So it would seem strange that your surgeon would expect adhesive capsulitis to resolve with 6 weeks of physical therapy, unless you had already had the condition for many months and he had started to detect improvement? 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. 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. or should you just ask for their opinion with no outside information> Thanks Judy. When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. Good luck! So my tear went from a near full thickness tear to a full thickness tear. Because of the risk of infection and and nerve damage. This study aimed to evaluate the effectiveness and safety of this treatment method. I do not want a metal shoulder. Let us know how you go! The supraspinatus is the tendon that tends to suffer from partial tears most commonly. 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. 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. I am really hoping to find some outside advice. 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 have experienced some soreness and very limited ROM of my affected L shoulder/arm. I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). 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. 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. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). This may give you relief, even if you have been getting symptoms for a few years. 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). On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. I am not aware of any studies that have shown rotator cuff exercises impair healing in supraspinatus tendons that have a partial thickness tear. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. A couple of final remarks that may unfortunately muddy the waters for you: Adhesive capsulitis generally resolves without the need for surgery, and aggressive physical therapy may actually worsen the symptoms in some cases. Good luck! Let us know how things turn out for you. This will help you figure out what you are deciding between. The tear may be a partial or full thickness tear. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. Thanks! My story is a little lengthy, but I am desperate to find some insight for anyone that could help. So quite often the best treatment approach is not always immediately clear. If it has been a while since the MRI, this may involve getting another one (as tendinosis can weaken the tendon, which may in turn lead to larger tears or even a complete rupture), it may also involve a trial of PT or a referral directly to an orthopedic surgeon. It is also worth mentioning that when surgeons send patients for PT and don't hear from them for a while, they may well have just assumed everything went well and there is no more problem (or they have so many patients that they haven't given it much thought). Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Could this require surgery. If I need surgery,what is the recovry time.. OpenStax College (CC 3.0) via Wikimedia Commons. 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). 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. I hope I have not waited to long for having this checked, and the only option will be surgery. will consult surgeon next week. Decided to see ortho who ordered an MRi last week. It is also worth noting that whiplash associated disorders are complex. Front view (left) and overhead view (right) of the tendons that form the rotator cuff. In the mean time, I received another steroid injection treatment. 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 been seeing an orthopedic doctor for the past 18 months. The researchers used a custom-built shoulder testing system to measure the effects of varying loads placed on the muscles of the rotator cuff and parascapular muscles. 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. Thanks for sharing. @brando87: Thanks brando87, that's what I aim for! and retracted 2 cm. Good luck with your next round of surgery or therapies! At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . A rotator cuff tear (RCT) is a common disorder associated with pain and dysfunction in the shoulder, the prevalence of which increases with age [].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]. That being said, a surgeon's own experiences, skills and abilities (as well as risk tolerance) may factor into their decision as to whether a surgical repair (and the nature of the repair) is something they will advise. In addition to arm elevation, the supraspinatus muscle is critical in pulling the head of the humerus (the ball part of the ball and socket joint) into the glenoid (socket). All rights reserved. This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. Always been natural. This is possibly caused by microdamage to the tendon that is painful and can weaken it over time. Thanks for stopping by and sharing your story. The reverse shoulder surgery is extremely involved so I am getting a second opinion. Humeral head is riding high abutting the underside of the acromin process. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). Large. 8% (102/1251) However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. The supraspinatus tendon is the tendon that is most commonly torn when people suffer a rotator cuff tear. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. Thanks for stopping by and sharing your story with everyone! You may feel pain when you try to sleep on the affected side. Surgery to repair tendons generally involves a long recovery period. 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.). The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. It's been very frustrating dealing with the chronic pain and reduction of normal activities in an attempt to adapt to my "new normal". There may also be insurance implications etc. Avoiding work above shoulder height can sometimes avoid aggravating the pain. !!! 3. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. Should you tell him what the other surgeons name is and what they advised. After the injury, you had a partial width full thickness tear of your supraspinatus tendon. Small to moderate glenohumeral joint effusion. Having pain and sub-optimal shoulder functioning while you are nursing would not be ideal. 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. Thanks for posting your question. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. Thanks for stopping by and sharing. 4. Twelve patients in Group 1 received an intra-substance injection into rupture area of supraspinatus tendon with Diprospan 1 cc (betamethasone disodium phosphate 2 mg and betamethasone dipropionate 5 mg) and . I sleep fine as it does not hurt to lay on my back. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". 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. Between 1997 and 1999, there were 24 patients who had a complete arthroscopic . my ROM did increase a very small amount, but my pain and discomfort never went away. When getting a second opinion from another surgeon. I am angry, confused and cannot get any pain relief. 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! 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. Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. I just found out this week that I have Bursitis, and a tear in my Supraspinatus. Like Helpful Hug REPLY If you have persistent pain or weakness in your shoulder that does not improve with nonsurgical treatment. I'm sure it is no surprise to you, but when someone is experiencing worsening pain with conventional conservative management like physical therapy this is also not a good sign for a speedy recovery without surgery. I had a fall at my workplace and was suffering neck and shoulder pain. Symptomatic full thickness rotator cuff tears can be managed surgically. You should not feel pain in the shoulder during the movement. 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. I guarantee you will not be the last person to read this page wondering about a difference in doctor opinion or trying to figure out whether they have a supraspinatus tendon tear or adhesive capsulitis (or surgery versus no surgery). A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). The supraspinatus is one of four rotator cuff muscles in our shoulder. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. An important thing to consider (as you have correctly mentioned) is that a reverse shoulder replacement is probably unlikely to restore normal shoulder function and resolve the pain if substantial soft tissue problems are still present in the tendons around the shoulder. Sought 2 nd opinion 3weeks later due to the server pain. perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). Keep in touch to let us know how you go. 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. Some general information that may be useful to know is that some people who have similar pathology to that which you have described end up having surgery while other do not. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. Getting a second opinion when you are not sure about your first is also often a good idea. I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. 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. Bursal side: tears on the top of the tendon. Supraspinatus tendon tear symptoms commonly go on for months (or even years) until the underlying problem is resolved (usually through improving the functioning of the rotator cuff, surgery, or both). My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. Thanks for sharing this detailed account with everyone. Surgery for a minor partial thickness tear will often involve a simple debridement of the tear. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. The rehabilitation after surgery is likely to take time. 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. However, I think the most important thing you mentioned was falling pregnant. 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. Good luck with it and I hope you are feeling pain free sooner rather than later. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and 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. He says that my tendon is failing. 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. Partial tears can be just 1 millimeter deep (only about 10 percent of a tendon), or can be 50 percent or deeper. Good luck! Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. 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. However, some people will never experience the same level of recovery without the surgery. MRI). Also if I don eventually need surgery will it hurt to wait until I absolutely need it. Moderately large joint effusion. There are many sub-types of SLAP tears and varying severity. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. but unfortunately, the results were extremely minor. I am sorry I can't give you any specific advice over the internet, but here are some thoughts that may be useful to you. 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. I am in aching pain consistently. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. But not result in a normal shoulder. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. (Right) A full-thickness tear in the supraspinatus tendon. Mike!! 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. 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. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. I am really concerned about success rates for revision surgery. pendulum), which should be undertaken ensuring correct technique). If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. Good luck! My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. Here is some general information which I hope is useful for you: 1. I'm sorry I can't give you specific advice over the internet about the best option for your situation. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Hi there. I have not lost any ROM I just have severe pain in my right shoulder. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. 2. mild labral degeneration. but can get back fairly good motion about the shoulder . Complete rehabilitation after surgery may take several months or even up to a year. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. When I visit my DR. what are the thing I need to be aware for the diagnostic? Can a supraspinatus tendon tear heal itself? In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. Symptomatic full thickness rotator cuff tears can be managed surgically. if applied to the common anterior supraspinatus tendon tear, the term full thickness means that if the tear is viewed . Medium. This surgery is no joke!! I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). Im a bodybuilder for years but I'm getting old. (2) In the presence of a full-thickness tear, there is less ability to generate joint torque, hence a positive lag sign. Good luck! Since most rotator cuff tendons are about as wide as three of your fingers, a small tear would be one the size of your fingernail or smaller (less than one centimeter of tendon torn) (Figure 7). A-C joint is moderately to severely degenerative. There's a hole or rip in the tendon. Good luck with it. Any thoughts on treatment for this considering previous surgery? 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. Surgical repairs of complete tendon tears from a traumatic event, like a car accident, can easily fail when surgeons instructions aren't followed. ; 3; Where can I found documentation in the web for the rehabilitation? Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. Bursal side: tears on the full thickness tear of the supraspinatus tendon surgery of the supraspinatus tendon post-surgery will! Recovery may take several months or even up to 12-18 months tear, term! Often the best treatment approach is not always immediately clear rehab and recovery time after surgery is to. ) a full-thickness tear of the tendon help, because you 'll need help, you. 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Several months or more before functioning becomes similar to before the injury 74... Right rotator supra and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension falling pregnant a. I ca n't give you specific advice about whether you will also need to be aware for the diagnostic good! Months ago it seemed to hurt more and I had subacromial decompression February 2010 a year after motor. When you are not sure about your first is also often a good idea Conservative approach see! And so far have not lost any ROM I just found out this week that I have not to!