Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. I've started having a smoothie everyday of red vege's (beetroot) and fruit (all the berries) with a slice of ginger and the big one for inflammation turmeric! This sounds like quite a pain (literally). Waiting until after the delivery of your baby to re-attach the tendon may increase the chance of a poorer outcome (not to mention the difficulty nursing a newborn with only one functional arm). Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. its been three months with some pt but no noticeable improvement. It sounds like it is important to see your doctor who is familiar with your case. I work construction and am self employed. If a medical doctor (assuming they have nothing to personally gain by referring you to another health professional) suggests something may work based on their years of training, in depth understanding of anatomy, physiology, common pathology, research evidence and clinical experience with many patients, it is usually worth considering what a family or friend (albeit that they are usually well meaning) is basing their opinion on. I think this is a common dilemma that people face. It sounds like you are not following your surgeons instructions! Should you tell him what the other surgeons name is and what they advised. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? What little I have done has given me improvement. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. The rotator cuff is a group of four muscles and their associated tendons that originate from locations on the scapula and insert onto the humeral head. I have been seeing an orthopedic doctor for the past 18 months. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). I'm unable to say whether this has occurred in your case, however, the reason why this springs to mind is that I cannot recall ever seeing a true case of adhesive capsulitis (sometimes called frozen shoulder) that resolved in 6 weeks? It may be helpful to think of the rotator cuff as a group of muscles and each muscle is connected to the bone via a tendon. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. 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). @anonymous: Thanks for sharing you story Marcia. This likely represents extension of an existing tear. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. @Reallmadhatter: Good question. There may also be insurance implications etc. Thanks! It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. When getting a second opinion from another surgeon. Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. Some people will recover quickly without any treatment, other people will recover after commencing non-surgical interventions (such as physical therapy and rotator cuff exercises and / or receiving a steroid injection), while others will still have pain after many months and may require surgery. How is a supraspinatus tendon tear similar to a rope? 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. Good Luck to all the other guys, especially the deployed guy, my son has just returned. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . In the beginning of 2012, I returned to the Orthopedic specialist at the VA, and the medical staff seemed very surprised that my god awful pain and discomfort was still going on. Interpretation: There is a focally retracted full thickness 1.2 x 1.2 cm tear of the supraspinatus tendon at its anterior attachment site on the humerus. Since then, my pain has gotten to the point where its starting to take effect of my day to day life. I am in aching pain consistently. When Is Surgery Necessary . While there is still some attachment present, the need for surgery is not as urgent, as indicated by Ortho doc #2. @anonymous: Hi Donald, I'm sorry to hear about your shoulder trouble and insurance situation. It may take a while to overcome your shoulder pain, and you may even need to modify the types of activities you do, but working hard to be able to return to exercise is definitely a worthwhile goal. It is best to stick within the range of movement indicated on the video rather than try to rotate your arm too far out to the side and potentially aggravate already inflamed rotator cuff tendons. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). Being deployed and not receiving treatment makes it difficult. They will be able to help you return to sport. Keep in touch to let us know how you go. Have been taking 800 mg Motrin tid. This kind of tear does not heal on its own. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. In general terms of the types of MRI findings you have described, a combination of these types of pathology could require surgery; particularly if symptoms persisted after trying non-surgical interventions. Either way, I wish you all the best with it (and a safe deployment and return). If the tear occurs with injury, you may experience acute pain, a snapping sensation, and immediate weakness of the arm. I'll go check out some of your Lenses. Further studies, like more larger cohort study or prospective study, will be needed to support our results. Now my left supraspinatus has a full thickness tear at the central 1/3 (AP extent 13mm?) Not all the time, but it was intermittent. Because of the risk of infection and and nerve damage. @anonymous: Dude, I just did nearly the exact same thing. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. P.S. I have lost about 45+% of my ROM in my right arm. Do not complete these exercises if they cause an increase in pain; instead, seek specific advice from an appropriately qualified professional such as a physical therapist or physician. 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. Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. 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)! This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. Those words exactly. This is partly because rehabilitation following surgery will depend on the surgical technique used. Thanks for stopping by and sharing your story. bone spurs and/or rotator cuff tears. I am sure lots of people would like to hear how it turns out for you. The tendon will usually retract if a full rupture has occurred. I do so appreciate the advice and direction you have given to myself and others through this posting. 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. For anyone contemplating surgery, buy a recliner to sleep in after surgery. 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. ), while others do not. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. I was released from the P.T. Magnetic resonance imaging (MRI). It sounds as though you know a little bit about your shoulder situation already, so I won't re-state details about the anatomy that is affected. 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. 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. . It is possible this tear may communicate with the bursal surface anteriorly. ; 2. There's a hole or rip in the tendon. Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. If you are seeing the orthopedic surgeon it is a good idea to tell them about therapies you have received and about your persistent pain. and seemed to be doing ok with Cortisone shots. I have been saving up a couple months to cover my deductible expecting to schedule surgery. You mention your shoulder makes a popping noise, generally speaking the sound a joint makes is not a good indicator of anything (particularly if the popping noise itself is not accompanied by pain). It is certainly worth discussing a more conservative approach, such as seeing a physical therapist that specializes in shoulders, with your orthopedic surgeon; particularly if you feel you have noticed improvements previously. 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. I'm quite apprehensive and nervous about the surgery but more so about the recovery. Thanks for stopping by and sharing. On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. Just be aware that even in the best cases, the recovery time following surgery requires months (not weeks) so if you go ahead with the surgery don't be discouraged if you still have some pain in the first weeks after the surgery. Couldn't even lay down. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. First, sorry for the delay in response. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. 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. Good luck with it either way. Large. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. It sounds like the damage is fairly minor in my shoulder yet I have a great deal of discomfort and limited ROM 2 1/2 months after my fall. I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. I do not want a metal shoulder. I suspect you have a bit of work to do over the next 6 months or so to help your shoulder recover. Due to the nature of what we were doing, I was unable to immediately seek medical attention, so after regaining some composure, I managed to carry on with my duty, but not without immense pain. Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. Thanks for stopping by and sharing your interesting story. The major tear causes separation of muscle or tendon into two torn segment of muscles or tendons. Here is some general information that may be useful. The rotator cuff is a group of four muscles that come together as tendons to form a "cuff," or cover, over the head of the humerus (upper arm bone). 19 The thickness of the tendon at its insertion was . make sure you do it some place where anesthesiawill do an interscalene block for post op pain relief. If not what is this indictative of. If you are not keen to rush into surgery don't be afraid to ask your orthopedic specialist about conservative treatment options that may be worth trialing, on the other hand, your surgeon may be able to give you a good indication of whether they think surgery is the most promising option. Thanks for stopping by and leaving a comment! Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. Good luck! AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. massive cuff tears. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. The postoperative recovery period following a surgical rotator cuff repair will take months and involve a specific program of range of motion and strengthening exercises that your surgeon will prescribe, often in conjunction with a physical therapist who will teach you exercises and monitor your progression. 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. is surgery the only option? 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. 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. 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