Hey DrMikeM doin some research and came across your sight and thought I'd add my two cents. perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). Thanks for stopping by and sharing your interesting story. If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) To recap I have had debridement and subacromial decompression, am 34 years old and now have arthritis, bursitis, tendinitis and impingement. 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. I'm 43 and have been suffering from shoulder issues for over a year. Background: Good functional results have been reported for arthroscopic repair of rotator cuff tears, but the rate of tendon-to-bone healing is still unknown. I had a fall at my workplace and was suffering neck and shoulder pain. However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great. 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)! What do you think of the other therapies? I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. 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. Like Helpful Hug REPLY You may note weakness of your arm and difficulty with routine activities such as combing your hair or reaching behind your back. It allows a provider to assess the structures of your shoulder during movement. It seems as though you have now had two MRI reports. On one hand, I want the second opinion to be formulated entirely based on my case information (not on what another surgeon did or did not recommend). I guess my question is does this always require surgery? Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. If surgery is not indicated, your doctor should be able to refer you to a physical therapist who will likely assess your shoulder movement and be able to provide you with a tailored program to help strengthen your rotator cuff. 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. Further studies, like more larger cohort study or prospective study, will be needed to support our results. Mike!! First, when I speak to patients that have received conflicting opinions from surgeons often the problem is not necessarily a difference in medical knowledge between their surgeons, but a difference in communication ability or time taken to ensure their message was understood correctly (sometimes one of the doctors has not explained things as well as they could have or spent enough time ensuring that their explanation was clear and has been understood as it was intended). 2023 The Arena Media Brands, LLC and respective content providers on this website. I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. 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. pain that gets worse when you lift your arm. Heuberer et al 15 used the knotless cinch-bridge technique for supraspinatus tears. I just found out this week that I have Bursitis, and a tear in my Supraspinatus. 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. Thanks for sharing. However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. When I went in, he told me that after looking at my MRI, he did not think that anything was necessary, and instead wanted me to go back into physical therapy and continue to get steroid injection treatments. People doing repetitive work above shoulder height may find themselves at higher risk of a supraspinatus tear. Thanks for stopping by and leaving a comment. indications. Also not sure how long I should wait. 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. When the most effective non-surgical interventions (such as physical therapy) have not been able to provide sufficient relief of symptoms, then arthroscopic shoulder surgery is often considered. However, other parts of the rotator cuff may also be involved in the injury. have got bursal thickening as well and mild thickening of. Severe pain after. my MRI result come out that supraspinant tendom has partial tear. ; 3; Where can I found documentation in the web for the rehabilitation? Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. This is partly because rehabilitation following surgery will depend on the surgical technique used. 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. What I really want right now is to regain enough to get through normal everyday activities and not feel limited trying to lift an object and also not drop things so frequently. @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. Best to have a chat with your doctor. . You may feel pain when you try to sleep on the affected side. I am sorry I can't give you specific advice but here is some general information that may be useful to you. Not too sure if this article is still active but I'll ask anyways. Strengthening the rotator cuff is not really like going to the gym and lifting heavy weights. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. Dr. Mike. I all of a sudden lost all my strength in my right arm and dropped the box. However, I can just mention some general information that may be of interest. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. As such, a therapist can provide a safe and progressive therapy program. Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). Retraction of the supraspinatus tendon medial to the glenoid. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. 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). Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. @anonymous: Hi Vicki, I'm glad the information was useful to you. In your opinion, do I have any other option other than surgery? A full-thickness tear will decrease the capacity of a muscle to do work. Many will report ongoing symptoms despite several months of medication and limited use of the arm. Full thickness tears: usually categorized by size in centimeters. Without seeing the scan or conducting a physical examination, I can only offer some general comments in response. Of course, if you feel you cannot have an open and honest discussion about the pros and cons of surgery in your particular case with your surgeon, dont be afraid to seek a second independent opinion from another specialist. In 2 of the 24 patients, the rotator cuff tear completely healed on its own. Sorry I can't give you specific advice over the internet, but it sounds like your shoulder specialist will be able to give you good personalized advice on Tues. While some clinicians may argue that nonoperative treatment delays inevitable surgical repair, our study shows that patients can do very well over time. I don't think there is a clear answer to this one. Thanks for stopping by and leaving a comment. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. 50% of symptomatic full-thickness tears progress at 2 years and bigger tears progress faster. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. 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. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! Sometimes in cases like this your surgeon may want to try an injection. In full-thickness tears, surgery is indicated in many patients. D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. If a condition stays the same or become worse, then its usually a good idea to get it checked out again, or even a second opinion if you are not happy. Getting a second opinion when you are not sure about your first is also often a good idea. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! From my perspective, I have seen many patients with supraspinatus tendinosis who have benefited a great deal from physical therapy (but nothing is certain, and some patients may not receive great benefit and require a different intervention). A complete, full thickness tear means that the tear goes all the way through the tendon. Im a bodybuilder for years but I'm getting old. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! There also is mild tendinosis of the infraspinatus at the footprint. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. Rotator cuff exercises will usually be important for anyone looking to return to a racket sport following a supraspinatus tendon tear or shoulder labrum tear (or even someone looking to prevent those injuries). Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. All the 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. Advice welcomed. Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. Either way, don't be afraid to ask your surgeon lots of questions (likelihood of success in your case, what will happen after surgery, recovery time-frames etc.). It will be your Godsend. No visible labral tear. I here is incidental note made that the teres minor muscle is prominently atrophic. I suspect you have a bit of work to do over the next 6 months or so to help your shoulder recover. I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). The right suprasinatus tendon contains a partial width full thickness tear measuring 4 by 2mm, in the anterior fibers approximately 8mm lateral to the biceps tendon. It may be present with overhead activities such as lifting or reaching (e.g., serving in tennis, painting a ceiling). Players involved in sports requiring fast throwing actions (baseball) or overhead hitting (volleyball, tennis) may also sustain a traumatic injury to their rotator cuff and the supraspinatus tendon in particular. 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. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). Don't be afraid to say how you feel (no doubt you'd do this in a respectful way) about trying a whole bunch of non-surgical options, but not seeing any lasting results (as you have described for us above) and being keen to move forward toward some kind of resolution to the problem. 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.). labra are not evaluated 4. That being said, I am scheduled for surgery on 6 Nov. The supraspinatus is one of four rotator cuff muscles in our shoulder. Thanks for the update and let us know how you go. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. It sounds like you are on the right track with your surgeon and physical therapist. Large. I can say though that PT's are trained to help people with painful ROM. 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 physician or orthopedic specialist should be able to give you specific advice about whether it is worth having an MRI in your specific case. 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. By June '13 I was better in many ways than before the injury. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). There is some spurring at the glenoid articular surface. Thanks. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". So in summary Tim, I would say I feel for you buddy. Here I am 5 days post op. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. That was July of 2011. So quite often the best treatment approach is not always immediately clear. The medical staff there did an x-ray, which did not turn anything up, and once again, were not overly concerned with my condition, but just instructed me to continue to ice pack my shoulder and take some pain medication. Decided to see ortho who ordered an MRi last week. Pain can also be brought on by laying on the side. I was released from the P.T. The popping may or may not be related to your shoulder pain (difficult for me to say without an examination etc.) Hopefully your doctor can give you specific advice in this regard. What does all that mean in simple layman terms? Patients ranged in age from twenty-nine to seventy-nine years. I hope I will not follow suit! )amount of fluid in acromioclavicular joint and last but not least 5.) Hi there. 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). Those words exactly. @DrMikeM: Dr Mike - as you rightly say I must wait to learn the actual facts of my case - and I have an appointment soon so I will learn then I hope. Have been taking 800 mg Motrin tid. However, there are a variety of factors that will need to be considered. 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Tendon repair I just found out this week that I have bursitis, and over my bicep ( )!
full thickness tear of the supraspinatus tendon surgery