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). The tear of the subscapularis muscle is less common then the tear of the other rotator cuff muscles, such as the supraspinatus, infraspinatus or suprascapularis. Thanks for stopping by and sharing your story. There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. My question to you is why can they not try to repair the rotator cuff using a graft of somesort. The type of repair performed is based on the findings at surgery. . I served in the Navy for many years, and in April of 2010 I had a little mishap. 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. I'll go check out some of your Lenses. Bursal side: tears on the top of the tendon. This kind of tear does not heal on its own. Sorry for the delay in response. I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. Some general information that may be useful to know is that some people who have similar pathology to that which you have described end up having surgery while other do not. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. I will congratulate you on actually doing your exercises! In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. Thanks for stopping by and leaving a comment. thank you for your considiration and helle from Turkey:-). A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). Good luck! If you have concerns, you could ask the surgeon when you next see him whether he thinks your symptoms are from the tendon tear and rotator cuff dysfunction or whiplash? Early diagnosis and treatment of a rotator cuff tear may prevent symptoms such as loss of strength and loss of motion from setting in. The supraspinatus is one of four rotator cuff muscles in our shoulder. The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. Good luck! I hope some of the general information I provided in my response to Tim's (or others) comment is useful. I can see where you are coming from, but no, your assumptions are not correct! Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. How do you treat a supraspinatus tear? About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . If the injection does give you pain relief, it may allow you a couple of months without pain to do exercises that can strengthen your rotator cuff and improve the biomechanics at your shoulder in an effort to reduce irritation of the bursa and Supraspinatus tendon. Especially since my injury has gotten worse instead of better. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. I had periodic pain and tingling running all the way down my forearm. Any thoughts on treatment for this considering previous surgery? Full thickness tears of the rotator cuff are described as small, medium, large or massive (Figures 7, 8, 9 and 10). Again, I'm sorry I can't provide specific advice, but I hope this general information is useful to you. Subcortical reactive changes superiorly and laterally at the humeral head are present. I don't lay on the side of the hurt arm as I don't think it will be good for it. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. A full thickness tear is not usually a complete rupture. 2023 The Arena Media Brands, LLC and respective content providers on this website. Let us know how you go. Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. This may not give immediate relief, but hopefully will show some benefit within 6 weeks. If you do opt for surgery. Either way, I wish you all the best with it (and a safe deployment and return). Hopefully your doctor can give you specific advice in this regard. Because of the risk of infection and and nerve damage. The researchers used a custom-built shoulder testing system to measure the effects of varying loads placed on the muscles of the rotator cuff and parascapular muscles. Good luck with it. . P.S. However, I think the most important thing you mentioned was falling pregnant. There may also be insurance implications etc. In some cases, surgery to repair the tendon is also required. However, I can just mention some general information that may be of interest. 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. In full-thickness tears, surgery is indicated in many patients. Here is some general information which I hope is useful for you: 1. 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. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Advertisement. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. The results are: full thickness cuff tear 2.3 cm AP involving supra spinets and a portion of infra spinets at distal critical zone and enthesis. It allows a provider to assess the structures of your shoulder during movement. Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. Good luck! I think this is a common dilemma that people face. I also have no insurance and don't know about surgery. Good luck! As I think you already suspect, an MRI is likely to have greater diagnostic accuracy for ruling out (or in) the involvement of other structures in your shoulder, such as the long head of Biceps Brachi. I would expect the radiologist and orthopedic surgeon at a VA hospital would both be skilled in this regard. It is worth noting that dislocating a shoulder generally causes soft tissue trauma, like tears in the glenoid labrum (the bit that acts like a big suction cup keeping the ball part of the arm in the shoulder socket), as well as other structures. 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. 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. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. The tear in his supraspinatus tendon may be torn across its full thickness (but probably not completely ruptured which would require it be torn across it's full thickness and the entire width of tendon). The rotator cuff tendons attach to the head of the humerus in bony spots referred to as the greater and lesser tuberosities. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. and seemed to be doing ok with Cortisone shots. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. I know that since it has been years since seeing a dr about it that I should make an appointment, but what is your opinion of my situation? Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. It is also worth noting that whiplash associated disorders are complex. Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. Generally speaking, treatment options for shoulder injuries that include supraspinatus tendon tears and other findings similar to those you have reported could include surgery, or more conservative treatments like a trial of physical therapy or injections. The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. Thanks. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). 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. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. People doing repetitive work above shoulder height may find themselves at higher risk of a supraspinatus tear. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. Most of the time, it is accompanied by another rotator cuff muscle tear. If your primary physician has already made the diagnosis, an orthopaedic surgeon can review both surgical and nonsurgical options and start treatment. Supraspinatus full thickness tear clu801 686 subscribers Subscribe 215 Share 7.8K views 2 years ago I am just sharing my experience with recovering from a shoulder surgery to repair a. Seek immediate help if you are experiencing a medical emergency. Surgical repair can often be . On the other hand, physical therapy can often help supraspinatus tendon tears but sometimes they do need surgery in order for a suitable recovery to occur. Most people with ongoing pain will usually try the conservative interventions before considering surgery. After surgery, the repair must be protected from certain activities that may put healing at risk. When you speak to your doctor and discuss your plan for treatment, make sure you discuss any relevant work / sport related activities so you both know what to expect. A full thickness cuff tear (RTC) can be classified by size (small, medium, large and massive i.e. 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. If you are in doubt, don't be afraid to get a second opinion. Had periods of pain go from the back of my shoulder down my arm like before. If the nearly complete tear were to become a complete tear, this would require surgery (ideally quite quickly) to re-attach the tendon otherwise the functioning of the supraspinatus muscle (it elevates the upper arm) would be lost. 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). 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