full thickness tear of the supraspinatus tendon surgery full thickness tear of the supraspinatus tendon surgery

Should this shoulder have an MRI? I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. The likeliness of these issues increases with age and is more common in the dominant hand; in addition, if you experience a degenerative tear in one shoulder, youre at a greater risk for a tear in the other shoulder. 11. 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)! It would be much wiser to follow your surgeons instructions (which usually involve keeping arm in sling for 6+ weeks depending on surgery / surgeon etc. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. It was a small rotator cuff tear. I'm experiencing the exact same pain you described, and the Army doc told me I was too young to tear a rotator cuff. Physiotherapy interventions typically consist of stretching and strengthening exercises but can also include electrotherapy and other physical modalities such as ultrasound, moist heat and laser therapy.16-19 Treatment by injections in recent studies often involves corticosteroids, hyaluronic acid and platelet-rich plasma.20-22 The literature suggests that the majority of patients begin with non-surgical treatment and if pain persists or improvement in function is less than optimal, surgery is considered. Although very uncommon, it is possible that the report did contain an error. Any disagreements that arise will be resolved through discussion or with a third reviewer. Either way, I wish you all the best with it (and a safe deployment and return). I am wondering if I can recover without a surgery option. For more information: Rotator Cuff Injuries - Clinical Practice Guideline (CPG) | American Academy of Orthopaedic Surgeons (aaos.org). 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. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). 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. 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. Should you tell him what the other surgeons name is and what they advised. All the best. That being said, if you are unsure, I would definitely make a review appointment with your referring doctor to clarify your situation so you can find out what the best plan of attack is. 2023 Melbourne Arm Clinic. The best treatment option for alleviation of pain and restored shoulder function in the elderly is still debated.8 Studies have shown satisfactory healing and promising clinical outcomes following surgical repair. 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. The rotator cuff is a group of four muscles and their associated tendons that originate from locations on the scapula and insert onto the humeral head. There are two categories of supraspinatus tears, degenerative and acute. Titles and abstracts will then be screened by one reviewer for assessment against the inclusion criteria for the review. Small to moderate glenohumeral joint effusion. Needless to say, I started to feel like I was getting jerked around and not getting any realistic attention. Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. Effect sizes will be expressed as either odds ratios (for dichotomous data or weighted (or standardized) mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. In layman terms, I would say this means your supraspinatus tendon has probably been irritated for quite a while, and has a small tear near where it attaches to the bone (but tendon is currently still attached). Your arm is kept in your shoulder socket by the rotator cuff. JBI Database of Systematic Reviews and Implementation Reports, Get new journal Tables of Contents sent right to your email inbox, https://reviewersmanual.joannabriggs.org/, Management of full thickness rotator cuff tears in the elderly: a systematic review protocol, Articles in Google Scholar by Michael Nganga, Other articles in this journal by Michael Nganga, Privacy Policy (Updated December 15, 2022). A-C joint is moderately to severely degenerative. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. Dr. Mike great info here thanks. It will be your Godsend. There are at least three important factors that contribute to supraspinatus tendon tears. This sounds like a difficult situation. At a 10-year follow-up, tendon repair is superior to physiotherapy in the treatment of small and medium-sized rotator cuff tears. Does the fact that it mentions there is some retraction mean the tendon is completely torn or is it possible it is only partly torn. Depending on the severity of your tear, your surgeon may recommend starting with a non-surgical treatment like physiotherapy and supraspinatus tear exercises with the goal of restoring the range of movement and the strength of the shoulder, activity modification (changing your lifestyle to avoid the tasks that increase your pain and may exacerbate the tear), pain management with non-steroidal anti-inflammatory medications, analgesics, and cortisone injections. Come September of 2010 I chose not to re-enlist and returned home. The recovery after surgical tendon repairs often takes longer than recovering from broken bones. 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. Good luck! I have pain all the time, it hurts to put a shirt on, can't lay on it, reaching out to my side it hurts to turn my pillow. Here is some general information which I hope is useful for you: 1. Thanks for stopping by and sharing your story. Generally speaking, do small tears need surgical repair? Some days later, I was called back to the VA so they could tell me what they found. Good luck with it either way. Supraspinatus is the most commonly injured rotator cuff tendon. I am angry, confused and cannot get any pain relief. Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). @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. I am close to retirement and I am afraid I will not be able to do the things I once enjoyed, outdoor activities. You may search for similar articles that contain these same keywords or you may If you get a chance please let us know how you go. There is supraspinatus muscular atrophy. Advice welcomed. 24. I agree that shoulder pain for years, that has not resolved is definitely a good indicator that seeing a doctor is a good idea! 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). Some will have more training, experience or ability in helping patients to overcome the biomechanical factors that can cause shoulder impingement and supraspinatus tears. The rotator cuff contributes to both stability and movement of the glenohumeral joint and is vital to the functioning of the upper limb.1 It consists of the supraspinatus, subscapularis, teres minor and infraspinatus muscles. If you research it it's a complicated operation that demands some of the best surgerical skills. Because most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging, people over 40 are at greater risk. Patients 80 years and over have an even higher occurrence rate of 80%. 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. Any advice would be greatly appreciated. Here I am 5 days post op. It's a supraspinatus tendon tear with 50% thickness and no labral tear. As mentioned in the video, the aim of these resistance band exercises is not to increase your range of movement but to instead strengthen the rotator cuff muscles which will help protect the soft tissue structures around the shoulder in the long term. 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). JBI Evidence Synthesis16(8):1628-1633, August 2018. Thanks for stopping by and leaving a comment! Waiting until after the delivery of your baby to re-attach the tendon may increase the chance of a poorer outcome (not to mention the difficulty nursing a newborn with only one functional arm). I was in a car accident about 18 months ago with damage to my left side of my body, stated with my fingers, to my leg and lastly my arm. However, I can just mention some general information that may be of interest. 7. Good luck with your decision! Thanks for stopping by and sharing your interesting story. its been three months with some pt but no noticeable improvement. 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. However, in some cases it is clear that surgery is likely to be the best option. It was sometime in the early months of 2011 that I was sent off to have an MRI done. Time passed. So a second opinion may not always yield the same advice (even though both surgeons may be giving appropriate advice based on their own circumstances and information). I am sorry I can't provide you specific advice over the internet. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. Rotator cuff integrity, measured by direct magnetic resonance arthrography or conventional MRI. 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. In most rotator cuff tears, the tendon is torn away from the bone. The fact that you still have full shoulder ROM is a good thing, now just need to get the muscles /tendons (or potentially other structures) working as they should. Instead specific movements are required, these shouldn't cause pain while performing the exercise. Tears that develop slowly due to overuse may also cause pain and arm weakness. When a surgeon sutures 1 a healthy tendon, it holds. I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. This level of degradation is not particularly common for someone so young, but does happen from time to time and may well lead to a complete rupture. Any thoughts? I wish you a speedy and full recovery. If the injection does give you pain relief, it may allow you a couple of months without pain to do exercises that can strengthen your rotator cuff and improve the biomechanics at your shoulder in an effort to reduce irritation of the bursa and Supraspinatus tendon. What we often don't see is the subsequent shoulder surgery and months of rehabilitation (sometimes in the off-season) to repair the damaged structures. Rest, pain relievers and physical therapy can help. bone spurs and/or rotator cuff tears. Rotator cuff injuries are common, especially as you get older. that can be just as difficult to resolve as any structural injury. 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. As you have correctly identified, there is quite a long recovery period following surgical repairs of rotator cuff injuries, but on the other hand, there is a pretty good success rate among people who follow the post-operative instructions. @brando87: Thanks brando87, that's what I aim for! I had periodic pain and tingling running all the way down my forearm. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. Being deployed and not receiving treatment makes it difficult. 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. Where required, authors of papers will be contacted to request for missing or additional data. It will be worth developing a good relationship with your doctor (and physical therapist) who can help you do the right things to recover as quickly as possible. my ROM did increase a very small amount, but my pain and discomfort never went away. I sleep fine as it does not hurt to lay on my back. This will help minimize strain on the back. Baumer TG, Chan D, Mende V, Dischler J, Zauel R, van Holsbeeck M, et al. 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. Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. 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. 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). old I was in good physical shape as a letter carrier(28 yrs) but have been mostly sedentary recovering from the first surgery. Good luck with it. but can get back fairly good motion about the shoulder . 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. 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). i d glad if ortopedist or physiotherapist reply ansver. Due to the nature of what we were doing, I was unable to immediately seek medical attention, so after regaining some composure, I managed to carry on with my duty, but not without immense pain. This illustration of the shoulder highlights the major components of the joint. 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. The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). For all you that are going to have this surgery be prepared for the long haul you will feel the feelings of uselessness, frustration, anger, and people looking at you like your full of it hang in there! for an examination, an x-ray or MRI, but other times soft tissue injuries can lead people to report similar symptoms even though no dislocation occurred. Tenderness, loss of function, shoulder weakness, shoulder impingement, and pain when raising or rotating the arm are the main physical signs your orthopaedic surgeon will be looking for in the physical examination, while the imaging tests will show changes in the bones such as shoulder blade shape via X-rays and changes in the movement, shape, thickness of the tendons and other problems like bursitis or arthritis via MRIs and ultrasound testing. 1. The technicians wont say more and nor will my doctor. 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. Bae KH, Kim JW, Kim TK, Kweon SH, Kang HJ, Kim JY, et al. Thanks for stopping by, you have raised some very good questions. A torn rotator cuff may weaken your shoulder. This has caused thickening and abnormal signal in the supraspinatus tendon consistent with tendinopathy and/or a partial tear. Large tear involving the supraspinatus and infraspinatus Fig. I am really concerned about success rates for revision surgery. modify the keyword list to augment your search. The purpose of this study was to compare clinical outcome measures at least 1 year postoperatively between patients who had completion of a high-grade partial thickness supraspinatus tear to a full-thickness tear (PT) and those who had an isolated full-thickness supraspinatus tear (FT). I think this is a common dilemma that people face. Large rotator cuff tear with poor quality tissue Fig. Athletes are especially vulnerable to overuse tears, particularly tennis players and baseball pitchers. 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. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. To be as specific as I can, It feels like someone shoved a knife right into the top of my shoulder blade and right down inside my shoulder. It should be noted that some rotator cuff tears are not painful. Berth A, Neumann W, Awiszus F, Pap G. Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. 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). This includes small (01 cm) and medium (13 cm) tears. Thanks for posting your question. Mary Kay. I'm just about at the point of desperation here. Remaining tendons of the rotator cuff are normal in signal and morphology. The acromion connects with the collar bone (clavicle) very close to the ball and socket (glenohumeral) joint of the shoulder. may email you for journal alerts and information, but is committed There are two main causes of rotator cuff tears: injury and wear (degeneration). 22. That way you can make an informed decision in consultation with advice from your doctor. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. (Right) A full-thickness tear in the supraspinatus tendon. Full-thickness RCTs are present in approximately 25 % of individuals in their 60 s and 50 % of individuals in their 80 s; however, the reported incidence is lower for patients < 55 years of age (4-8 %) [ 1, 2 ]. In planning your treatment, your doctor will consider: There is no evidence of better results from surgery performed near the time of injury versus later on. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. If the pain has been present for only a couple of months (or less) and there were minimal risk of worsening the condition with delay, then often a trial of conservative management (e.g. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. I'll go check out some of your lenses now. These types of tears can also be symptomatic meaning that it causes significant pain and impedes your ability to perform basic everyday tasks or asymptomatic, meaning that the tear doesnt cause significant pain, but should still be monitored by an orthopaedic surgeon since tears can grow worse over time. The main action of the supraspinatus muscle is to abduct the shoulder joint (lift your arm out sideways and upwards). Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! However, your doctor may also suggest surgery if you are very active and/or use your arms for overhead work or sports. It sounds like you may be putting yourself at unnecessary risk? The size of the tear may increase over time. In some cases, surgery to repair the tendon is also required. As a general principle, when soft tissues like tendons or ligaments are damaged (think sprain or strain), but are in very close proximity to one another (I don't consider 1cm retracted to be very close in this context), the structures can often heal and become as strong (or perhaps stronger) than they were before. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. 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. These are recommendations only and may not apply to every case. There are several treatment options for a rotator cuff tear, and the best option is different for every person. Patients 55 years and over have recently been found to be receiving surgical treatment for rotator cuff tears, indicating a rising trend towards surgical repair of rotator cuff tears.24 While surgery is considered an effective treatment, recurrent tears are common, especially degenerative tears, which are frequent in the older population.1 Studies on non-surgical treatments have also demonstrated positive results for full thickness rotator cuff tears.2 Exercise therapy may improve joint stability and reduce translation of the glenoid humeral joint, but has difficulty restoring kinematics to that of an intact rotator cuff.16. 5. Time progressed, pain continued and my ROM slowly worsened. 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.