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. Dr. Burks explains what the injury is and when to . There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis. Let us know how things turn out for you. Muscular and tendinous structures including remaining portions of the rotator cuff are also felt to remain otherwise unremarkable in signal and morphology. It is important the the surgical repair of the tendon is protected initially to ensure that a re-injury does not occur. The orthopedic said that after 6 weeks of PT if there is pain then we looka possible surgery, is there something else that I should do or look at? Good luck! All rights reserved. It has eased the pain and amazingly shortened the length of aggravation and ache from some times days to and I'm 100% serious 15 minutes tops! If surgery is not indicated, your doctor should be able to refer you to a physical therapist who will likely assess your shoulder movement and be able to provide you with a tailored program to help strengthen your rotator cuff. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. There is synovial fluid at the glenohumeral articulation. I am 55 and active, so I don't want to hurt my "golden" years, so I am not sure what to think. Pitchers, swimmers, and tennis players are common examples. Sorry we are unable to give specific advice over the internet, but I hope this general information is helpful! . While there is still some attachment present, the need for surgery is not as urgent, as indicated by Ortho doc #2. Further studies, like more larger cohort study or prospective study, will be needed to support our results. I do not want a metal shoulder. This may not give immediate relief, but hopefully will show some benefit within 6 weeks. In the interim, physio, chiro, massage, taping were part of my pain management and ROM for all pain sites relating to MVA. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. Full thickness tears may involve only part of one tendon (usually the supraspinatus). Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). 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. Medium. This information is provided as an educational service and is not intended to serve as medical advice. 2. mild labral degeneration. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. 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. Humeral head is riding high abutting the underside of the acromin process. 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. 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. In addition to arm elevation, the supraspinatus muscle is critical in pulling the head of the humerus (the ball part of the ball and socket joint) into the glenoid (socket). Three techniques are used for rotator cuff repair: Traditional open repair Mini-open repair Arthroscopic repair Your orthopaedic surgeon can recommend which technique is best for you. @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. I found it very helpful as I am sure all your other subscribers found it to be too. 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. @DrMikeM: Thank you Dr. Mike for answering my question. My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. The use of steroid injection for treatment of a full-thickness rotator cuff tear is still controversial. and seemed to be doing ok with Cortisone shots. I do not want a metal shoulder. There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described. My doctor has told me I need to have arthroscopic revision rotator cuff repair. 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? Degeneration of the infraspinatus tendon with bursa side fraying. 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! My husband just had and MRI and it showed a Nonretracted small insertion full-thickness tear of the supraspinatus tendon. Most people who I have seen with whiplash (albeit usually from motor vehicle accidents more than falls) tend to notice a great deal of improvement over the first few weeks, but some have symptoms that persist. I was instructed to ice pack my shoulder and take it easy. What ever recommendation you received, you are looking up more information on line. I experienced a fall on August 31, 2012. I don't think there is a clear answer to this one. By June '13 I was better in many ways than before the injury. 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). substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. 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. It is located in the top portion of the back of the shoulder blade (the superior posterior portion above the spine of the scapula) known as the supraspinatus fossa. Small to moderate glenohumeral joint effusion. How is a supraspinatus tendon tear similar to a rope? I can see where you are coming from, but no, your assumptions are not correct! Let us know how you go! Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. program with a small packet of exercise instructions and told to continue them and to come back in a few months for an updated physical examination. If you have only seen your family physician or general practitioner so far it would be a good idea to ask them about a referral to an orthopedic specialist who primarily treats patients with shoulder conditions. Even though most tears cannot heal on their own, you can often achieve good function without surgery. Each of the rotator cuff muscles can be affected; the supraspinatus muscle is most commonly affected, followed by the infraspinatus, the subscapularis and the teres minor muscles. Complete tears: More commonly referred to as a full-thickness tear, this injury entirely separates the tendon from the bone. For most of my life I trained with bodybuilding-style workouts 4 or 5 days per week. 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). ( x-ray, phys ther,corticosteroid inj. I am in aching pain consistently. Went down a water slide on a mat head first arms supporting my body. Thanks for stopping by and leaving a comment. They usually present as a sharp pain at the outside or front of the shoulder, particularly with arm elevation (raising the arm to the side or front). When supraspinatus tendon tear symptoms are chronic and severe, an orthopedic specialist will be able to provide good advice on likely recovery and treatment options, including the likelihood of successful recovery with or without surgery. Edema is seen involving an intracapsular segment of biceps tendon with possible interstitial tears. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. Usually getting a second opinion is not a bad option if you are not confident that the first opinion is going to lead to the best outcome for you, but I expect that may well be impossible while you are still on deployment? I served in the Navy for many years, and in April of 2010 I had a little mishap. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. Overall, it will often take 6 months or more before the shoulder is completely back to normal. Thanks for stopping by and sharing. It may be present with overhead activities such as lifting or reaching (e.g., serving in tennis, painting a ceiling). I am disappointed not to have been referred to a surgeon, but I have to admit the exercises have already helped me sleep better. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. sorry for the double posting, first time user. If you do opt for surgery. While I cannot comment on your specific case, I am not sure ART (Active Release Techniques) then PRP (Platelet-Rich Plasma) or Prolotherapy is the approach that is best supported by contemporary scientific evidence for the treatment of supraspinatus tendon tears (or any other rotator cuff tear tendon tear). . I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. Patients ranged in age from twenty-nine to seventy-nine years. Whiplash is more difficult to detect with common imaging approaches, like an MRI, than supraspinatus tendon tears. Not too sure if this article is still active but I'll ask anyways. Good luck with it. Lots of people express feeling useless, frustrated, and angry at times. When Is Surgery Necessary . It sounds like you are not following your surgeons instructions! I'm sorry I can't provide you with specific advice, rather I only provide some general information. 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). It has been associated with older age and osteoarthritis, but often seems to occur when there is extra fluid in the gleno-humeral (ball and socket) joint. I'm still processing in my head what I heard in a VM left 10hrs ago, because I finally found out the findings from my shoulder MRI/Arthogram completed about 6 weeks ago. High abutting the underside of the infraspinatus tendon with possible interstitial tears are common examples commonly referred to as degenerative. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been.! Own, you are looking up more information on line of some sort help. 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