There is inhomogeneous and bulbous appearance of the distal .subscapularis tendon with tendinosis. A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. If muscles of the rotator cuff are not providing adequate stability throughout the shoulder's range of motion, this can contribute to shoulder impingement and a break down of the supraspinatus tendon. The technicians wont say more and nor will my doctor. Good luck! Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. Generally speaking, do small tears need surgical 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. labra are not evaluated 4. All the best with it. Full-thickness tears of the supraspinatus and infraspinatus tendons at their attachment site with retraction of torn fibers up to the lateral aspects of the acromial process. In 2 of the 24 patients, the rotator cuff tear completely healed on its own. However, I went in to see my GP last week for an initial visit and have been advised to do a month of strengthening exercises. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full Reallmadhatter Mar 14, 2013 @ 3:44 pm. The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. You may find it interesting to note that a prior subacriomial decompression is not necessarily an indication that future surgery to address other injuries or further biomechanical problems will not be successful. Infraspinatus tendon is somewhat hetrogeneous in its deep attachment with what appears to be intra-substance tears down to enthesopathic change at footprint. Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? That is some interesting advice you have received. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. These types of injuries seem quite common for people who work in construction and are often associated with doing work above shoulder height. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. The popping may or may not be related to your shoulder pain (difficult for me to say without an examination etc.) 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.) Severe pain after. I am sure lots of people would like to hear how it turns out for you. Front view (left) and overhead view (right) of the tendons that form the rotator cuff. This information is provided as an educational service and is not intended to serve as medical advice. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. Our hypothesis was that arthroscopic repair of full-thickness supraspinatus tears achieves a rate of complete tendon healing equivalent to those reported in the literature with open or mini-open techniques. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. 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. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. and seemed to be doing ok with Cortisone shots. There are many sub-types of SLAP tears and varying severity. From the information you have provided it is difficult to say whether surgery will be needed. I plan on asking the surgeon these questions, but wanted your expert opinion. 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. I worked closely with a physiotherapist for a good four months and pain got worse. Should this shoulder have an MRI? Massive. Popping noises can occur for a variety of reasons, the most common of which are completely normal. There are several video examples to accompany the written explanation. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. Thanks for stopping by and sharing your story. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. They decided to do a re examination of my MRI to see if there was something they were missing. There also is mild tendinosis of the infraspinatus at the footprint. Small to moderate glenohumeral joint effusion. I am 72, I just got the mri with same partial tear. 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. I found it very helpful as I am sure all your other subscribers found it to be too. 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. As defense lawyers are quick to point out, rotator cuff tendons, just like lots of our other joints and tendons, tend to degenerate as we age. Knee Surgery . Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. If they suggest surgery, ask them about what you can expect after surgery and the likely recovery time (including how long it is likely to be before you can use your arm for normal occupational or day to day activities). Sometimes the success rate of a second surgery is not as high as the success rate of the first surgery but still much higher than any other alternative. It is difficult to know whether your husband will need surgery based on this information alone. Small area of subacromial bursitis present. Sleeping on my right side became impossible. Getting a second opinion when you are not sure about your first is also often a good idea. 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). However, some people will never experience the same level of recovery without the surgery. I appreciate your thoughts on this matter. That being said, I am scheduled for surgery on 6 Nov. The reverse shoulder surgery is extremely involved so I am getting a second opinion. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. Since then, my pain has gotten to the point where its starting to take effect of my day to day life. I do not want a metal shoulder. One of the most painful experiences ever. Now, my Ortho doc #2 who recommended i do the MRI also reccomends a surgery to fix the tear. Some general information you may find useful is that generally not a lot of people seem to have a full recovery following a SLAP lesion without surgery. I then went to see another orthopaedic surgeon who said I have whiplash. There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. In my reports say that I have less fluid and possible tear. Rotator Cuff and Shoulder Conditioning Program, Rotator Cuff Tears: Frequently Asked Questions, Rotator Cuff and Shoulder Rehabilitation Exercises. Unfortunately I can't give you specific advice over the internet. 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. Good luck! You should not feel pain in the shoulder during the movement. While I can't give you specific advice over the internet, it sounds like you are doing a great job following the recommednations of your doctors. Overall my subscapularis does appear intact." Sometimes in cases like this your surgeon may want to try an injection. Retraction of the supraspinatus tendon medial to the glenoid. Thanks for stopping by and leaving a comment. ROM decreased. I suspect you have a bit of work to do over the next 6 months or so to help your shoulder recover. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. Seek immediate help if you are experiencing a medical emergency. 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. However, other parts of the rotator cuff may also be involved in the injury. Good luck! there is minimal AC arthrosis. If in doubt call your surgeons office. I am wondering if I can recover without a surgery option. 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. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. is surgery the only option? Always been natural. There is synovial fluid at the glenohumeral articulation. However, there are a variety of factors that will need to be considered. While there is still some attachment present, the need for surgery is not as urgent, as indicated by Ortho doc #2. 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. Thanks for stopping by and sharing your interesting story. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. 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. Further studies, like more larger cohort study or prospective study, will be needed to support our results. He says surgery is inevitable but due to a difficult recovery I should wait til I can't take the pain any longer. Sought 2 nd opinion 3weeks later due to the server pain. Other symptoms of a subscapularis tear are unique to this injury. Between 1997 and 1999, there were 24 patients who had a complete arthroscopic . I sleep fine as it does not hurt to lay on my back. Thanks! INTRODUCTION. I sleep fine as it does not hurt to lay on my back. Good luck! A full-thickness tear might also be described as extending from the anterior leading edge with 1 cm of supraspinatus remaining intact or as involving the midportion with 1 cm of supraspinatus intact anteriorly and 1 cm of infraspinatus intact posteriorly, and so forth. There are at least three important factors that contribute to supraspinatus tendon tears. Does a full thickness tear of the supraspinatus tendon need surgery? This study aimed to evaluate the effectiveness and safety of this treatment method. I hope I have not waited to long for having this checked, and the only option will be 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). If tendon tears (including small tears) have not responded to conservative (non-surgical) treatments or recovered naturally after a few months, then surgery is often considered. I can reach behind my back ok. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. In the mean time, I received another steroid injection treatment. I have full-thickness tear of supraspinatus tendon ,with 1.5 cm cap without tendon retraction plus supraspinatus Ask an Expert Medical Questions The Physician, Doctor 1,261 Satisfied Customers Versatile Emergency Physician, 20 years experience as a Physician. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. These include: pain that gets worse at night. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). Massage may give you some short term relief, but I'm not sure massage on its own will have long term benefit that is additional to natural healing. 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. They loaded the muscles under three separate conditions: 1) rotator cuff . I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. They usually present as a sharp pain at the outside or front of the shoulder, particularly with arm elevation (raising the arm to the side or front). Debridement involves trimming the frayed edges of the tear back to healthy tissue in order to allow it to heal itself. 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