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). 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. As defense lawyers are quick to point out, rotator cuff tendons, just like lots of our other joints and tendons, tend to degenerate as we age. @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. However it does bother me when i open the car door and my current range of left arm is restricted when i left up straight. Good luck! I do not want a metal shoulder. I left out a bunch of other things that are normal. 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 got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. Remaining tendons of the rotator cuff are normal in signal and morphology. Good luck! If you know you have a rotator cuff tear, worsening pain and decreasing strength may mean the tear is getting larger. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. 6 months ago a different ortho diagnosed the problem as frozen shoulder and gave me a cortizone shot followed by physio therapy for few weeks. Not all the time, but it was intermittent. Although I probably wouldn't be forthcoming with the name of the first surgeon or advice given unless the surgeon actually asked about this directly. Edema is seen involving an intracapsular segment of biceps tendon with possible interstitial tears. One of the most painful experiences ever. !!! He kind of scared me regarding the recovery for this. Of the 49 rim-rent tears, 24 (49.0%) involved the anterior-most fibers of the supraspinatus tendon, one of which extended to involve the infraspinatus tendon. over the years, but not really in recent year, as my shoulders got cranky. The rehabilitation after surgery is likely to take time. Pain can also be brought on by laying on the side. I am really concerned about success rates for revision surgery. bested on all of the above. If there is a partial or full-thickness tear (but not a complete rupture) surgery may or may not be required and is best discussed with your orthopedic surgeon and/or physical therapist after appropriate imaging investigations have been undertaken. MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. 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. 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. It sounds as though you know a little bit about your shoulder situation already, so I won't re-state details about the anatomy that is affected. I have experienced some soreness and very limited ROM of my affected L shoulder/arm. If you are in doubt, don't be afraid to get a second opinion. Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! Arthroscopy 1993;9(2): 195-200. 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. I'll go check out some of your lenses now. Medicine and physiotherapy often help in reducing pain but the effect is temporary. ), a shoulder x-ray may not reveal anything conclusive. 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. only taking out for prescribed exercises (e.g. 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). Thoughts on surgery? When I visit my DR. what are the thing I need to be aware for the diagnostic? I appreciate your thoughts on this matter. Advice welcomed. I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. Good luck! That is some interesting advice you have received. The tendon that seems to be most commonly affected is the supraspinatus, although it could also easily be either infraspinatus, long head of biceps, subscapularis or teres minor tendons. However, improving rotator cuff functioning is usually a good idea and your physio should be able to assess your current situation and provide you with a suitable tailored program of exercises as they see fit. 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. This likely represents extension of an existing tear. I still have periodic pain that will radiate from the back of my shoulder, down my tricep, and over my bicep. At the final follow-up, the VAS, Constant, ASES, and UCLA scores were 1.1 0.9, 84.3 16.4, 88.3 17.4, and 31.1 6.0, respectively. I am sorry I can't give you specific advice but here is some general information that may be useful to you. 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. A full-thickness tear will decrease the capacity of a muscle to do work. If you want any further clarification just post any follow up question. Acute Tear If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. 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. if your initial injury was work related. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction. Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. Grade 1 strain of the lateral deltoid muscle and teres minor muscle. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery. Above my shoulder or behind my back without pain. She did an MRI and said it was tendonosis, and suggested PT. Good luck! A rotator cuff tear can extend or get larger over time. 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. When getting a second opinion from another surgeon. I plan on asking the surgeon these questions, but wanted your expert opinion. Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant. My story is a little lengthy, but I am desperate to find some insight for anyone that could help. So my tear went from a near full thickness tear to a full thickness tear. Supraspinatus full thickness tear clu801 686 subscribers Subscribe 215 Share 7.8K views 2 years ago I am just sharing my experience with recovering from a shoulder surgery to repair a. and still end up with an unexpected problem. The rotator cuff is a group of tightly connected muscles that stabilize the shoulder joint. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. I have lost about 45+% of my ROM in my right arm. Let us know how you go! I plan on asking the surgeon these questions, but wanted your expert opinion. Large. I am really hoping to find some outside advice. So in summary Tim, I would say I feel for you buddy. In active individuals who use the arm for overhead work or sports. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. Due to the nature of what we were doing, I was unable to immediately seek medical attention, so after regaining some composure, I managed to carry on with my duty, but not without immense pain. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. In layman terms, I would say this means your supraspinatus tendon has probably been irritated for quite a while, and has a small tear near where it attaches to the bone (but tendon is currently still attached). The specific post-surgery rehabilitation is often differs between surgeons in different regions (depending on the specific techniques they use). 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). 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. Supraspinatus is the most commonly injured rotator cuff tendon. The type of repair performed is based on the findings at surgery. Also, don't be afraid to ask doctors / surgeons lots of questions. Had mild discomfort in shoulder for a few weeks in August. There are other things your physical therapist may be able to help you with to give you some relief in the short term. I have spoke with people that have had surgery on their shoulder and they say that is a very painful surgery, and they still have problems from time to time with their shoulder. Moderately large joint effusion. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). After surgery, the repair must be protected from certain activities that may put healing at risk. I was in a car accident about 18 months ago with damage to my left side of my body, stated with my fingers, to my leg and lastly my arm. Ongoing serious pain influencing daily life, sleep etc. The recovery after surgical tendon repairs often takes longer than recovering from broken bones. The researchers used a custom-built shoulder testing system to measure the effects of varying loads placed on the muscles of the rotator cuff and parascapular muscles. A partial tear may require only a trimming or smoothing procedure called a dbridement. 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. 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. After an initial diagnosis from an Orthopedic specialist, the initial course of action was a steroid injection treatment into the "affected area" and a course of physical therapy. I have a referral to a specialist and hopefully I will have some answers soon. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. Should you immobilize or not move a shoulder with a suspected partial rotator cuff tear? I am wondering if I can recover without a surgery option. Following the post-surgery protocol will help minimize the chance of a poor outcome and further problems. There is some spurring at the glenoid articular surface. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. These injections usually include an anti-inflammatory that can last for a couple months delivered directly to the problem area(s) and a local anesthetic that will work for the first few days until the anti-inflammatory starts to give relief. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. While it is estimated that 65-70% of all shoulder pain involves the rotator cuff tendon, it has been estimated that 5 to 40 % of people without shoulder pain have full-thickness tears of the rotator cuff. The incident happened on Sept 25 and it is now Nov 10. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. It is one of the most frequently damaged tendons. Supraspinatus tendon tears are the most common tendon tear in the shoulder region. He says the tendon is fraying like a ropethat he would need to reattach to the bone. In this study, 24 patients who had full thickness supraspinatus tears and who opted to forego surgery were tracked over time. Unfortunately I can't give you specific advice over the internet, without conducting a physical examination etc. The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. If, however, you are active or use your arm for overhead work or sports, surgery is most often recommended because many tears will not heal without surgery. Time progressed, pain continued and my ROM slowly worsened. I'm sorry I can't provide you with specific advice, rather I only provide some general information. Wish me luck!!! Pain is moderate. A full rupture will require surgery (usually quite urgently). It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). Depending on your age and lifestyle, physical therapy may be a better option than surgery even for complete rotator cuff tears. A couple of final remarks that may unfortunately muddy the waters for you: Adhesive capsulitis generally resolves without the need for surgery, and aggressive physical therapy may actually worsen the symptoms in some cases. It sounds like you may be putting yourself at unnecessary risk? It allows a provider to assess the structures of your shoulder during movement. I've only got a couple of minutes, so I'll keep this short. To happen if you do or do n't be afraid to ask lots questions!, physical therapy may be a better option than surgery even for complete rotator cuff muscles are to. 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