Good luck! 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. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. Thanks for sharing this detailed account with everyone. MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. Some minor tears may be treated without surgery. Good luck! I can reach behind my back ok. 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. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. 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. The blue arrows represent a full-thickness tear in the supraspinatus tendon, which is the most common site for rotator cuff tears. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. No, it may not be too late to get relief. I had surgery in Mar 2012 for decompression,near full thickness bursa tear and a near full thickness supraspinatus tear with degeneration and general multi-directional laxity of the shoulder capsule.I know the work I have preformed and physical activities over the past 20yrs haven't helped but it was an acute injury that ended it.Since surgery I have been to a physiotherapist but after a few sessions I was experiencing a spot of pain (hot spot) which the physio dismissed as surgery related pain.To make a long story short, gym didn't go well to which I was told by my physio that I was overdoing it (I followed the program to the letter) anyway a second opinion found I have got a high grade partial tear and possible partial full thickness tear and bursa thickening and bunching on adduction. Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. In many cases, surgery is required. i d glad if ortopedist or physiotherapist reply ansver. Good luck with it and I hope you are feeling pain free sooner rather than later. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. It's a supraspinatus tendon tear with 50% thickness and no labral tear. I have experienced some soreness and very limited ROM of my affected L shoulder/arm. It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. That being said, I am scheduled for surgery on 6 Nov. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. This sounds like a difficult situation. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. @anonymous: Thanks for sharing you story Marcia. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). I do not want a metal shoulder. No tendon retraction or muscle belly atrophy. By June '13 I was better in many ways than before the injury. I started adding exercise back in to my life a couple of months ago and what had been intermittent pain has once again become fairly continual. 6 months ago a different ortho diagnosed the problem as frozen shoulder and gave me a cortizone shot followed by physio therapy for few weeks. The primary indication for an acromioplasty in a patient with a full-thickness or bursal rotator cuff tear is for a type 2 or 3 acromion with a frayed CA ligament attachment. It sounds like you may be putting yourself at unnecessary risk? Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. This kind of tear does not heal on its own. 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. 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'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. A full-thickness tear, which usually means the tendon is torn from its insertion on the humerus (the most common injury), is repaired directly to bone. 2023 The Arena Media Brands, LLC and respective content providers on this website. You're more likely to be at risk of a supraspinatus tear if: you're over the age of 40. Arthroscopy 1993;9(2): 195-200. 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). According to Dr. Bob Burks, professor of orthopedics, 60 percent to 70 percent of patients will have some sort of tear by age 80. and seemed to be doing ok with Cortisone shots. Subacromial decompression surgery is the most common option to open up the subacromial space and is combined with a rotator cuff repair if the supraspinatus tendon is torn. Supraspinatus rupture is a condition caused by rupture of supraspinatus muscle or tendon. These types of injuries seem quite common for people who work in construction and are often associated with doing work above shoulder height. A full-thickness tear will decrease the capacity of a muscle to do work. 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. Mild AC arthropathy. Large. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. Good luck! Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. @anonymous: Hi Hans, Thanks for stopping by and sharing your story. I'm sorry I can't give you specific advice about your situation, if you are unsure of which advice from your two doctors is correct a third opinion may help you make sense of it. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. Her MRI shows a full thickness tear of supraspinatus tendon and a tear of the majority of the infraspinatus tendon (with a few lower infraspinatus fibers still attached). @DrMikeM: Thank you Dr. Mike for answering my question. 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. Couldn't even lay down. Any thoughts? 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). infraspinatus tendon had full-thickness tear . My arm was nearly frozen for a period of about 10 minutes, but I slowly started regaining some ROM. Here is some general information which I hope is useful for you: 1. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. The infraspinatus contains a subtle hypochoic region measuring 0.5cm within the tendon substance consistent concerning for an intrasubstance tear. patients should expect to return to full work duty by 6-10 months after surgery. 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. 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. A moderate size full thickness tear . Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. It is important the the surgical repair of the tendon is protected initially to ensure that a re-injury does not occur. No. I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. Good luck with it. Thanks for sharing. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. Not too sure if this article is still active but I'll ask anyways. I have full range of motion and only occasional soreness now and again, but can't sleep on that side. @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. Edema is seen involving an intracapsular segment of biceps tendon with possible interstitial tears. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. It can be difficult to find good information on the web for specific rehabilitation following surgery. 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. At approximately the 3:40 mark in the video above, there are a few exercises to help increase the range of the movement in the shoulder. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. Generally speaking, for shoulder pain related to rotator cuff injuries following trauma, often the first strategy is to see whether the pain and other symptoms improve with non-surgical management approaches. However, I can just mention some general information that may be of interest. Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. pain management and physical therapy) may be the first choice to see if surgery can be avoided. A full-thickness rotator cuff tear is characterized by a focal transmural tendon discontinuity, . This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. 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. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. @DrMikeM: Dr Mike - as you rightly say I must wait to learn the actual facts of my case - and I have an appointment soon so I will learn then I hope. 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. Small area of subacromial bursitis present. If they repair the tendon surgically, this will probably involve wearing a sling and not using that shoulder actively for at least 4-6 weeks and then quite slow gradual progression for the weeks / months after that. Follow up not til next Wednesday. I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! It allows a provider to assess the structures of your shoulder during movement. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. Patients ranged in age from twenty-nine to seventy-nine years. Let us know how things turn out for you. Full-thickness rotator cuff tears are diagnosed with the help of a thorough history and physical examination, as well as the use of imaging studies, most commonly, MRI. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. )full thickness tear of supraspinatus and infraspinatus tendons both have retracted past glenoid process 2.) 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. Most of the time, it is accompanied by another rotator cuff muscle tear. 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. Not all the time, but it was intermittent. Popping noises can occur for a variety of reasons, the most common of which are completely normal. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. Rotator cuff exercises are often prescribed for people with a partial tear of the supraspinatus tendon. 5. and video above) full thickness tears occur when portions of the rotator cuff tendon The supraspinatus muscle provides stability to the glenohumeral joint and is a frequent source of pain and disability. The radiomics model of full- or partial-thickness tears displayed moderate performance with an accuracy of 76.4%, a sensitivity of 79.2%, and a specificity of 74.3% for . 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). Supraspinatus tear can be caused by lifting something too heavy, falling on your arm, or dislocating your shoulder. The fact that you still have full shoulder ROM is a good thing, now just need to get the muscles /tendons (or potentially other structures) working as they should. Either way, I wish you all the best with it (and a safe deployment and return). When the supraspinatus tendon is torn but not completely ruptured, usually a period of conservative management with a physical therapy program will be trialed rather than rushing into surgery. Sorry for the delay, I have been away. 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%. The presence of greater tuberosity cortical irregularity and joint fluid was most important in the diagnosis of full-thickness supraspinatus . bone spurs and/or rotator cuff tears. ), while others do not. its been three months with some pt but no noticeable improvement. I found it very helpful as I am sure all your other subscribers found it to be too. 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. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). 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). Particularly about what many people are likely to experience during the often long road to recovery. Thanks for stopping by. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. It seems to be a long recovery period with a great deal of physical therapy following. He prescribed Vicodin and arthrotec for painbut I would like to get pregnant within a year but would like to be fixed first for obvious reasons. While hauling a box of machine gun ammunition up a ladder (I was holding onto the ladder with one arm and the box of ammo in the other) my right shoulder randomly decided to give up on me. It seems as though you have now had two MRI reports. 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. How do you repair a rotator cuff tear? This will help minimize strain on the back. In the case of a non-retracted full thickness supraspinatus tear and acromioclavicular degeneration, surgery may well be the best option to maximize the long term outcome. As far as general information goes, it is also worthwhile noting that chronic pain and inflammation at a joint can lead to secondary changes (weakening muscles, changes in the way the body processes pain etc.) Second, I am sorry to hear about your fall and subsequent shoulder pain. indications. 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full thickness tear of the supraspinatus tendon surgery