I appreciate your thoughts on this matter. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. only taking out for prescribed exercises (e.g. 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). have got bursal thickening as well and mild thickening of. I had surgery last Thursday for a complete tear of the supraspinatus tendon due to a car accident and was told the tendon was repaired with titanium staples.My concern is of the staples coming out ,I wear a sling whenever outside but have been taking it off when sleeping in my recliner which I've found the best since the accident.If I am just walking around the house I've let it hang down and do not feel pain at the shoulder so figure there is no risk of them pulling out by doing this,am I correct? Thanks for stopping by and leaving a comment. Some days later, I was called back to the VA so they could tell me what they found. Any suggestions and generally how long is the recovery period? @DrMikeM: Thank you Dr. Mike for answering my question. and retracted 2 cm. As such, a therapist can provide a safe and progressive therapy program. Having pain and sub-optimal shoulder functioning while you are nursing would not be ideal. A full-thickness tear is when the wear in the tendon goes all the way through the tendon. Methods: Sixty-five consecutive shoulders with a chronic full-thickness supraspinatus tear were repaired arthroscopically in sixty-five patients with use of a tension-band suture technique. He kind of scared me regarding the recovery for this. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. I have always found the anatomy of the shoulder to be very interesting. Debridement involves trimming the frayed edges of the tear back to healthy tissue in order to allow it to heal itself. 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. Purpose: The objective of this study is to report on the complete arthroscopic repair of full-thickness tears of the supraspinatus.Type of Study: Prospective cohort study. 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. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. The supraspinatus muscle is a relatively small muscle, but very it's important one. Full thickness tears may involve only part of one tendon (usually the supraspinatus). Some quite compelling research has indicated that a substantial proportion of people (particularly young people) who receive this kind of treatment will go on to have further shoulder problems (sometimes instability in the shoulder joint or pain and discomfort from damaged structures). 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. I am unable to carry any significant weight. This study aimed to evaluate the effectiveness and safety of this treatment method. To recap I have had debridement and subacromial decompression, am 34 years old and now have arthritis, bursitis, tendinitis and impingement. Pain is really consistent and moderate with moments of severe. He says that my tendon is failing. Thanks for stopping by and sharing your story. Let us know how things turn out for you. Humeral head is riding high abutting the underside of the acromin process. 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. I suspect you have a bit of work to do over the next 6 months or so to help your shoulder recover. You have a full thickness rotator cuff tear. I maybe take a few Advil a week with no loss of function at all. Thanks for posting your question. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. Acromioclavicular joint degenerative changes, which means nothing to me. Although the presence of a small tear visible on an MRI does not always mean that is the problem causing your shoulder pain. 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). If you get a chance drop by again and let us know how you went. Also, don't be afraid to ask doctors / surgeons lots of questions. I guess my question is does this always require surgery? They decided to do a re examination of my MRI to see if there was something they were missing. Couldn't even lay down. @Reallmadhatter: Good question. 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. Had periods of pain go from the back of my shoulder down my arm like before. Particularly about what many people are likely to experience during the often long road to recovery. The tendon will usually retract if a full rupture has occurred. It's been very frustrating dealing with the chronic pain and reduction of normal activities in an attempt to adapt to my "new normal". Can a supraspinatus tendon tear heal itself? 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. Symptomatic full thickness rotator cuff tears can be managed surgically. A few hours after the incident, I was able to seek some medical attention from our on board medic, who believed I had dislocated my shoulder, but was not overly concerned with my condition. Anyways, my appointment for surgery on my right shoulder is in 2 weeks.. Arthroscopic.. it use to ache and ache at night but recently its not so bad. It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. I was released from the P.T. I am in aching pain consistently. I was referred to a surgeon who stated that they could not repair the rotator cuff due to the size of the tear from a surgical standpoint. Good luck! Thanks for stopping by and sharing. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. I experienced a fall on August 31, 2012. At age 74, not sure whether to endure surgery with hard rehab and recovery or continue with PT . 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. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. I am 55 yrs. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. All material on this website is protected by copyright. The close proximity of the supraspinatus tendon to the acromion-clavicular arch is a common contributing factor in supraspinatus tears, particularly when the tendon becomes impinged between these bone structures with activities that require arm elevation. The average duration of follow-up was twenty-nine months. sir i am a shuttle badminton player.. i got injury on my shoulder .. doc told to tke MRI scan.. after taking MRI scan these are the final impressions.. 1.partial tear in the supraspinatus tendon at the level of insertion in the greater tubersity for a length of about 15mm with intact insertion, 2 partial tear in the anterior superior labrum. Approximately 1% of the adult population will have shoulder pain at some point in their lives. is surgery the only option? Some general information you may find useful is that generally not a lot of people seem to have a full recovery following a SLAP lesion without surgery. Sorry we are unable to give specific advice over the internet, but I hope this general information is helpful! bone spurs and/or rotator cuff tears. Arthroscopy 1993;9(2): 195-200. Infraspinatus tendon is somewhat hetrogeneous in its deep attachment with what appears to be intra-substance tears down to enthesopathic change at footprint. 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. I appreciate your thoughts on this matter. 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. Sometimes in cases like this your surgeon may want to try an injection. Most people regain shoulder function and strength within four to six months after surgery, but full recovery may take up to 12-18 months. Supraspinatus tear: If you want a chance for a full recovery surgeryis your best option. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. They will be able to tell you the likelihood of a supraspinatus tear and adhesive capsulitis (or any other pathology), as well as the recommended course of action for your particular circumstance. Of the 49 rim-rent tears, 24 (49.0%) involved the anterior-most fibers of the supraspinatus tendon, one of which extended to involve the infraspinatus tendon. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. 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. So in summary Tim, I would say I feel for you buddy. I am 55 and active, so I don't want to hurt my "golden" years, so I am not sure what to think. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. 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. 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! Overall my subscapularis does appear intact." 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). Good luck with it. @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. 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. Good luck with it! @brando87: Thanks brando87, that's what I aim for! Magnetic resonance imaging (MRI). It is also very interesting to note that for those people who have persistent whiplash symptoms there is often a change in the way their brain processes sensation from the neck and shoulder region. I have full-thickness tear of supraspinatus tendon ,with 1.5 cm cap without tendon retraction plus supraspinatus Ask an Expert Medical Questions The Physician, Doctor 1,261 Satisfied Customers Versatile Emergency Physician, 20 years experience as a Physician. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. I am really concerned about success rates for revision surgery. So quite often the best treatment approach is not always immediately clear. 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). You may feel pain when you try to sleep on the affected side. However, not all tears need surgery. I wish you a speedy and full recovery. 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. If you know you have a rotator cuff tear, worsening pain and decreasing strength may mean the tear is getting larger. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. It is plausible to sustain one or the other (or both) from a fall. 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. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. But not result in a normal shoulder. Medium. Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. These types of injuries seem quite common for people who work in construction and are often associated with doing work above shoulder height. I do so appreciate the advice and direction you have given to myself and others through this posting. Massive. Any advice would be appreciated thanks. that can be just as difficult to resolve as any structural injury. @anonymous: Oh Tonia, I feel for you. It must have been quite a knock, there is some quite serious damage there. 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