I can say though that PT's are trained to help people with painful ROM. However, your doctor should be able to provide you with good advice in this regard after they speak with you, conduct an assessment and look at your scan. But shoulder exercises from now until I die. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. Lol. old I was in good physical shape as a letter carrier(28 yrs) but have been mostly sedentary recovering from the first surgery. I've seen musicians and artists with poor shoulder function be able to perform their art as well as they did before their injury; sometimes through making some adaptations, but other times almost no adaptation was required (depending on their technique / instrument / art etc.). 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. @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. I was released from the P.T. Those words exactly. Yes, also a good idea about discussing with your surgeon the potential risks or benefits from delaying surgery in your case. A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. If a medical doctor (assuming they have nothing to personally gain by referring you to another health professional) suggests something may work based on their years of training, in depth understanding of anatomy, physiology, common pathology, research evidence and clinical experience with many patients, it is usually worth considering what a family or friend (albeit that they are usually well meaning) is basing their opinion on. Pain is really consistent and moderate with moments of severe. Good luck! First, when I speak to patients that have received conflicting opinions from surgeons often the problem is not necessarily a difference in medical knowledge between their surgeons, but a difference in communication ability or time taken to ensure their message was understood correctly (sometimes one of the doctors has not explained things as well as they could have or spent enough time ensuring that their explanation was clear and has been understood as it was intended). Information on this topic is also available as an OrthoInfo Basics PDF Handout. Some minor tears may be treated without surgery. pendulum), which should be undertaken ensuring correct technique). When supraspinatus tendon tear symptoms are chronic and severe, an orthopedic specialist will be able to provide good advice on likely recovery and treatment options, including the likelihood of successful recovery with or without surgery. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? When getting a second opinion from another surgeon. (Right) A full-thickness tear in the supraspinatus tendon. Similarly pain and dysfunction in the shoulder may cause you to use it less, which may in turn lead to weaker muscles and tendons (which may lead to more difficulty during and after a subsequent surgery). It's very good of you to reply so promptly and clearly though. Acromioclavicular joint degenerative changes, which means nothing to me. Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. Superior subluxation of the humeral head. 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. Good luck with it. 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. its been 5 months since my partialthickness tear of mysupraspinatus the the footplate..im 56 and also have degenerative change o the acromioclavicular joint impinging on the supraspinatus at the myotendinous junctionNarrowing of the acromiohumral distancetenosynovitis of the lpng head of the bicepswill I need surgery???? I would make sure your surgeon knows you are planning on falling pregnant within the next 12 months. A rotator cuff tear (RCT) is a common disorder associated with pain and dysfunction in the shoulder, the prevalence of which increases with age [].Full-thickness RCTs are present in approximately 25 % of individuals in their 60 s and 50 % of individuals in their 80 s; however, the reported incidence is lower for patients < 55 years of age (4-8 %) [1, 2]. 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. The major tear causes separation of muscle or tendon into two torn segment of muscles or tendons. (MRI), demonstrating a full-thickness supraspinatus tear. Popping noises can occur for a variety of reasons, the most common of which are completely normal. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. . Is surgery my only option? is PT a good options. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. However, host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. 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 have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. Dr. Mike. Thanks again Dr. Rotator Cuff Tears: Surgical Treatment Options. The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. Even pain from a full-thickness tear can be relieved without surgery through exercises that make other muscles strong enough to pick up the slack. It is also worth noting that whiplash associated disorders are complex. That being said, contemporary surgical repairs and surgical re-attachments have relatively high rates of success (albeit after a difficult post-surgical recovery period) when performed in a timely manner. There may also be insurance implications etc. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. Communication between health professionals (such as PTs and surgeons) may not be as good as it could be. I hope some of the general information I provided in my response to Tim's (or others) comment is useful. Any advice would be appreciated thanks. An exercise or physical therapy program is necessary to regain strength and improve function in the shoulder. I am aware than many clinicians who administer prolotherapy advocate for its benefits though. There are generally (at least) two main foci when considering whether to have surgery soon or to delay as long as possible. The MRI report says: 1. very large, nearly complete tear of the supraspinatus tendon from the tendon insertion with 1cm retraction of tendon fibers. I don't know what exactly to do, or what my REALISTIC problem could be. Overall, it will often take 6 months or more before the shoulder is completely back to normal. That is some interesting advice you have received. 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. Good luck! Degeneration of the infraspinatus tendon with bursa side fraying. Full thickness tears may involve only part of one tendon (usually the supraspinatus). Once the full thickness of the tendon is torn, we classify the tears based upon the shape and the number of tendons involved. I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). As you have correctly identified, there is quite a long recovery period following surgical repairs of rotator cuff injuries, but on the other hand, there is a pretty good success rate among people who follow the post-operative instructions. 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. As I think you already suspect, an MRI is likely to have greater diagnostic accuracy for ruling out (or in) the involvement of other structures in your shoulder, such as the long head of Biceps Brachi. When a rotator cuff is torn, the tendon part of the muscle tears away from the bone of the upper arm. Sleeping on my right side became impossible. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. A full-thickness tear, which usually means the tendon is torn from its insertion on the humerus (the most common injury), is repaired directly to bone. I understand most of it but I was wondering is there supposed to be fluid in the acromioclavicular joint. If you get a chance, drop by and let us know how you go with your recovery! Good luck! Shoulder arthroscopy and rotator cuff repair (supraspinatus repair) is the best treatment option with a 90 to 95 % success rate. @anonymous: Thanks for keeping us up to date. Getting a second opinion when you are not sure about your first is also often a good idea. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. Supraspinatus tear: If you want a chance for a full recovery surgeryis your best option. Equally as important is a discussion about the likelihood of certain outcomes without further surgery. Hope that helps! 2. It is not possible for me to give you any specific advice over the internet etc., but here are some general thoughts. I worked closely with a physiotherapist for a good four months and pain got worse. A full-thickness tear will decrease the capacity of a muscle to do work. I have noticed these types of shoulder pathology often occur among people who work (or have worked) in jobs that are physically demanding on the shoulders (or have a recreation / sporting background that may have contributed to shoulder girdle degeneration). The infraspinatus contains a subtle hypochoic region measuring 0.5cm within the tendon substance consistent concerning for an intrasubstance tear. A 90 to 95 % success rate most patients the supraspinatus: does tendon. 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