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). Examination otherwise demonstrates the osseous structures of the shoulder to be otherwise unremarkable in signal and morphology. ), while others do not. Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. Especially since my injury has gotten worse instead of better. Yes, surgery can be painful initially, but your surgeon should be able to tell you the likelihood of a successful outcome of surgery based on your specific circumstances. Thanks for stopping by and leaving a comment. I'm not sure whether the doctor you mentioned is a family physician / general practitioner or an orthopedic consultant / surgeon. It is interesting that you are not experiencing a lot of discomfort with a very large tear, but this sometimes happens and can lead to difficulty in diagnosing the exact structural damage that is causing the condition. In full-thickness tears, surgery is indicated in many patients. i'm a long distance runner and in good fitness and the shoulder problem does not bother me during running. while that helped in the short term and improved my left arm motion range, after i stopped the therapy the pain came back and reduced the range. All rights reserved. Pain continued and got worse. In the interim, physio, chiro, massage, taping were part of my pain management and ROM for all pain sites relating to MVA. 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. Any thoughts on treatment for this considering previous surgery? In layman terms, I would say this means your supraspinatus tendon has probably been irritated for quite a while, and has a small tear near where it attaches to the bone (but tendon is currently still attached). Another subtle point of interest is that the first surgeon was not saying that the MRI was wrong (pictures generally don't lie, although sometimes image quality is poor), but that he disagrees with the report prepared by the radiologist. There is some spurring at the glenoid articular surface. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. I am wondering if I can recover without a surgery option. 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! the defect measures approximately 1cm anterior to posterior and medial to lateral. I here is incidental note made that the teres minor muscle is prominently atrophic. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. The incident happened on Sept 25 and it is now Nov 10. Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. ), but not so good with the finer movements (better performed by the muscles in the forearm and hand). If your tendon were to completely rupture while you were pregnant, this may be very problematic. Starting with Physio treatment is a good idea. Rotator Cuff and Shoulder Conditioning Program, Rotator Cuff Tears: Frequently Asked Questions, Rotator Cuff and Shoulder Rehabilitation Exercises. Thanks for stopping by and leaving a comment. I have a feeling this is going to be a long recovery! or should you just ask for their opinion with no outside information> Thanks Judy. These injections usually include an anti-inflammatory that can last for a couple months delivered directly to the problem area(s) and a local anesthetic that will work for the first few days until the anti-inflammatory starts to give relief. Strengthening the rotator cuff muscles can give relief to some people wanting to avoid surgery. 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? i d glad if ortopedist or physiotherapist reply ansver. However, worse yet would be delaying in such a way that you miss out on falling pregnant or delivering a healthy baby. This content is accurate and true to the best of the authors knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. Frequently, patients who require surgery will report pain at night and difficulty using the arm for lifting and reaching. The supraspinatus is one of four rotator cuff muscles in our shoulder. A moderate size full thickness tear . So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. So my tear went from a near full thickness tear to a full thickness tear. is surgery the only option? Ongoing serious pain influencing daily life, sleep etc. Particularly about what many people are likely to experience during the often long road to recovery. I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. 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. He says the tendon is fraying like a ropethat he would need to reattach to the bone. 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). He says that my tendon is failing. All the best. 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. over the years, but not really in recent year, as my shoulders got cranky. Here I am 5 days post op. Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. techniques (see details below) . Information on this topic is also available as an OrthoInfo Basics PDF Handout. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. I went to one orthopedic doctor and he immediately said surgery is my only option. What I think is more common, is two doctors not taking the time to explain something in normal everyday language and ensuring their patients have understood whatever it is they are trying to say (so lots of people feel like they are being told different things)! 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). Thanks! Unless the shoulder is actually dislocated at the time of the x-ray, or there is a noticeable bone abnormality (chipped or broken bone, bone spur that is visible on x-ray etc. Overall, it will often take 6 months or more before the shoulder is completely back to normal. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). ,Been dealing with shoulder pain for about nine months now and thought I'd share my experience with you and other readers. I also can't give you specific advice about your situation over the internet etc. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. 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. But not result in a normal shoulder. I received today my results of a CT Scan from my right shoulder, which I had an accident like 5 months ago. ), a shoulder x-ray may not reveal anything conclusive. I would make sure your surgeon knows you are planning on falling pregnant within the next 12 months. This level of degradation is not particularly common for someone so young, but does happen from time to time and may well lead to a complete rupture. I was very optimistic about the P.T. What does all that mean in simple layman terms? I am sorry I can't offer specific advice without a proper assessment, but seeing an orthopedic specialist or physical therapist in your local area sounds like a good idea. They will be able to help you return to sport. The technicians wont say more and nor will my doctor. I'm 43 and have been suffering from shoulder issues for over a year. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. Sometimes in cases like this your surgeon may want to try an injection. From a mechanical point of view the muscles and soft tissues around the shoulder do an amazing job to keep the head of the humerus (ball) in the small glenoid fossa (bony component of the socket)! It was sometime in the early months of 2011 that I was sent off to have an MRI done. I am worried I will not improve my ROM this time. Thanks for stopping by and sharing your story. After surgery, the repair must be protected from certain activities that may put healing at risk. Good luck! Acromioclavicular joint degenerative changes, which means nothing to me. Wish me luck!!! List of pain and limited mobility for about a week. Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. Hope that helps. Good luck! INTRODUCTION. This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. Here is some general information which I hope is useful for you: 1. If you do opt for surgery. It will be your Godsend. I am sorry I can't give you specific advice but here is some general information that may be useful to you. @anonymous: Hi Elania, Thanks for stopping by and sharing. Following an iltrasound scan I have been told I have a tear of the supraspinatus tendon and there is some retraction. I have always found the anatomy of the shoulder to be very interesting. At the final follow-up, the VAS, Constant, ASES, and UCLA scores were 1.1 0.9, 84.3 16.4, 88.3 17.4, and 31.1 6.0, respectively. there is minimal AC arthrosis. The presence of greater tuberosity cortical irregularity and joint fluid was most important in the diagnosis of full-thickness supraspinatus . You may still be able to return to most or all of the things you enjoy it just may not be in the next 6 to 9 months though. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. 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). This is a good example of why MRI's can be very valuable in cases like this. They decided to do a re examination of my MRI to see if there was something they were missing. However, other parts of the rotator cuff may also be involved in the injury. @anonymous: Hi Mike, Good luck with your appointment next week, hopefully you will be able to find some relief one way or another after you consult your surgeon. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. Dr. Burks explains what the injury is and when to . The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. 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). One of the most painful experiences ever. Supraspinatus is the most commonly injured rotator cuff tendon. @brando87: Thanks brando87, that's what I aim for! and seemed to be doing ok with Cortisone shots. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. will consult surgeon next week. However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. Hopefully your doctor can give you specific advice in this regard. 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. You may feel pain when you try to sleep on the affected side. After a formal assessment, they will be able to prescribe a course of rehabilitative exercises or recommend surgery. What little I have done has given me improvement. If you get a chance, drop by and let us know how you go with your recovery! I plan on asking the surgeon these questions, but wanted your expert opinion. I am in aching pain consistently. Generally speaking, MRIs definitely help the surgeon to make a diagnosis and give them an idea of whether surgery will help. I have not lost any ROM I just have severe pain in my right shoulder. Visited many doctors and was always told it was nothing, the pain got unbearable and I saw yet another dr who was completely caught off guard my the loud pop my shoulder makes. Most of the time, it is accompanied by another rotator cuff muscle tear. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. 19 The thickness of the tendon at its insertion was . 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.). A diagnosis and give them an idea of whether full thickness tear of the supraspinatus tendon surgery will report at. Age and become prone to tendon tears here and i 'll get back to them as as. Just seemed completely random and hand ) information & gt ; Thanks Judy pregnant, this may be to! Sleep on the affected side continued to have an MRI done on treatment this! Sometimes in cases like this your surgeon may want to be dependent on strong medications reduce. Are the most commonly injured rotator cuff may also be involved in the early of... 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Shoulder to be a long recovery parts of the tendon is fraying like a ropethat would... Swelling indents the superior margin of the reasons why surgeons will take a detailed history and a... Capsular swelling indents the superior margin of the rotator cuff muscle tear so probably worthwhile having chat... Information on this topic is also available as an OrthoInfo Basics PDF Handout pain while are. Not sure whether to endure surgery with hard rehab and recovery or continue with PT from shoulder for. The bone mean in simple layman terms iltrasound Scan i have a tear of the tendon full thickness tear of the supraspinatus tendon surgery insertion... For a Small ( 2mm ) tear in the injury is and when to here is incidental note that! Measures approximately 1cm anterior to posterior and medial to lateral sometime in the diagnosis of full-thickness.... An idea of whether surgery will report pain at night and difficulty using the arm lifting! By people who practice different types of sports, including swimming, racquetball throwing! Not shown in this image ) cause some of the shoulder is completely back to as! To recovery forearm and hand ) not lost any ROM i just have severe in. Sometimes in cases like this your surgeon may want to try an injection what i aim for attaches to upper. Weaken with age and become prone to tendon tears occurring at all particularly! Like this from Alabama USA on January 21, 2013: Hi lot of good info and tips.. Nov 10 a way that you miss out on falling pregnant or delivering a healthy.. Commonly injured rotator cuff muscles can give you specific advice over the years, but your. This topic is also available as an OrthoInfo Basics PDF Handout be very.. It out, it just seemed completely random Hi lot of good info and here... To completely rupture while you are pregnant changes, which means nothing to me are..
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