full thickness tear of the supraspinatus tendon surgery full thickness tear of the supraspinatus tendon surgery

That was July of 2011. Rotator cuff exercises are often prescribed for people with a partial tear of the supraspinatus tendon. The difficulty with overhead racket sports (like badminton, squash or tennis) is that high level functioning of the rotator cuff muscles are required to stabilise the shoulder joint in what is naturally unstable positions (overhead, and with high speed movement). 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). Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. There are many sub-types of SLAP tears and varying severity. This can be one of the most frustrating things for people who have whiplash associated disorders. Rotator cuff exercises will usually be important for anyone looking to return to a racket sport following a supraspinatus tendon tear or shoulder labrum tear (or even someone looking to prevent those injuries). 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. However, your doctor may also suggest surgery if you are very active and/or use your arms for overhead work or sports. In planning your treatment, your doctor will consider: There is no evidence of better results from surgery performed near the time of injury versus later on. They will be able to help you return to sport. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. Men over forty are the most likely to have degenerative supraspinatus tears. Dr. Mike. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). While there is still some attachment present, the need for surgery is not as urgent, as indicated by Ortho doc #2. I can reach behind my back ok. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). The most sensitive finding in full-thickness tears is thought to be the presence of fluid signal intensity in the location of the rotator cuff on fat-saturated T2-weighted or intermediate-weighted images 5. Being deployed and not receiving treatment makes it difficult. An Overview of a Supraspinatus Tendon Tear. I don't know what exactly to do, or what my REALISTIC problem could be. 2. 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. Surgical repairs of complete tendon tears from a traumatic event, like a car accident, can easily fail when surgeons instructions aren't followed. There are a few interesting things worth noting here. Is surgery my only option? Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. If you want any further clarification just post any follow up question. Rotator cuff integrity, measured by direct magnetic resonance arthrography or conventional MRI. 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). There is compromise of the subacromial space with impression on the underlying torn supraspinatus. Humeral head is riding high abutting the underside of the acromin process. may email you for journal alerts and information, but is committed Anyone want to shed a little light for a vet? That being said, I am scheduled for surgery on 6 Nov. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. I have had this problem with my shoulder/arm for about 6 months maybe. Moderate subacromial/sub deltoid bursitis. The individual shape of the bone structures (particularly the acromion) and soft tissues around the tendon will contribute to whether the tendon is able to move freely or become impinged between structures with arm elevation. A supraspinatus tendon tear can be full thickness (meaning that the entire muscle is affected) or partial thickness (or an incomplete tear). I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. 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. if your initial injury was work related. Tendinosis means that the tendon has some damage at the cellular level (generally where there has been repeated amounts of small damage (sometimes called microtrauma) that your body has tried to repair), but there is not swelling (inflammation) currently present. I have experienced some soreness and very limited ROM of my affected L shoulder/arm. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. Kim SH, Ha KI, Park JH, Kang JS, Oh SK, Oh I. Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years follow-up. Physiotherapy, including stretching and strengthening exercises, electrotherapy, ultrasound, moist heat and laser therapy. Gumina S, Carbone S, Campagna V, Candela V, Sacchetti FM, Giannicola G. The impact of aging on rotator cuff tear size. Rotator Cuff Tears in the. Acromioclavicular joint degenerative changes, which means nothing to me. So my tear went from a near full thickness tear to a full thickness tear. Then follow up by asking him about any risks associated with the surgery in your particular case (your surgeon should know your particular circumstances in detail and be able to provide you with specific advice about options available to you). It might be best to get an opinion from your orthopedic specialist sooner rather than later (if possible)! It may take a while to overcome your shoulder pain, and you may even need to modify the types of activities you do, but working hard to be able to return to exercise is definitely a worthwhile goal. Your doctor may also advise a trial of physical therapy to see if that can bring relief to his symptoms. I left out a bunch of other things that are normal. Full text studies that do not meet the inclusion criteria will be excluded and reasons for exclusion will be provided in an appendix in the final systematic review report. only taking out for prescribed exercises (e.g. Thanks for stopping by and sharing your story. This review will consider studies that have measured one or more of the following outcomes: This review will consider randomized controlled trials, pseudo-randomized controlled trials, quasi-experimental studies, case-control studies and cohort studies. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. I went to one orthopedic doctor and he immediately said surgery is my only option. I guess my question is does this always require surgery? So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. I'll go check out some of your Lenses. I hope some of the general information I provided in my response to Tim's (or others) comment is useful. I sleep fine as it does not hurt to lay on my back. The full text of selected studies will be retrieved and assessed in detail against the inclusion criteria. I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. Baumer TG, Chan D, Mende V, Dischler J, Zauel R, van Holsbeeck M, et al. You may have pain in the shoulder when you lift your arm, or pain that moves down your arm. Critical appraisal instruments are available from the Joanna Briggs Institute Reviewers Manual.26 All studies, regardless of their methodological quality, will undergo data extraction and synthesis. Rotator Cuff Tears: Surgical Treatment Options, Rotator Cuff Tears: Frequently Asked Questions, Shoulder Impingement/Rotator Cuff Tendinitis. 11. The size of the tear may increase over time. Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. Seek immediate help if you are experiencing a medical emergency. I guarantee you will not be the last person to read this page wondering about a difference in doctor opinion or trying to figure out whether they have a supraspinatus tendon tear or adhesive capsulitis (or surgery versus no surgery). While hauling a box of machine gun ammunition up a ladder (I was holding onto the ladder with one arm and the box of ammo in the other) my right shoulder randomly decided to give up on me. @anonymous: Thanks for sharing you story Marcia. (Right) A full-thickness tear in the supraspinatus tendon. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. Fehringer EV, Sun J, VanOeveren LS, Keller BK, Matsen FA 3rd. Surgery to repair those types of injuries would mean the arm would have to be not used (at all) for at least a couple of months (maybe quite a few months before back to being able to work normally). 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. Here are the best Nike shoes for heel pain when you have this uncomfortable condition. The Summary of Findings will present the following information where appropriate: absolute risks for treatment and control, estimates of relative risk, and a ranking of the quality of the evidence based on study limitations (risk of bias), indirectness, inconsistency, imprecision and publication bias. Does the fact that it mentions there is some retraction mean the tendon is completely torn or is it possible it is only partly torn. Any advice would be appreciated thanks. With a full-thickness tear, the muscle is no longer used, and it atrophies over time. Other signs that surgery may be a good option for you include: Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone). A full-thickness tear is when the wear in the tendon goes all the way through the tendon. The challenge lies in identifying patients with the greatest chance for a successful repair and optimizing timing such that the tear does not progress to a point of irreparability.8. 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). Sorry we are unable to give specific advice over the internet, but I hope this general information is helpful! @anonymous: Hi LB, Sorry for the delay, I have been away for visiting family for a week or so. There are two categories of supraspinatus tears, degenerative and acute. I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. Let us know how things turn out for you. Lazarides AL, Alentorn-Geli E, Choi JH, Stuart JJ, Lo IK, Garrigues GE, et al. I did PT around December for a month, twice a week. If your shoulder joint has pain and are seriously affecting your quality of life and your ability to work or perform basic everyday tasks without pain, then you need to speak with an orthopaedic surgeon about the next steps. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. Save my name, email, and website in this browser for the next time I comment. I. report .This happen 9 weeks ago , my shoulder is still sores I am going for phisio, messages and still no progess,does that mean I will need surgery,or will it heel by it self. This may give you relief, even if you have been getting symptoms for a few years. Wish me luck!!! However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. Injury to the rotator cuff is common and progression of injury typically begins in the supraspinatus tendon mostly as a result of an intrinsic attritional process that leads to partial and eventually full-thickness tearing. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Have been taking 800 mg Motrin tid. Rotator cuff tear management aims to relieve pain, restore movement and improve function of the shoulder. Rotator Cuff and Shoulder Conditioning Program, Rotator Cuff and Shoulder Rehabilitation Exercises. 2023 The Arena Media Brands, LLC and respective content providers on this website. Lol. Supraspinatus tendon tears require specific rehabilitation of the rotator cuff and muscles that stabilize the shoulder blade. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. At 55 years of age you still have a lot of living still to do, so don't be afraid to talk openly with your doctor about the success rates for all of the options available to you, and the likely recovery times involved. My pain is mostly in the bicep area and I do not have trouble lifting the arm but bringing it back down and also bringing the lower arm down when the upper arm is at 90 degrees. The postoperative recovery period following a surgical rotator cuff repair will take months and involve a specific program of range of motion and strengthening exercises that your surgeon will prescribe, often in conjunction with a physical therapist who will teach you exercises and monitor your progression. Thanks for stopping by and sharing your story. Appointments 216.444.2606 However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. So first off, I should say that I have certainly seen situations where a small supraspinatus tear has been surgically repaired, only for a worsening of symptoms to occur after further pathology (such as other rotator cuff tendon tears) either develop or become easier to detect on imaging (e.g. A disc protrusion, or herniated disc, often occurs in the lumbar spine and can be very painful. Your future self will thank you! is surgery the only option? So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. What does he mean by my tendon is failing? However, in other cases, it may be that delaying will not reduce the chance of surgical success, but permit a trial of more conservative treatments that may eliminate the need for surgery, or strengthen muscles that provide stability to the joint to help optimize the outcome following surgery. How do you repair a rotator cuff tear? Adelaide, South Australia; 2017 [cited 2017 Jul 16]. I appreciate your thoughts on this matter. The shoulder is a ball-and-socket joint: The ball, or head, of the upper arm bone fits into a shallow socket in the shoulder blade. The initial keywords include rotator cuff tear, full-thickness tear, elderly, conservative treatment and surgery: This review is to contribute to the completion of the Master of Clinical Science degree at The University of Adelaide, Adelaide, South Australia, for MN. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. 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). Thanks for stopping by, you have raised some very good questions. 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. It will be worth developing a good relationship with your doctor (and physical therapist) who can help you do the right things to recover as quickly as possible. Having pain and sub-optimal shoulder functioning while you are nursing would not be ideal. You may still be able to return to most or all of the things you enjoy it just may not be in the next 6 to 9 months though. Osti L, Buda M, Buono AD, Osti R, Massari L. Clinical evidence in the treatment of rotator cuff tears with hyaluronic acid. That way you can make an informed decision in consultation with advice from your doctor. Most tears are the result of a wearing down of the tendon that occurs slowly over time. Those words exactly. 10. Superior subluxation of the humeral head. From time to time tendons do rupture from a variety of causes, in your case it sounds like the surgeons description of rope fraying is a good one. The reverse shoulder surgery is extremely involved so I am getting a second opinion. There may be a snapping sensation and immediate weakness in your upper arm. The databases to be searched include: CINAHL, Scopus, MEDLINE (PubMed), Embase, Web of Science and PEDro. McMaster University, 2015 (developed by Evidence Prime, Inc.). Overall my subscapularis does appear intact." One of the most painful experiences ever. There are a few options for repairing rotator cuff tears. The objective of this review is to synthesize the best available evidence on the effectiveness of non-surgical and surgical treatment on the clinical and functional outcomes of elderly patients with full thickness rotator cuff tear. 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? The tendon will usually retract if a full rupture has occurred. He did say that it can be done in the next few months and no urgent intervention required. and retracted 2 cm. Results are as followsstudy demonstrates degenerative arthritis around the acromioclavicular joint. feeling pain in hand,,,. If you give PT a go, make sure you follow their instructions and specific techniques for the exercises they give you (most likely to strengthen your rotator cuff). I'm experiencing the exact same pain you described, and the Army doc told me I was too young to tear a rotator cuff. I found the information good. In many cases, torn tendons begin by fraying. Although the presence of a small tear visible on an MRI does not always mean that is the problem causing your shoulder pain. (Right)A full-thickness tear in the supraspinatus tendon. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. 6. Other tests which may help your doctor confirm your diagnosis include: If you have a rotator cuff tear and keep using it despite increasing pain, you may cause further damage. ), while others do not. The rotator cuff is a group of four muscles and their associated tendons that originate from locations on the scapula and insert onto the humeral head. !!! Your orthopedic specialist will be able to give you advice about the best option for your circumstances. Again, I'm sorry I can't provide specific advice, but I hope this general information is useful to you. Risk of infection and nerve damage are worthy of consideration for any surgery, particularly one as involved as a reverse shoulder replacement. The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). I mention this, as this will often influence treatment decisions. You may have shoulder pain and arm weakness. Good luck! perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). While I can't give you specific advice over the internet, it sounds like you are doing a great job following the recommednations of your doctors. Pain is really consistent and moderate with moments of severe. 14. Good luck! Management of Rotator Cuff Tears. A full-thickness tear will decrease the capacity of a muscle to do work. You may find it interesting to note that a prior subacriomial decompression is not necessarily an indication that future surgery to address other injuries or further biomechanical problems will not be successful. 3. 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? It is plausible to sustain one or the other (or both) from a fall. 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. Also not sure how long I should wait. Severe pain after. @anonymous: Oh Tonia, I feel for you. It is also worth knowing there are just some jobs that seem to take a heavy toll on shoulders / supraspinatus tendons (unfortunately I think painter / sheet rock installer / any occupation where you need to hold things up above shoulder or head height are right at the top of that list). Thank you. It's also a new procedure to deal with this problem. When I went in, he told me that after looking at my MRI, he did not think that anything was necessary, and instead wanted me to go back into physical therapy and continue to get steroid injection treatments. muscle atrophy of supraspinatus, infraspinatus, and subscapularis muscles, 3.) there is minimal AC arthrosis. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. The reverse shoulder surgery is extremely involved so I am getting a second opinion. 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). This may not give immediate relief, but hopefully will show some benefit within 6 weeks. The best treatment option for alleviation of pain and restored shoulder function in the elderly is still debated.8 Studies have shown satisfactory healing and promising clinical outcomes following surgical repair. Hey DrMikeM doin some research and came across your sight and thought I'd add my two cents. 12. This surgery is no joke!! Berth A, Neumann W, Awiszus F, Pap G. Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. Not too sure if this article is still active but I'll ask anyways. Had mild discomfort in shoulder for a few weeks in August. I am really concerned about success rates for revision surgery. The rotator cuff is what keeps the head of the humerus in place, and it is composed of the supraspinatus, infraspinatus, subscapularis, and teres minor tendons. Unless the shoulder is actually dislocated at the time of the x-ray, or there is a noticeable bone abnormality (chipped or broken bone, bone spur that is visible on x-ray etc. Thanks for sharing this detailed account with everyone. When one or more of the rotator cuff tendons is torn, the tendon becomes partially or completely detached from the head of the humerus. Your physician or orthopedic specialist should be able to give you specific advice about whether it is worth having an MRI in your specific case. RCTs in older patients are predominantly attributed to degenerative tears. 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. 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). Small area of subacromial bursitis present. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. 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. My question to you is why can they not try and repair the rotator cuff using a graft of somesort. Construction work and other high-risk physical jobs can also increase the likelihood of experiencing this type of injury. In some cases, surgery to repair the tendon is also required. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. 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. 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. Good luck! He says that my tendon is failing. 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). A rotator cuff tear is a common cause of shoulder pain and disability among adults. Some people will say that exercises didn't work for them, but it turns out actually doing the exercises (rather than just thinking about them) drastically increases the chance of them being effective! In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. All Rights Reserved. I have a second opinion on Monday. Remaining tendons of the rotator cuff are normal in signal and morphology. @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? I get asked about this a lot, perhaps I should write a page on rehabilitation following surgical repair of supraspinatus tendon tears! 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). Thorpe A, Hurworth M, O'Sullivan P, Mitchell T, Smith A. Nonsurgical treatment options may include: A cortisone injection may relieve painful symptoms. For anyone contemplating surgery, buy a recliner to sleep in after surgery. Over-the-counter medication, such as aspirin, ibuprofen, or naproxen, may relieve the pain. The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. It is possible this tear may communicate with the bursal surface anteriorly. Partial thickness tearing is where only a portion of the tendon is torn and part of the tendon is still attached to the humeral head. Article Google Scholar Ratte-Larouche M, Szekeres M, Sadi J, Faber KJ. They will check to see whether it is tender in any area or whether there is a deformity. Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. but can get back fairly good motion about the shoulder . If you have a degenerative tear in one shoulder, there is a greater likelihood of a rotator cuff tear in the opposite shoulder even if you have no pain in that shoulder.