This study aimed to evaluate the effectiveness and safety of this treatment method. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. Any advice would be greatly appreciated. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. Thank you for the info posted on this page. . The medical staff there did an x-ray, which did not turn anything up, and once again, were not overly concerned with my condition, but just instructed me to continue to ice pack my shoulder and take some pain medication. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. My doctor has told me I need to have arthroscopic revision rotator cuff repair. Exercise is important for many reasons (not the least of which are physical and mental health benefits). I can say though that PT's are trained to help people with painful ROM. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. Pitchers, swimmers, and tennis players are common examples. X-rays are often not very useful in diagnosing shoulder injuries. 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. 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. 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. 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). Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). A supraspinatus tear is the most common malady of the shoulder that appears in my orthopedic practice. Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. 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. Complete rehabilitation after surgery may take several months or even up to a year. The supraspinatus is one of four muscles that make up a group referred to as the rotator cuff muscles. I've seen musicians and artists with poor shoulder function be able to perform their art as well as they did before their injury; sometimes through making some adaptations, but other times almost no adaptation was required (depending on their technique / instrument / art etc.). Good luck! 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 . This surgery is no joke!! Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. I served in the Navy for many years, and in April of 2010 I had a little mishap. The tendon that seems to be most commonly affected is the supraspinatus, although it could also easily be either infraspinatus, long head of biceps, subscapularis or teres minor tendons. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. over the years, but not really in recent year, as my shoulders got cranky. That being said, contemporary surgical repairs and surgical re-attachments have relatively high rates of success (albeit after a difficult post-surgical recovery period) when performed in a timely manner. It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. Good luck with it. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. 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. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. Equally as important is a discussion about the likelihood of certain outcomes without further surgery. Hey DrMikeM doin some research and came across your sight and thought I'd add my two cents. I am sorry, this is not a nice situation to be in, but doesn't sound as though you are at the end of the line yet. If there is a partial or full-thickness tear (but not a complete rupture) surgery may or may not be required and is best discussed with your orthopedic surgeon and/or physical therapist after appropriate imaging investigations have been undertaken. I'm sorry I can't give you specific advice over the internet about the best option for your situation. 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. The supraspinatus tendon is the tendon that is most commonly torn when people suffer a rotator cuff tear. twice, second time relief only lasted 5 minutes) finally local doc ordered M.R.I. You mentioned rotator cuff and tendonosis like they were different things. and seemed to be doing ok with Cortisone shots. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. (See Fig. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. ROM decreased. if your initial injury was work related. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. Some minor tears may be treated without surgery. No tendon retraction or muscle belly atrophy. I think these are promising approaches for the types of pathology you described. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). 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. However, in some cases it is clear that surgery is likely to be the best option. It sounds like you are not following your surgeons instructions! 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. The supraspinatus is the tendon that tends to suffer from partial tears most commonly. If muscles of the rotator cuff are not providing adequate stability throughout the shoulder's range of motion, this can contribute to shoulder impingement and a break down of the supraspinatus tendon. Even though most tears cannot heal on their own, you can often achieve good function without surgery. I wear an arm sling a lot to relieve weight from my shoulder, which helps to some degree. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. Make sure you understand their explanation of what problems are occurring around you shoulder and what treatment options are available to you. If in doubt call your surgeons office. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. 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). Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. @anonymous: mike but not dr. mike. dr mike,a i got an mri shoulder pain, the surgen said it was adhesive capsulitis and with about 6 weeks of pt it would be fine, but the mri report also said there was a tear, the doctor said the report was wrong, needless to say i got a second opinion, the next doctor ordered a new mri and he suggest surgery , i am at a loss, should i get a 3rd opinion just to be sure? These tears can be painful. There is some really good information in what you have said. This is partly because rehabilitation following surgery will depend on the surgical technique used. I have lost about 45+% of my ROM in my right arm. @anonymous: Hi Les, I am glad you found this information helpful. These include . MORE VIDEOS Find Your Condition Ankle Pain Arthritis Back Pain If you get a chance drop by again and let us know how you went. I was told that there were a few other muscles around the supraspinatus that were torn and I also had some bone spurs that could also be causing some irritation. Supraspinatus tear can be caused by lifting something too heavy, falling on your arm, or dislocating your shoulder. If you do opt for surgery. But shoulder exercises from now until I die. The goal of acromioplasty is to increase the size of the subacromial space. 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. However, some people will never experience the same level of recovery without the surgery. This website also contains material copyrighted by third parties. I had rotator cuff surgery in May for a Small(2mm) tear In the supraspinatus tendon. Early diagnosis and treatment of a rotator cuff tear may prevent symptoms such as loss of strength and loss of motion from setting in. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. Should this shoulder have an MRI? Children are such a blessing and that time nursing your newborn is such a special and important time. 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? When a tear occurs, there is frequently atrophy of the muscles around the arm and loss of motion of the shoulder. In terms of some general information that may be of interest to you, there are a couple of things I can share from my perspective. The retracted margin of the tendon is at the level of the lateral and anterior margin of the anterior acromion. It is possible this tear may communicate with the bursal surface anteriorly. so, my question is if i make physical strengt evercises to improve rotory cuff at this level-now,isn't it bad to heal the particular supraspinat muscle. I'm 43 and have been suffering from shoulder issues for over a year. tendon transfer. There is fluid distending the long head of the biceps tendon sheath, representing tenosynovitis. I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. 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. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Good luck! With a focus on the surgical treatment of reparable full-thickness rotator cuff tears, this article aims to provide an overview of the current knowledge on the treatment of rotator cuff disorders and to highlight which new aspects are relevant. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). Remember that you are not aiming for speed; slow, steady, and controlled movement is best. The pain is manageable if you stay on top of it with pain medication. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. Had mild discomfort in shoulder for a few weeks in August. Overall my subscapularis does appear intact." 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. However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. The blue arrows represent a full-thickness tear in the supraspinatus tendon, which is the most common site for rotator cuff tears. 5. and video above) full thickness tears occur when portions of the rotator cuff tendon Again, I'm sorry I can't provide specific advice, but I hope this general information is useful to you. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. There are other things your physical therapist may be able to help you with to give you some relief in the short term. 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. 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. 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. Thanks for stopping by. What I really want right now is to regain enough to get through normal everyday activities and not feel limited trying to lift an object and also not drop things so frequently. Drugs, supplements, and natural remedies may have dangerous side effects. Surface anteriorly arm sling a lot to relieve weight from my shoulder, which helps to some degree you not... 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