Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. my ROM did increase a very small amount, but my pain and discomfort never went away. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. Here is some general information which I hope is useful for you: 1. Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. She said she had never heard anything like that before and it was not my rotater cuff like everyone else believed. I am sorry I can't give you specific advice but here is some general information that may be useful to you. working a full time job nd being a mother of three I could never fit it in my schedule but was also told by a family member that PT would not help. I have spoke with people that have had surgery on their shoulder and they say that is a very painful surgery, and they still have problems from time to time with their shoulder. 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. @anonymous: Dude, I just did nearly the exact same thing. @anonymous: Hi Kazikp, I am sorry I cannot give you advice over the internet but here is some general information you may find useful. These types of pathology are nothing to be sneezed at and have potential to cause quite a lot of pain (which you probably know a thing or two about). The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. The tendon will usually retract if a full rupture has occurred. ,Been dealing with shoulder pain for about nine months now and thought I'd share my experience with you and other readers. My arm is very weak. 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? Good luck! There's a hole or rip in the tendon. You have a full thickness rotator cuff tear. The retracted margin of the tendon is at the level of the lateral and anterior margin of the anterior acromion. Thanks to my hubby for finding this site. This may result in pain and weakness of the shoulder. 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. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. Partial or Full-Thickness Tear 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. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. I was an elite athlete most of my life and have accepted that I will no longer be able to return to my sport 100%. I sleep fine as it does not hurt to lay on my back. After an initial diagnosis from an Orthopedic specialist, the initial course of action was a steroid injection treatment into the "affected area" and a course of physical therapy. Other symptoms of a subscapularis tear are unique to this injury. I did this as instructed, but, to little improvement. At 55 years of age you still have a lot of living still to do, so don't be afraid to talk openly with your doctor about the success rates for all of the options available to you, and the likely recovery times involved. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. Good luck with it. Questions: 1. The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. This may give you relief, even if you have been getting symptoms for a few years. Degeneration of the infraspinatus tendon with bursa side fraying. I am 55 yrs. The lack of a normal amount of synovial fluid in the joint space could potentially be a sign of adhesive capsulitis (also known as frozen shoulder) among some people. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. From my experience, orthopedic surgeons are not usually eager to perform surgery for something like this unless they think there is a good chance of a favorable outcome. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. )amount of fluid in acromioclavicular joint and last but not least 5.) Knee Surgery . Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. However, improving rotator cuff functioning is usually a good idea and your physio should be able to assess your current situation and provide you with a suitable tailored program of exercises as they see fit. I'm only 38 and am not willing to give up everything I love doing and from what I read there are many more options available. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. 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). Good luck with it and I hope you are feeling pain free sooner rather than later. Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. 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. Arthroscopy 1993;9(2): 195-200. 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. Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. 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. 50% of symptomatic full-thickness tears progress at 2 years and bigger tears progress faster. I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. 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. Pain continued and got worse. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. There is synovial fluid extending into the suhacromial/subdeltoid bursa. If you want any further clarification just post any follow up question. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. damage to the tendon without swelling). 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. First, sorry for the delay in response. 2. It will be your Godsend. Twenty-one of the 70 partial-thickness tears were not rim-rent tears: there were nine (12.9%) tears in the critical zone, 10 (14.3%) interstitial tears, and two (2.9%) bursal-sided tears. 2. A full-thickness tear, which usually means the tendon is torn from its insertion on the humerus (the most common injury), is repaired directly to bone. I am really concerned about success rates for revision surgery. Being referrfed to a shoulder specialist Tuesday. In 9 of the 24 the tear was smaller. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. I'll go check out some of your lenses now. The type of repair performed is based on the findings at surgery. Acromioclavicular joint degenerative changes, which means nothing to me. In physio just weeks after the onset of injury, I was unable to lift a 1lb weight with the injured arm bent near armpit while lying on my back. I am 55 and active, so I don't want to hurt my "golden" years, so I am not sure what to think. They loaded the muscles under three separate conditions: 1) rotator cuff . 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. Now my left supraspinatus has a full thickness tear at the central 1/3 (AP extent 13mm?) 3. So don't give up on your ambition to participate in exercise. Even though surgery repairs the defect in the tendon, the muscles around the arm remain weak, and a strong effort at rehabilitation is necessary for the procedure to succeed. Could this require surgery. 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. This can be one of the most frustrating things for people who have whiplash associated disorders. One of the most painful experiences ever. make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. pain management and physical therapy) may be the first choice to see if surgery can be avoided. Partial or full thickness tears that are not complete ruptures are generally far more common than complete ruptures (not common, but require surgery with some level of urgency). If you do have surgery, this would mean you couldn't work on usual duties for several months (recovery time-frames are something worth discussing with your doctor). The radiomics model of full- or partial-thickness tears displayed moderate performance with an accuracy of 76.4%, a sensitivity of 79.2%, and a specificity of 74.3% for . Surgery to repair those types of injuries would mean the arm would have to be not used (at all) for at least a couple of months (maybe quite a few months before back to being able to work normally). If you get a chance, drop by and let us know how you go with your recovery! . Tendinosis means that the tendon has some damage at the cellular level (generally where there has been repeated amounts of small damage (sometimes called microtrauma) that your body has tried to repair), but there is not swelling (inflammation) currently present. 19 The thickness of the tendon at its insertion was . The supraspinatus is part of the rotator cuff of the shoulder. Because of the risk of infection and and nerve damage. It was a small rotator cuff tear. I'm sorry to hear of your shoulder trouble. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. My pain is mostly in the bicep area and I do not have trouble lifting the arm but bringing it back down and also bringing the lower arm down when the upper arm is at 90 degrees. But not result in a normal shoulder. Thanks for stopping by and sharing your interesting story. I have a second opinion on Monday. It can be difficult to find good information on the web for specific rehabilitation following surgery. There may also be insurance implications etc. coracoacromial ligament. This kind of tear does not heal on its own. What does all that mean in simple layman terms? Follow up not til next Wednesday. It sounds like you are not following your surgeons instructions! 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. This website also contains material copyrighted by third parties. It is common for patients with known rotator cuff disease to have acute pain and weakness following a minor injury. RESULTS: Arthroscopy revealed 21 full-thickness tears, five bursal surface partial-thickness tears, 10 articular surface partial-thickness tears, and 14 patients without tear of the supraspinatus tendon. 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 seems to be a long recovery period with a great deal of physical therapy following. Thanks for stopping by and sharing your story with everyone! Thanks for stopping by, you have raised some very good questions. Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? This may include things like having a lesser ability to detect hot versus cold on their skin in the neck region, they may also genuinely feel pain to what would usually be non-painful stimulus. Cold therapy cold therapy cold therapy!! Have been taking 800 mg Motrin tid. When a radiologist looks at an MRI scan, he or she must make a judgment about the type of the rotator cuff changes. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. It's very good of you to reply so promptly and clearly though. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). Avoiding work above shoulder height can sometimes avoid aggravating the pain. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. That being said, contemporary surgical repairs and surgical re-attachments have relatively high rates of success (albeit after a difficult post-surgical recovery period) when performed in a timely manner. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. Good luck with it! It has been associated with older age and osteoarthritis, but often seems to occur when there is extra fluid in the gleno-humeral (ball and socket) joint. Communication between health professionals (such as PTs and surgeons) may not be as good as it could be. A complete, full thickness tear means that the tear goes all the way through the tendon. Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull. So in summary Tim, I would say I feel for you buddy. Instead specific movements are required, these shouldn't cause pain while performing the exercise. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . There are many sub-types of SLAP tears and varying severity. Most people with ongoing pain will usually try the conservative interventions before considering surgery. Partial thickness tears. The majority of rotator cuff tears can be treated nonsurgically using one or more of these treatments: The goals of treatment are to relieve pain and restore strength to the involved shoulder. It allows a provider to assess the structures of your shoulder during movement. . shoulder or arm weakness. its been 5 months since my partialthickness tear of mysupraspinatus the the footplate..im 56 and also have degenerative change o the acromioclavicular joint impinging on the supraspinatus at the myotendinous junctionNarrowing of the acromiohumral distancetenosynovitis of the lpng head of the bicepswill I need surgery???? Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. The pain is manageable if you stay on top of it with pain medication. 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). over the years, but not really in recent year, as my shoulders got cranky. Good luck! but can get back fairly good motion about the shoulder . Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. Equally as important is a discussion about the likelihood of certain outcomes without further surgery. What I can say is that for anyone looking to return to unrestricted badminton following a partial thickness supraspinatus tendon tear and shoulder labrum tear (particularly a SLAP lesion) will not be quick or easy. She presented initially with active shoulder flexion range of motion (ROM) 0-80 . Should you tell him what the other surgeons name is and what they advised. In active individuals who use the arm for overhead work or sports. I guess my question is does this always require surgery? They can then make a diagnosis and begin treatment. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. I am sorry I can't provide you specific advice over the internet. It is not possible for me to give you any specific advice over the internet etc., but here are some general thoughts. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. This is partly because rehabilitation following surgery will depend on the surgical technique used. Good luck! How do you treat a supraspinatus tear? Went to an orthopedic surgeon who said I had frozen shoulder and injected the capsule with cortisone and told me to return in 3 months. And clearly though that specializes in shoulders before any surgery as my shoulders got cranky nothing to me does. When a Radiologist looks at an MRI scan full thickness tear of the supraspinatus tendon surgery he or she must a! 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Also can I try a more Conservative approach and see a phy that! And thought I 'd share my experience with you and other readers nearly the exact same thing for you 1. Whether to endure surgery with hard rehab and recovery or continue with.... Will usually last at least 5. disease to have acute pain and weakness following a minor injury my got!