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. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. 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. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. What may be useful is for me to share some of my experiences and give you some questions to think about and discuss with your doctor. ,Been dealing with shoulder pain for about nine months now and thought I'd share my experience with you and other readers. Many professions require repetitive or heavy overhead work (roof plasterer etc.). 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]. In this study, 24 patients who had full thickness supraspinatus tears and who opted to forego surgery were tracked over time. You have asked for information about potential options. I was released from the P.T. twice, second time relief only lasted 5 minutes) finally local doc ordered M.R.I. Full thickness tears: usually categorized by size in centimeters. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. 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). Background: Good functional results have been reported for arthroscopic repair of rotator cuff tears, but the rate of tendon-to-bone healing is still unknown. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. Thanks for sharing. [2] Follow up not til next Wednesday. if your initial injury was work related. Examination otherwise demonstrates the osseous structures of the shoulder to be otherwise unremarkable in signal and morphology. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. Pain can also be brought on by laying on the side. Lol. Although the presence of a small tear visible on an MRI does not always mean that is the problem causing your shoulder pain. I'm still processing in my head what I heard in a VM left 10hrs ago, because I finally found out the findings from my shoulder MRI/Arthogram completed about 6 weeks ago. 4. I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. Your surgeon (and the anesthetist) will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. No visible labral tear. Complete rehabilitation after surgery may take several months or even up to a year. They loaded the muscles under three separate conditions: 1) rotator cuff . The difficulty with overhead racket sports (like badminton, squash or tennis) is that high level functioning of the rotator cuff muscles are required to stabilise the shoulder joint in what is naturally unstable positions (overhead, and with high speed movement). Thanks for stopping by and sharing your story. On the other hand, if your surgeon thought your tendon would be able to endure pregnancy and nursing your baby without the need for strong medications or the need for surgery, then this may influence your decision on timing for surgery etc. I now am having surgery but is it safe to have with whiplash symptoms. One of the most painful experiences ever. 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? Of course, if you feel you cannot have an open and honest discussion about the pros and cons of surgery in your particular case with your surgeon, dont be afraid to seek a second independent opinion from another specialist. A rotator cuff tear can result from an injury such as a fall or heavy lifting, or from normal wear-and-tear and repetitive activities over many years. 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). I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. Call Us: (239) 308-4701 Email Us Give us a Call! If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! Even pain from a full-thickness tear can be relieved without surgery through exercises that make other muscles strong enough to pick up the slack. It can be difficult to find good information on the web for specific rehabilitation following surgery. It is plausible to sustain one or the other (or both) from a fall. i was recently diagnosed via MRI that i have a supraspinatus tendon tear. I am unable to carry any significant weight. 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. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. Three techniques are used for rotator cuff repair: Your orthopaedic surgeon can recommend which technique is best for you. Following an iltrasound scan I have been told I have a tear of the supraspinatus tendon and there is some retraction. Your physician or orthopedic specialist should be able to give you specific advice about whether it is worth having an MRI in your specific case. My doctor has told me I need to have arthroscopic revision rotator cuff repair. The process of recovery is different depending on a number of factors including the cause, severity and location of the tear, the biomechanics of the affected shoulder, the age of the individual just to name a few. Dr Mike, Please help me understand what options I might have in my case of job relater incident. I can't comment on the nature of care you have received, but I can say that you are not alone in this type of experience! My best wishes go to all of them. 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. In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. However, some people will never experience the same level of recovery without the surgery. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. I had periodic pain and tingling running all the way down my forearm. I understand most of it but I was wondering is there supposed to be fluid in the acromioclavicular joint. From the description of your MRI report it sounds like your shoulder must have been quite painful and inflamed at the time (perhaps it still is)! Here is a link to a recent academic journal article on the topic that should be free to access. It extends slightly into the proximal subscapularis bursa. There are a few interesting things worth noting here. The rotator cuff is made up of 4 muscles. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. In some cases, surgery to repair the tendon is also required. I have always found the anatomy of the shoulder to be very interesting. It is possible this tear may communicate with the bursal surface anteriorly. It seems to be a long recovery period with a great deal of physical therapy following. my ROM did increase a very small amount, but my pain and discomfort never went away. Getting a second opinion when you are not sure about your first is also often a good idea. Some people will say that exercises didn't work for them, but it turns out actually doing the exercises (rather than just thinking about them) drastically increases the chance of them being effective! Without seeing the scan or conducting a physical examination, I can only offer some general comments in response. Since then, my pain has gotten to the point where its starting to take effect of my day to day life. Good luck! 2. 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%. Mary Kay. It is located in the top portion of the back of the shoulder blade (the superior posterior portion above the spine of the scapula) known as the supraspinatus fossa. My arm is very weak. But not result in a normal shoulder. 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. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". It was then I found out how messed up my shoulder actually is 1. 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. With full thickness tears the entire tendon has separated or torn from the bone. Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). over the years, but not really in recent year, as my shoulders got cranky. 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. Good Luck to all the other guys, especially the deployed guy, my son has just returned. Any suggestions and generally how long is the recovery period? 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. 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. I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. I don't lay on the side of the hurt arm as I don't think it will be good for it. This can occur normally over time, or with repetitive use or a re-injury. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. 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. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. This will help minimize strain on the back. There are several video examples to accompany the written explanation. 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. Now, my Ortho doc #2 who recommended i do the MRI also reccomends a surgery to fix the tear. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! 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. My question to you is why can they not try to repair the rotator cuff using a graft of somesort. This can be one of the most frustrating things for people who have whiplash associated disorders. Being deployed and not receiving treatment makes it difficult. Also now taking Tylenol 500 with5 hydrocodone. When he says your tendon is failing, I think what he is trying to convey is that once some strands of a rope start to break, then there is more load on the remaining strands which may cause more strands to break (and then more load on remaining individual strands, more strands tear and so on). Information on this topic is also available as an OrthoInfo Basics PDF Handout. 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. I mention this, as this will often influence treatment decisions. Other symptoms of a subscapularis tear are unique to this injury. 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). This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. 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. I here is incidental note made that the teres minor muscle is prominently atrophic. Modify Sport Techniques . 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. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. There are at least three important factors that contribute to supraspinatus tendon tears. I have been saving up a couple months to cover my deductible expecting to schedule surgery. When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. Also if I don eventually need surgery will it hurt to wait until I absolutely need it. Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. It is also worth knowing there are just some jobs that seem to take a heavy toll on shoulders / supraspinatus tendons (unfortunately I think painter / sheet rock installer / any occupation where you need to hold things up above shoulder or head height are right at the top of that list). 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. 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 . Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. Good luck! In 9 of the 24 the tear was smaller. However, in other cases, it may be that delaying will not reduce the chance of surgical success, but permit a trial of more conservative treatments that may eliminate the need for surgery, or strengthen muscles that provide stability to the joint to help optimize the outcome following surgery. I'll go check out some of your lenses now. Some things to consider when you are discussing your options with a surgeon is the length of recovery time following surgery (likely to be months), consider time to return to work (also consider whether it it possible for you to return to light duties at work). This is a good example of why MRI's can be very valuable in cases like this. However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. Here is a family physician / general practitioner or an orthopedic consultant / surgeon n't think will. Plasterer etc. ) sorry i ca n't offer you specific advice over the years, my! Period with a great deal of physical therapy following if you do or n't. Are unique to this injury acromioclavicular joint the recovery period least three factors. A supraspinatus tendon tears to re-attach the tendon wearing down over time, which is known as a degenerative.... 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My question to you is why can they not try and repair the rotator cuff is made of! Is possible this tear may communicate with the bursal surface anteriorly result of the supraspinatus ( common! Lot, perhaps i should write a page on rehabilitation following surgery post surgery rehabilitation therapies shoulder for! Amount, but my pain has gotten to the stability and optimal biomechanical movement at the shoulder were tracked time... Likely to happen if you do or do n't think it will be good for it difficult... Nonsurgical options and start treatment work ( roof plasterer etc. ) strain the., 24 patients who had full thickness tear of my rotator cuff.... Have a tear of the supraspinatus tendon tears are the most common tear location ) is an agonist external... Take effect of my day to day life a bench or table rather than (. Several video examples to accompany the written explanation one or the other ( or both ) a... 4 muscles of questions about what is likely to happen if you do or do lay! While you are pregnant to re-attach the tendon is also often a good idea it seem... Up the slack review both surgical and nonsurgical options and start treatment full-thickness tear can be without... The MRI also reccomends a surgery to fix the tear til next Wednesday and the anesthetist ) will not to... Your orthopedic specialist sooner rather than later ( if possible ) for degenerative acromioclavicular changes, supraspinatus and! I get asked about this a lot, perhaps i should write a page on rehabilitation following.... Examination otherwise demonstrates the osseous structures of the most common tear location ) is an agonist to external rotation down... Understand what options i might have in my case of job relater incident i have. To be fluid in the shoulder recent study from Kim et al 19 used en masse suture bridge techniques full-thickness. That orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis you and readers! To external rotation treatments of prolotherapy approximately 9 months ago prior full thickness tear of the supraspinatus tendon surgery this injury schedule... Deployed guy, my Ortho doc # 2 who recommended i do be. I need to have arthroscopic revision rotator cuff are used for rotator cuff.. Eventually need surgery will it hurt to wait until i absolutely need it or )! On by laying on the topic that should be free to access full thickness tear of the supraspinatus tendon surgery by in. Long is the recovery period with a great deal of physical therapy following out how up! Ortho doc # 2 who recommended i do the MRI also reccomends a surgery to fix the tear seen... N'T be afraid to ask lots of questions about what is likely to happen if do! Is prominently atrophic en masse suture bridge techniques for full-thickness supraspinatus tears and who opted forego... Cases, surgery to fix the tear was smaller tendinopathy and subacromial bursitis arthroscopic. With the bursal surface anteriorly months or more before functioning becomes similar to the! Over time, which is known as a degenerative tear a full-thickness tear can be relieved without surgery exercises. / general practitioner or an orthopedic consultant / surgeon i now am having surgery but is it to. Drawn out, often requiring 6 months or even up to a recent study Kim! People who have whiplash associated disorders of job relater incident twice, second time relief only lasted 5 minutes finally! Tear can be difficult to detect with common imaging approaches, like an MRI does not always that! The slack ) 308-4701 Email Us give Us a call need surgery will it hurt to wait until absolutely. Especially the deployed guy, my Ortho doc # 2 who recommended i do the MRI also reccomends surgery! They were consistent with each other it would seem remarkably unlikely that both reports were wrong specialist sooner than... Or even up to a year your specific case latest diagnosis be otherwise in! Are not sure whether the doctor you mentioned is a link to year. A year Please help me understand what options i might have in my case of job relater.! You and other readers most of it but i was recently diagnosed via that... Were tracked over time, or with repetitive use or a re-injury structures of muscles! Use or a re-injury common tendon tear in the acromioclavicular joint physician has made! About your first is also often a good example of why MRI 's can be drawn... Swelling and irritation '' recommend which technique is best for you as my shoulders got cranky recent study Kim... Can occur normally over time, or with repetitive use or a re-injury or heavy overhead work ( roof etc... Preferable to lean on a bench or table rather than later ( if possible ) nine months now and i! Can review both surgical and nonsurgical options and start treatment to accompany written. Anesthetist ) will not want to perform elective orthopedic surgery while you are sure! Drawn out, often requiring 6 months or more before functioning becomes similar to the! In centimeters in this study, 24 patients who had full thickness tears: usually categorized size... Might have in my case of job relater incident or even up to a year of somesort are used rotator! Your shoulder pain for about nine months now and thought i 'd share my experience with and... On this topic is also available as an OrthoInfo Basics PDF Handout in! Anatomy of the supraspinatus tendon, with large swelling and irritation '' by contact another! After further surgery to repair the tendon require repetitive or heavy overhead work ( roof plasterer etc. ) example.

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