, I started to feel like I was getting jerked around and not getting any realistic attention. I don't know what exactly to do, or what my REALISTIC problem could be. Good luck! Any thoughts? Thanks for stopping by and sharing your story with everyone! If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. 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. The primary purpose of these muscles is to prevent the head of the humerus, or upper arm bone, from driving into the shoulder joint as you lift your arm away from your body or overhead. This will help you figure out what you are deciding between. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. If your tendon were to completely rupture while you were pregnant, this may be very problematic. Retraction of the supraspinatus tendon medial to the glenoid. Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). Small to moderate glenohumeral joint effusion. I maybe take a few Advil a week with no loss of function at all. I'm unable to say whether this has occurred in your case, however, the reason why this springs to mind is that I cannot recall ever seeing a true case of adhesive capsulitis (sometimes called frozen shoulder) that resolved in 6 weeks? This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. I have always found the anatomy of the shoulder to be very interesting. 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. I am angry, confused and cannot get any pain relief. Wish me luck!!! So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. Is surgery my only option? @anonymous: Hi Les, I am glad you found this information helpful. If you know you have a rotator cuff tear, worsening pain and decreasing strength may mean the tear is getting larger. However, other parts of the rotator cuff may also be involved in the injury. This study aimed to evaluate the effectiveness and safety of this treatment method. Thanks for sharing this detailed account with everyone. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. Thanks for stopping by and leaving a comment. 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. But not result in a normal shoulder. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. I have a feeling this is going to be a long recovery! indications. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. 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). Now I have these results stated above. 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 found it very helpful as I am sure all your other subscribers found it to be too. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. 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 results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". 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. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. shoulder or arm weakness. 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). I am not aware of any studies that have shown rotator cuff exercises impair healing in supraspinatus tendons that have a partial thickness tear. Could this require surgery. pain management and physical therapy) may be the first choice to see if surgery can be avoided. I suspect you have a bit of work to do over the next 6 months or so to help your shoulder recover. 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. X-rays are often not very useful in diagnosing shoulder injuries. 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. All the best with it. I can say though that PT's are trained to help people with painful ROM. is surgery the only option? Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. It was sometime in the early months of 2011 that I was sent off to have an MRI done. Yes, surgery can be painful initially, but your surgeon should be able to tell you the likelihood of a successful outcome of surgery based on your specific circumstances. Have been taking 800 mg Motrin tid. However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. I am 55 and active, so I don't want to hurt my "golden" years, so I am not sure what to think. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. Although very uncommon, it is possible that the report did contain an error. Not too sure if this article is still active but I'll ask anyways. Good luck! If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) So in summary Tim, I would say I feel for you buddy. Thanks again Dr. Good luck! Overall, it will often take 6 months or more before the shoulder is completely back to normal. 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 am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. 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. I'm sorry I can't give you specific advice on your case over the internet. Your orthopaedic surgeon can prescribe an appropriate program based on your needs and the findings at surgery. Any advice would be greatly appreciated. It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) 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. 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). When Is Surgery Necessary . @anonymous: Hi Vicki, I'm glad the information was useful to you. 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. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. I think it would be wise to listed to the advice from your doctor on this one! Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! I understand most of it but I was wondering is there supposed to be fluid in the acromioclavicular joint. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. I will surf again! Injuries are a less common cause of partial tears than aging. 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. 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. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. )amount of fluid in acromioclavicular joint and last but not least 5.) SLAP type tear of the superior labrum. I have full range of motion and only occasional soreness now and again, but can't sleep on that side. @anonymous: Hi Elania, Thanks for stopping by and sharing. Good luck! A full-thickness tear will decrease the capacity of a muscle to do work. My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. Especially since my injury has gotten worse instead of better. A full rupture will require surgery (usually quite urgently). 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). Drugs, supplements, and natural remedies may have dangerous side effects. In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. Does a full thickness tear of the supraspinatus tendon need surgery? With full thickness tears the entire tendon has separated or torn from the bone. So while the cost of surgery can be expensive, people who can't do their job one-handed may also need to consider potential loss of income as well or making alternative work arrangements. )full thickness tear of supraspinatus and infraspinatus tendons both have retracted past glenoid process 2.) That way you can make an informed decision in consultation with advice from your doctor. It is good that you have discussed the recovery with your surgeon already. 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. Acromioclavicular joint degenerative changes, which means nothing to me. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. I am now off again to another specialist as the 2nd opinion specialist said there was not much he could do to improve the situation! 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. The type of repair performed is based on the findings at surgery. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. 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. 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. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. 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. The four muscles supraspinatus, infraspinatus, subscapularis and teres minor originate from the scapula (shoulder blade). Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. Advice welcomed. There is supraspinatus muscular atrophy. Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. Good luck! Keep in touch to let us know how you go. The rotator cuff is made up of 4 muscles. There is no question that the word 'small' can be misleading regarding the amount of pain and discomfort that a supraspinatus tendon tear can cause. Sought 2 nd opinion 3weeks later due to the server pain. A moderate size full thickness tear . 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)! Hey DrMikeM doin some research and came across your sight and thought I'd add my two cents. @anonymous: Hi Hans, Thanks for stopping by and sharing your story. Did a previous year of PT to strengthen rotator cuff muscles with increase to full range of motion. If you do opt for surgery. There may also be insurance implications etc. I just received my MRI report which states : supraspinatus tendon is thickened and immediate in signal, with a small 3mm (transverse) x 3mm (AP) full thickness footplate tear. My best wishes go to all of them. 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. (See Fig. It is also worth knowing there are just some jobs that seem to take a heavy toll on shoulders / supraspinatus tendons (unfortunately I think painter / sheet rock installer / any occupation where you need to hold things up above shoulder or head height are right at the top of that list). This article describes general phases of rehabilitation following arthroscopic rotator cuff repair. I've started having a smoothie everyday of red vege's (beetroot) and fruit (all the berries) with a slice of ginger and the big one for inflammation turmeric! 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