Questions: 1. and seemed to be doing ok with Cortisone shots. The reverse shoulder surgery is extremely involved so I am getting a second opinion. In the supraspinatus tendon, increased expression of MMP-1, MMP-9, MMP-13, and vascular endothelial growth factor was found in the full-thickness group. I am glad that you noticed some relief after the surgery on your right shoulder and that the exercises for your left shoulder have already helped you get better quality sleep. Must also have to bring the arm back with my other arm if I am lying and have the arm overheadwhich now longer will lie flat on the floor if it is overhead.It has been recommende to do ART then PRP and possibly prolotherapy. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. pain that increases with shoulder use. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. old I was in good physical shape as a letter carrier(28 yrs) but have been mostly sedentary recovering from the first surgery. @anonymous: Oh Tonia, I feel for you. If they do cause pain, then it is important to check with the PT that the technique and level of resistance is appropriate for your condition. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. It can be difficult to find good information on the web for specific rehabilitation following surgery. A soft tissue hematoma occurs when a ruptured blood vessel leaks blood into the surrounding fatty tissue. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful. Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. Full thickness tearing is characterized by the complete removal of the tendon from the bone.2 This includes large tears (35 cm) and massive tears (>5 cm).3 In the geriatric population, rotator cuff tears are a prominent clinical problem and many patients report difficulty with routine tasks of daily living. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. Is It a Full-Thickness or a Partial-Thickness Tear of the Rotator Cuff? Tearing can be caused by atraumatic tears due to overuse and longstanding degeneration.4 Tear enlargement can occur due to increasing age.2 Patients who experience enlarging rotator cuff tears are five times more likely to develop symptoms than those with tears that remain the same.2 Older individuals have progressively become more active, increasing the chances of sustaining large and massive rotator cuff tears. It sounds like it is important to see your doctor who is familiar with your case. You mentioned rotator cuff and tendonosis like they were different things. Thanks for stopping by and leaving a comment! Based on the information you have provided above, I would say there are several structures that could potentially be causing this ongoing problem, of which a supraspinatus tendon tear is one (but is difficult to speculate without a physical examination / seeing the MRI etc. 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. Over-the-counter medication, such as aspirin, ibuprofen, or naproxen, may relieve the pain. From my perspective, I have seen many patients with supraspinatus tendinosis who have benefited a great deal from physical therapy (but nothing is certain, and some patients may not receive great benefit and require a different intervention). Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. I guess my question is does this always require surgery? I am not aware of any studies that have shown rotator cuff exercises impair healing in supraspinatus tendons that have a partial thickness tear. Most tears occur in the supraspinatus tendon, but other parts of the rotator cuff may also be involved. The plastic surgeon gave me 3 options, leave it be and it would only get worse as i age, cortisone shots which is just temp obviously or fix it.. should i get another mri to see if its healed some, i have got partial thickness insertional tear in supraspinatus 9mm*5mm. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Subgroup analyses will be conducted if appropriate based on participant age, type of non-surgical, and type of surgical treatment. Should this shoulder have an MRI? I'll go check out some of your lenses now. Studies published from 2010 up to present will be included, as the review conducted by Downie, B. et al. Players involved in sports requiring fast throwing actions (baseball) or overhead hitting (volleyball, tennis) may also sustain a traumatic injury to their rotator cuff and the supraspinatus tendon in particular. You may be trying to access this site from a secured browser on the server. If you research it it's a complicated operation that demands some of the best surgerical skills. ), a shoulder x-ray may not reveal anything conclusive. Starting with Physio treatment is a good idea. So a second opinion may not always yield the same advice (even though both surgeons may be giving appropriate advice based on their own circumstances and information). From the information you have provided it is difficult to say whether surgery will be needed. The supraspinatus muscle is a relatively small muscle, but very it's important one. That is some interesting advice you have received. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. The rotator cuff contributes to both stability and movement of the glenohumeral joint and is vital to the functioning of the upper limb.1 It consists of the supraspinatus, subscapularis, teres minor and infraspinatus muscles. At first, the pain may be mild and present only when lifting your arm over your head, such as reaching into a cupboard. @anonymous: Thanks for sharing you story Marcia. Advice welcomed. The lack of a normal amount of synovial fluid in the joint space could potentially be a sign of adhesive capsulitis (also known as frozen shoulder) among some people. Good luck with it! bone spurs and/or rotator cuff tears. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). Learn about different types of rib injuries and how they are treated. 10. Wish me luck!!! modify the keyword list to augment your search. As another rule of thumb, if you are getting mixed opinions from non-specialist doctors, it is often a good idea to refer you to a specialist (who will have most likely have seen your condition ever other day and have plenty of experience treating it). Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. labra are not evaluated 4. It is difficult for me to comment further based on this information. This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. An initial limited search of PubMed and CINAHL will be undertaken. If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. They will have you move your arm in several different directions to measure the range of motion of your shoulder. The longer these tears are left untreated, the more chance the tendon tear will enlarge and retract which results in more difficult surgery to repair this damage. 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. (Right) A full-thickness tear in the supraspinatus tendon. In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. Miller RM, Popchak A, Vyas D, Tashman S, Irrgang JJ, Musahl V, et al. Some simple tests during a physical examination should enable your doctor to determine whether your symptoms are likely to improved with a surgical repair of the tendon. The full text of selected studies will be retrieved and assessed in detail against the inclusion criteria. A torn rotator cuff may weaken your shoulder. Some days later, I was called back to the VA so they could tell me what they found. There are two categories of supraspinatus tears, degenerative and acute. is likely to be required if you want less shoulder pain. ; 2. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. Similarly, some benefit from conservative approaches (physical therapy / injections etc. If it has been a while since the MRI, this may involve getting another one (as tendinosis can weaken the tendon, which may in turn lead to larger tears or even a complete rupture), it may also involve a trial of PT or a referral directly to an orthopedic surgeon. Been thoroughly researching (scr surgery)Superior capsular reconstruction. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! However, it sounds as though you must be under the care of a medical team in order to have received MRI results, which is a good thing. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). FULL THICKNESS / COMPLETE SUPRASPINATUS TEAR TREATMENT - YouTube 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. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. My question to you is why can they not try to repair the rotator cuff using a graft of somesort. I served in the Navy for many years, and in April of 2010 I had a little mishap. The technicians wont say more and nor will my doctor. (Left)Overhead view of the four tendons that form the rotator cuff. Cai YZ, Zhang C, Lin XJ. Had mild discomfort in shoulder for a few weeks in August. Any thoughts on treatment for this considering previous surgery? Thanks for stopping by and sharing your story. !!! 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. A rotator cuff tear is a common cause of shoulder pain and disability among adults. Ongoing serious pain influencing daily life, sleep etc. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. So in summary Tim, I would say I feel for you buddy.
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