Dr. Burks explains what the injury is and when to . That is some interesting advice you have received. Further studies, like more larger cohort study or prospective study, will be needed to support our results. Supraspinatus is the most commonly injured rotator cuff tendon. My question to you is why can they not try to repair the rotator cuff using a graft of somesort. If, however, you are active or use your arm for overhead work or sports, surgery is most often recommended because many tears will not heal without surgery. Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. . Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. 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). However, your doctor should be able to provide you with good advice in this regard after they speak with you, conduct an assessment and look at your scan. What ever recommendation you received, you are looking up more information on line. No black and white answer for this one I'm afraid. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. Hey DrMikeM doin some research and came across your sight and thought I'd add my two cents. A few hours after the incident, I was able to seek some medical attention from our on board medic, who believed I had dislocated my shoulder, but was not overly concerned with my condition. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). 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. 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). @DrMikeM: Thank you Dr. Mike for answering my question. There may also be insurance implications etc. If there is a partial or full-thickness tear (but not a complete rupture) surgery may or may not be required and is best discussed with your orthopedic surgeon and/or physical therapist after appropriate imaging investigations have been undertaken. Good luck! I am really concerned about success rates for revision surgery. Good luck! Second, I am sorry to hear about your fall and subsequent shoulder pain. Usually getting a second opinion is not a bad option if you are not confident that the first opinion is going to lead to the best outcome for you, but I expect that may well be impossible while you are still on deployment? I was instructed to ice pack my shoulder and take it easy. At the . 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! Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle, which is located at the back of the shoulder. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. I have had shoulder pain for years and years. Had periods of pain go from the back of my shoulder down my arm like before. Good luck! Come September of 2010 I chose not to re-enlist and returned home. there is a small full thickness insertional tear identified relating to the posterior supraspinatus. and seemed to be doing ok with Cortisone shots. With partial thickness rotator cuff tears only part of the tendon has torn off the bone. I have been saving up a couple months to cover my deductible expecting to schedule surgery. They can then make a diagnosis and begin treatment. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. If you are seeing a physio for this condition, they should be able to provide you some good information about the post-surgery protocols that surgeons in your local area will be likely to prescribe. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. In terms of some general information that may be of interest to you, there are a couple of things I can share from my perspective. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. If in doubt call your surgeons office. Popping noises can occur for a variety of reasons, the most common of which are completely normal. However, in some cases it is clear that surgery is likely to be the best option. 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. I do not want a metal shoulder. SLAP type tear of the superior labrum. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). Thanks for stopping by and sharing your story. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. A supraspinatus tear is the most common malady of the shoulder that appears in my orthopedic practice. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. I'm sure it is no surprise to you, but when someone is experiencing worsening pain with conventional conservative management like physical therapy this is also not a good sign for a speedy recovery without surgery. When getting a second opinion from another surgeon. With complete tears, the tendon has come off (detached) from where it was attached to the bone. @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. I am close to retirement and I am afraid I will not be able to do the things I once enjoyed, outdoor activities. Medium. 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). Keep in touch to let us know how you go. Some people will recover quickly without any treatment, other people will recover after commencing non-surgical interventions (such as physical therapy and rotator cuff exercises and / or receiving a steroid injection), while others will still have pain after many months and may require surgery. This may result in pain and weakness of the shoulder. She said she had never heard anything like that before and it was not my rotater cuff like everyone else believed. All the best with it. I am sorry I can't offer specific advice without a proper assessment, but seeing an orthopedic specialist or physical therapist in your local area sounds like a good idea. 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. 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). The difficulty with overhead racket sports (like badminton, squash or tennis) is that high level functioning of the rotator cuff muscles are required to stabilise the shoulder joint in what is naturally unstable positions (overhead, and with high speed movement). The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. have got bursal thickening as well and mild thickening of. In 2 of the 24 patients, the rotator cuff tear completely healed on its own. There are other things your physical therapist may be able to help you with to give you some relief in the short term. I had surgery last Thursday for a complete tear of the supraspinatus tendon due to a car accident and was told the tendon was repaired with titanium staples.My concern is of the staples coming out ,I wear a sling whenever outside but have been taking it off when sleeping in my recliner which I've found the best since the accident.If I am just walking around the house I've let it hang down and do not feel pain at the shoulder so figure there is no risk of them pulling out by doing this,am I correct? After surgery, the repair must be protected from certain activities that may put healing at risk. I am really hoping to find some outside advice. Hope that helps! Good luck! Interpretation: There is a focally retracted full thickness 1.2 x 1.2 cm tear of the supraspinatus tendon at its anterior attachment site on the humerus. and seemed to be doing ok with Cortisone shots. Either way, I wish you all the best with it (and a safe deployment and return). Pitchers, swimmers, and tennis players are common examples. So my tear went from a near full thickness tear to a full thickness tear. 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). When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. The rotator cuff exercises should not cause pain while the exercise is being performed. I have always found the anatomy of the shoulder to be very interesting. In 9 of the 24 the tear was smaller. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. If you get a chance please let us know how you go. 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). They decided to do a re examination of my MRI to see if there was something they were missing. 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. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. I'm not really sure how the whole army doctor situation works while you are on deployment, but I think if you have ongoing symptoms then it is worth making sure the appropriate people know. Overall my subscapularis does appear intact." This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Lol. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. Advice welcomed. Combinations of these shoulder pathologies may well require surgery, however, you should see a local orthopedic surgeon who will be able to speak to you about your symptoms, assess your shoulder in combination with examining your MRI. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. that can be just as difficult to resolve as any structural injury. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. program with a small packet of exercise instructions and told to continue them and to come back in a few months for an updated physical examination. 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! (Right) A full-thickness tear in the supraspinatus tendon. Small to moderate glenohumeral joint effusion. A couple of final remarks that may unfortunately muddy the waters for you: Adhesive capsulitis generally resolves without the need for surgery, and aggressive physical therapy may actually worsen the symptoms in some cases. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . X-rays are often not very useful in diagnosing shoulder injuries. The average duration of follow-up was twenty-nine months. My best wishes go to all of them. Some simple tests during a physical examination should enable your doctor to determine whether your symptoms are likely to improved with a surgical repair of the tendon. 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. Small. I will congratulate you on actually doing your exercises! Some minor tears may be treated without surgery. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. Good luck! Without seeing the scan or conducting a physical examination, I can only offer some general comments in response. Surgical repair can often be . The supraspinatus muscle is a relatively small muscle, but very it's important one. 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 tears: usually categorized by size in centimeters. I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. In the beginning of 2012, I returned to the Orthopedic specialist at the VA, and the medical staff seemed very surprised that my god awful pain and discomfort was still going on. Did a previous year of PT to strengthen rotator cuff muscles with increase to full range of motion. I was told that there were a few other muscles around the supraspinatus that were torn and I also had some bone spurs that could also be causing some irritation. How do you repair a rotator cuff tear? I just found out this week that I have Bursitis, and a tear in my Supraspinatus. Good luck with your decision! I am 72, I just got the mri with same partial tear. I have not lost any ROM I just have severe pain in my right shoulder. Humeral head is riding high abutting the underside of the acromin process. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. This can occur normally over time, or with repetitive use or a re-injury. Good luck! It can be difficult to find good information on the web for specific rehabilitation following surgery. Ongoing serious pain influencing daily life, sleep etc. This is partly because rehabilitation following surgery will depend on the surgical technique used. 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. 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