In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. I understand most of it but I was wondering is there supposed to be fluid in the acromioclavicular joint. 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). It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) Studies have reported that, compared to older individuals, younger patients under 55 years have a higher ratio of smaller tears likely to occur from traumatic events.5,6 Patients over 60 have been found to be twice as likely to experience large rotator cuff tears and three times more likely to experience massive rotator cuff tears compared with younger patients.7,8 The prevalence of full-thickness rotator cuff tears may occur in up to 22% of all patients over 65.9 Approximately 25% of patients in their 60 s and 45% of patients in their 70 s suffer from rotator cuff tears.10 Patients 80 years and over have an even higher occurrence rate of 80%.8, Rotator cuff tear management aims to relieve pain, restore movement and improve function of the shoulder. It's a supraspinatus tendon tear with 50% thickness and no labral tear. Good luck with your decision! 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). My arm is very weak. )amount of fluid in acromioclavicular joint and last but not least 5.) Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. Your surgeon will be able to explain the potential risks and benefits (as well as if he thinks any alternatives are likely to be helpful). List of pain and limited mobility for about a week. 2. mild labral degeneration. People who have partial thickness supraspinatus tendon tears following a fall or mechanical trauma often report similar symptoms to people with whiplash associated disorders (aka whiplash). 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. Infraspinatus tendon is somewhat hetrogeneous in its deep attachment with what appears to be intra-substance tears down to enthesopathic change at footprint. It may be as small as a pinpoint, or the tear may involve the entire tendon. Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). Supraspinatus tendon tears are the most common tendon tear in the shoulder region. It is certainly worth discussing a more conservative approach, such as seeing a physical therapist that specializes in shoulders, with your orthopedic surgeon; particularly if you feel you have noticed improvements previously. Your orthopedic specialist will be able to give you advice about the best option for your circumstances. That is one of the reasons why surgeons will take a detailed history and conduct a physical examination to gather clinically relevant information. feeling pain in hand,,,. Painters, carpenters, and others who do overhead work also have a greater chance for tears. But not result in a normal shoulder. I will congratulate you on actually doing your exercises! I have been saving up a couple months to cover my deductible expecting to schedule surgery. 2023 The Arena Media Brands, LLC and respective content providers on this website. I then took the second opinion of an orthopaedic surgeon who found a superantanaus partial tendon thickness tear and rotator cuff dysfunction through mri scan. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). and retracted 2 cm. 3. your express consent. These four muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) stabilize the glenohumeral joint, enable rotation around the joint, and provide a counterforce to . Learn about different types of rib injuries and how they are treated. I was an elite athlete most of my life and have accepted that I will no longer be able to return to my sport 100%. I am 55 yrs. 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. I found the information good. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. Consult with your orthopaedic surgeon to determine the best solution for your case, your supraspinatus tears, any other associated injuries, and your lifestyle. Any type of tear should be regularly monitored by your orthopaedic surgeon in case of further progression or damage. Exercise rehabilitation in the non-operative management of rotator cuff tears: a review of the literature. Don't even think you won't need help, because you'll need help with even the most basic daily tasks. It sounds like you are not following your surgeons instructions! Some minor tears may be treated without surgery. Your shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). For more information: Rotator Cuff Injuries - Clinical Practice Guideline (CPG) | American Academy of Orthopaedic Surgeons (aaos.org). 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). For awhile I was able to get my arm somewhat back to normal but wilh slight aching. Thank you for the info posted on this page. 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). Massage may give you some short term relief, but I'm not sure massage on its own will have long term benefit that is additional to natural healing. These findings may guide clinicians to optimise loads, velocities and shoulder ranges . They will check for other problems with your shoulder joint. Small tear involving the supraspinatus tendon only Fig. I went to one orthopedic doctor and he immediately said surgery is my only option. Good luck! MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. Getting a second opinion when you are not sure about your first is also often a good idea. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. Another study found similar findings and reported that rotator cuff tear repair was much more successful in younger patients compared with an older cohort.23 Therefore, based on the evidence, treatment options that may be effective for younger patients may not necessarily provide the same results for elderly patients. I appreciate your thoughts on this matter. However, your doctor may also suggest surgery if you are very active and/or use your arms for overhead work or sports. A full thickness tear is not usually a complete rupture. This can occur due to trauma or repeated micro-trauma and present as a partial or full-thickness tear. 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. Dr. Mike. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. 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? There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. 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. 5. If the tendon has been completely ruptured (no longer attached), then surgery will definitely be required with some level of urgency for the tendon to be successfully reattached. Abrisham SM, Kermani-Alghoraishi M, Ghahramani R, Jabbari L, Jomeh H, Zare M. Additive effects of low-level laser therapy with exercise on subacromial syndrome: a randomised, double-blind, controlled trial. The medical staff there did an x-ray, which did not turn anything up, and once again, were not overly concerned with my condition, but just instructed me to continue to ice pack my shoulder and take some pain medication. 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. Rotator cuff integrity, measured by direct magnetic resonance arthrography or conventional MRI. Rotator Cuff Tears: Surgical Treatment Options, Rotator Cuff Tears: Frequently Asked Questions, Shoulder Impingement/Rotator Cuff Tendinitis. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). I'll go check out some of your lenses now. Sorry I can't give you specific advice over the internet, but it sounds like your shoulder specialist will be able to give you good personalized advice on Tues. Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. 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. 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. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. Is surgery my only option? That way you can make an informed decision in consultation with advice from your doctor. shoulder weakness. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). will consult surgeon next week. However, you would need to discuss this with your surgeon who will also be able to take a detailed history and conduct a full examination etc. 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. I have experienced some soreness and very limited ROM of my affected L shoulder/arm. Stocking up on prepared foods or meal prepping in advance and freezing things, as well as scheduling services like house cleaning and laundry is also helpful. After a formal assessment, they will be able to prescribe a course of rehabilitative exercises or recommend surgery. 10. I take anti-inflammatory meds for a long time for other problems, but it sure has not helped my arm. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. Glenohumeral joint effusion and finding may signify capsulosynovitis or perhaps capsular strain. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. The acriomioclavicular joint usually should have some fluid that helps lubricate the joint, but when it is specifically mentioned in an imaging report (like an MRI report), they are usually indicating that there are able to see more fluid then one might usually expect (in someone without any shoulder pathology). It turns out, this management approach is not terribly effective in leading to a prompt repair of the damaged structures. Treatment of rotator cuff tears in older individuals: a systematic review. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full Reallmadhatter Mar 14, 2013 @ 3:44 pm. Because of the return of the recent pain, another MRI was ordered and the Radiologist wrote: "1. Some general information you may find useful is that generally not a lot of people seem to have a full recovery following a SLAP lesion without surgery. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. P.S. Rotator Cuff Tears: Causes, Symptoms & Treatment - Cleveland Clinic Overall my subscapularis does appear intact." 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). I am 55 and active, so I don't want to hurt my "golden" years, so I am not sure what to think. 16. 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. You should not feel pain in the shoulder during the movement. Fig.1 Normal rotator cuff attachment around the humeral head Fig. Thanks for stopping by, you have raised some very good questions. I have had shoulder pain for years and years. Management of full thickness rotator cuff tears in the : JBI Anyone want to shed a little light for a vet? No visible labral tear. If a condition stays the same or become worse, then its usually a good idea to get it checked out again, or even a second opinion if you are not happy. Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. You mentioned rotator cuff and tendonosis like they were different things. 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. This may result in pain and weakness of the shoulder. What we often don't see is the subsequent shoulder surgery and months of rehabilitation (sometimes in the off-season) to repair the damaged structures. I started adding exercise back in to my life a couple of months ago and what had been intermittent pain has once again become fairly continual. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. )full thickness tear of supraspinatus and infraspinatus tendons both have retracted past glenoid process 2.) Dr. Raymond Wittstadt answered Hand Surgery 38 years experience Rotator Cuff Tear: If you are 31 and have a full thickness tear of your suprspinatous tendon, you have a problem. 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. It's also a new procedure to deal with this problem. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. It seems to be a long recovery period with a great deal of physical therapy following. Keyword Highlighting I had a fall at my workplace and was suffering neck and shoulder pain. The reverse shoulder surgery is extremely involved so I am getting a second opinion. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. So don't give up on your ambition to participate in exercise. Also an ex ray of my shoulder "Demonstrate my humeral head close to abutting my acromion. Now I have these results stated above. Many people have seen sporting heroes dislocate a shoulder during a heavy contact, have a medic "pop" it back in, then continue on 15 minutes later. But not result in a normal shoulder. A rotator cuff tear can result from an injury such as a fall or heavy lifting, or from normal wear-and-tear and repetitive activities over many years. 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?