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. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. 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. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. 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. An orthopedic surgeon will be able to provide you with all the information you need regarding surgery, however, regarding exercises to return to badminton it might be wise to see a physical therapist (also known as physiotherapist) who specialises in sports injuries and rehabilitation. 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! When supraspinatus tendon tear symptoms are chronic and severe, an orthopedic specialist will be able to provide good advice on likely recovery and treatment options, including the likelihood of successful recovery with or without surgery. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. Dr. Burks explains what the injury is and when to . But not result in a normal shoulder. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. The primary purpose of these muscles is to prevent the head of the humerus, or upper arm bone, from driving into the shoulder joint as you lift your arm away from your body or overhead. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. Am I destined for surgery in order to regain even 50% of what I've loss or should I try another round of prolotherapy? Partial thickness tears. Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. Here is some general information which I hope is useful for you: 1. I have a feeling this is going to be a long recovery! ), a shoulder x-ray may not reveal anything conclusive. 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. Strengthening the rotator cuff muscles can give relief to some people wanting to avoid surgery. Good luck! The rehabilitation after surgery is likely to take time. I have had this problem with my shoulder/arm for about 6 months maybe. I am sorry I can't provide you specific advice over the internet. 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. Good luck with it. Original injury was 4 years ago in a MVA and I've been experiencing pain when sleeping on injured side, intermittent loss of sensation for the entire arm resulting in dropping things, loss of muscular endurance and increased pain for repetitive activities ranging from ribcage level and upward, loss of muscular strength and increased pain for lifting objects at the present moment equivalent in weight to a litre of milk or heavier, and an overall sense of lack of spacial awareness for the injured arm as if my arm is not "connected" to my body. I left out a bunch of other things that are normal. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. >5cm), depth (partial or full thickness), degree of fatty infiltration (Goutallier. 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. Dr Mike, Please help me understand what options I might have in my case of job relater incident. 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 am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. I think it would be wise to listed to the advice from your doctor on this one! I can say though that PT's are trained to help people with painful ROM. The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. Arthroscopy 1993;9(2): 195-200. 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. I have been saving up a couple months to cover my deductible expecting to schedule surgery. If you have any uncertainty around the need for your sling use, please call your surgeon's office today. sorry for the double posting, first time user. 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. When Is Surgery Necessary . However, given that you already have an MRI it sounds like you are already under the care of your doctor, which is great. Time progressed, pain continued and my ROM slowly worsened. I am close to retirement and I am afraid I will not be able to do the things I once enjoyed, outdoor activities. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. feeling pain in hand,,,. D.C. Stitch positioning influences the suture hold in supraspinatus tendon repair. Good luck with it. damage to the tendon without swelling). I guess my question is does this always require 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. SLAP type tear of the superior labrum. 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.). I went to one orthopedic doctor and he immediately said surgery is my only option. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. He prescribed Vicodin and arthrotec for painbut I would like to get pregnant within a year but would like to be fixed first for obvious reasons. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. (See Fig. Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. Surgical repair can often be . I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. Don't be afraid to have an open discussion with your GP about whether or not a referral to a surgeon is the right way to go (or not) for your specific circumstance. Can a full thickness tear of the supraspinatus heal without surgery? There is a small band of hyperintensity on the footprint attachment of the anterior aspect of supraspintus in keeping with tendinopathy -small unretracted intra-substance tear. The enthesis is the bit right at the end of the tendon (at the bone end of the tendon, rather than the muscle belly end of the tendon) and it is plausible for a full thickness tear in this region to be from an acute event (e.g. Either way, I wish you all the best with it (and a safe deployment and return). My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. I have a referral to a specialist and hopefully I will have some answers soon. I am really concerned about success rates for revision surgery. I then went to see another orthopaedic surgeon who said I have whiplash. But not result in a normal shoulder. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. According to Dr. Bob Burks, professor of orthopedics, 60 percent to 70 percent of patients will have some sort of tear by age 80. It sounds like you may be putting yourself at unnecessary risk? That is some interesting advice you have received. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. Similarly pain and dysfunction in the shoulder may cause you to use it less, which may in turn lead to weaker muscles and tendons (which may lead to more difficulty during and after a subsequent surgery). Generally speaking, treatment options for shoulder injuries that include supraspinatus tendon tears and other findings similar to those you have reported could include surgery, or more conservative treatments like a trial of physical therapy or injections. Your orthopedic specialist will be able to give you advice about the best option for your circumstances. This will help you figure out what you are deciding between. Instead specific movements are required, these shouldn't cause pain while performing the exercise. 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). If they repair the tendon surgically, this will probably involve wearing a sling and not using that shoulder actively for at least 4-6 weeks and then quite slow gradual progression for the weeks / months after that. Bursal side: tears on the top of the tendon. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. The acriomioclavicular joint usually should have some fluid that helps lubricate the joint, but when it is specifically mentioned in an imaging report (like an MRI report), they are usually indicating that there are able to see more fluid then one might usually expect (in someone without any shoulder pathology). Good luck with it! Here is a link to a recent academic journal article on the topic that should be free to access. thank you for your considiration and helle from Turkey:-). One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). 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. Generally speaking, do small tears need surgical repair? Good luck! Very much appreciated. I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. I am angry, confused and cannot get any pain relief. The rotator cuff exercises should not cause pain while the exercise is being performed. dr mike,a i got an mri shoulder pain, the surgen said it was adhesive capsulitis and with about 6 weeks of pt it would be fine, but the mri report also said there was a tear, the doctor said the report was wrong, needless to say i got a second opinion, the next doctor ordered a new mri and he suggest surgery , i am at a loss, should i get a 3rd opinion just to be sure? Overall my subscapularis does appear intact." 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. Debridement involves trimming the frayed edges of the tear back to healthy tissue in order to allow it to heal itself. I don't lay on the side of the hurt arm as I don't think it will be good for it. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. 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. 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 . The radiomics model of no tears or tears achieved a high overall accuracy of 93.6%, sensitivity of 91.6%, and specificity of 95.2% for supraspinatus tendon tears. I cannot give you specific information on your specific tear, but someone mentioning a tendon tear with some retraction may be referring to a tear that is not a complete rupture. Irreparable. Patients ranged in age from twenty-nine to seventy-nine years. . can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. 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