Good luck! 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. I don't think there is a clear answer to this one. if your initial injury was work related. Thanks. On one hand, I want the second opinion to be formulated entirely based on my case information (not on what another surgeon did or did not recommend). Surgical repairs of complete tendon tears from a traumatic event, like a car accident, can easily fail when surgeons instructions aren't followed. The tear may be a partial or full thickness tear. 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? I'm only 38 and am not willing to give up everything I love doing and from what I read there are many more options available. Background: Good functional results have been reported for arthroscopic repair of rotator cuff tears, but the rate of tendon-to-bone healing is still unknown. The speed of recovery after surgery will depend on the type of surgery and following the surgeon's recommended protocol. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. I can reach behind my back ok. I am sorry I can't provide you specific advice over the internet. The close proximity of the supraspinatus tendon to the acromion-clavicular arch is a common contributing factor in supraspinatus tears, particularly when the tendon becomes impinged between these bone structures with activities that require arm elevation. 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. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. This may give you relief, even if you have been getting symptoms for a few years. damage to the tendon without swelling). A full thickness tear is not usually a complete rupture. and seemed to be doing ok with Cortisone shots. As a general principle, when soft tissues like tendons or ligaments are damaged (think sprain or strain), but are in very close proximity to one another (I don't consider 1cm retracted to be very close in this context), the structures can often heal and become as strong (or perhaps stronger) than they were before. Couldn't even lay down. You mention your shoulder makes a popping noise, generally speaking the sound a joint makes is not a good indicator of anything (particularly if the popping noise itself is not accompanied by pain). I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. 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. 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). Because of the return of the recent pain, another MRI was ordered and the Radiologist wrote: "1. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. will consult surgeon next week. Some can be altered with conservative rehabilitation exercises in order to prevent further tearing and ongoing pain, while others cannot be altered without surgery. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Cold therapy cold therapy cold therapy!! It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. Thanks for stopping by and sharing your story. Partial or full thickness tears that are not complete ruptures are generally far more common than complete ruptures (not common, but require surgery with some level of urgency). I have a feeling this is going to be a long recovery! I have always found the anatomy of the shoulder to be very interesting. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. This muscle is often used by people who practice different types of sports, including swimming, racquetball and throwing spears or weights. 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. 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). In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. What little I have done has given me improvement. An important thing to consider (as you have correctly mentioned) is that a reverse shoulder replacement is probably unlikely to restore normal shoulder function and resolve the pain if substantial soft tissue problems are still present in the tendons around the shoulder. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. but unfortunately, the results were extremely minor. P.S. However, it is worth noting a common misconception about full thickness tears. Thanks for stopping by and leaving a comment. What ever recommendation you received, you are looking up more information on line. If you have any uncertainty around the need for your sling use, please call your surgeon's office today. People tend to expect recovery after surgery will take a few weeks. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. 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. @pawpaw911: Hi Pawpaw911, thanks for dropping by. ; 3; Where can I found documentation in the web for the rehabilitation? Any advice would be greatly appreciated. I had periodic pain and tingling running all the way down my forearm. I am really hoping to find some outside advice. I'm sorry I can't give you specific advice over the internet, but hopefully you will find the following general information interesting. I am in aching pain consistently. The pain is manageable if you stay on top of it with pain medication. 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. 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. Thanks for posting your question. ), while others do not. There is compromise of the subacromial space with impression on the underlying torn supraspinatus. The four muscles supraspinatus, infraspinatus, subscapularis and teres minor originate from the scapula (shoulder blade). The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. my ROM did increase a very small amount, but my pain and discomfort never went away. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. I think these are promising approaches for the types of pathology you described. A rotator cuff tear may result from an acute injury, such as a fall, or may be caused by normal aging-related wear and tear with degeneration of the tendon. Good luck with it! I'm sorry I can't provide you with specific advice, rather I only provide some general information. 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). It was then I found out how messed up my shoulder actually is 1. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. He says that my tendon is failing. The Arena Media Brands, LLC and respective content providers to this website may receive compensation for some links to products and services on this website. Complete rehabilitation after surgery may take several months or even up to a year. I here is incidental note made that the teres minor muscle is prominently atrophic. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. So while the cost of surgery can be expensive, people who can't do their job one-handed may also need to consider potential loss of income as well or making alternative work arrangements. Partial thickness tears. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). If your surgeon does recommend surgery, be sure to ask about the likely recovery times and how long your arm movements will be restricted for. 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. Nonetheless, it worth noting that as a general principle, synovial fluid is very important and helps lubricate the joint. In my reports say that I have less fluid and possible tear. Decided to see ortho who ordered an MRi last week. 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. Surgical repair can often be . ROM hurts so I'm not sure. Good luck with it. On the other hand, if surgery is inevitable or at least the most likely outcome, then the treating doctor / surgeon(s) may recommend early surgery. The specific post-surgery rehabilitation is often differs between surgeons in different regions (depending on the specific techniques they use). Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. I've . Magnetic resonance imaging (MRI). 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. There is fluid distending the long head of the biceps tendon sheath, representing tenosynovitis. Not all the time, but it was intermittent. Good luck with it. Cause There are two main causes of rotator cuff tears: injury and wear (degeneration). The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? It can be difficult to find good information on the web for specific rehabilitation following surgery. 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. Sometimes in cases like this your surgeon may want to try an injection. Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. 2. Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. From the information you have provided it is difficult to say whether surgery will be needed. Starting with Physio treatment is a good idea. The technicians wont say more and nor will my doctor. Sorry for the delay, I have been away. Hopefully your doctor can give you specific advice in this regard. Partial tears can be just 1 millimeter deep (only about 10 percent of a tendon), or can be 50 percent or deeper. This is just general information of course. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. A few months passed, and I was called into the orthopedic surgen, who was a shoulder specialist, for a "pre surgery consultation". If tendon tears (including small tears) have not responded to conservative (non-surgical) treatments or recovered naturally after a few months, then surgery is often considered. Thanks for stopping by, you have raised some very good questions. There may also be insurance implications etc. 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. Heuberer et al 15 used the knotless cinch-bridge technique for supraspinatus tears. The right suprasinatus tendon contains a partial width full thickness tear measuring 4 by 2mm, in the anterior fibers approximately 8mm lateral to the biceps tendon. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. I just received my MRI report which states : supraspinatus tendon is thickened and immediate in signal, with a small 3mm (transverse) x 3mm (AP) full thickness footplate tear. 2. mild labral degeneration. It is also very interesting to note that for those people who have persistent whiplash symptoms there is often a change in the way their brain processes sensation from the neck and shoulder region. That being said, a surgeon's own experiences, skills and abilities (as well as risk tolerance) may factor into their decision as to whether a surgical repair (and the nature of the repair) is something they will advise. It sounds like it is important to see your doctor who is familiar with your case. Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? Any suggestions and generally how long is the recovery period? The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. Thankyou. 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