My story is a little lengthy, but I am desperate to find some insight for anyone that could help. It would be particularly unusual for a radiologist to see a tear that was non-existent (perhaps more likely to miss one that was hard to see than to see one that is not there). I have always found the anatomy of the shoulder to be very interesting. I found it very helpful as I am sure all your other subscribers found it to be too. Thanks for stopping by and sharing your story. X-rays are often not very useful in diagnosing shoulder injuries. Sorry we are unable to give specific advice over the internet, but I hope this general information is helpful! The rotator cuff muscles are critical to the stability and optimal biomechanical movement at the shoulder joint. Instead specific movements are required, these shouldn't cause pain while performing the exercise. Methods: Between 1995 and 1999, 139 full arthroscopic rotator cuff repairs were performed; 37 were repairs of full-thickness supraspinatus tears. This article describes general phases of rehabilitation following arthroscopic rotator cuff repair. Some minor tears may be treated without surgery. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears. Generally speaking, MRIs definitely help the surgeon to make a diagnosis and give them an idea of whether surgery will help. Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull. Your orthopedist may now be recommending a rotator cuff surgery or management with non-surgical methods. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. Good luck! Your orthopaedic surgeon can prescribe an appropriate program based on your needs and the findings at surgery. I've only got a couple of minutes, so I'll keep this short. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. twice, second time relief only lasted 5 minutes) finally local doc ordered M.R.I. However, other parts of the rotator cuff may also be involved in the injury. 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. If your tendon were to completely rupture while you were pregnant, this may be very problematic. 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). In this study, 24 patients who had full thickness supraspinatus tears and who opted to forego surgery were tracked over time. 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. A few hours after the incident, I was able to seek some medical attention from our on board medic, who believed I had dislocated my shoulder, but was not overly concerned with my condition. Re-attaching the tendon to the bone as you have described is a substantial surgery, the first months of recovery after this type of surgery are very important to ensure that the tendon does not detach / rupture and optimal recovery can occur. @anonymous: Thanks for keeping us up to date. Full-thickness tears of the supraspinatus and infraspinatus tendons at their attachment site with retraction of torn fibers up to the lateral aspects of the acromial process. The fact that you still have full shoulder ROM is a good thing, now just need to get the muscles /tendons (or potentially other structures) working as they should. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. It is also worth noting that some conditions, particularly when joints are unstable or there is ongoing aggrevation, have better outcomes by being seen and receiving intervention sooner rather than later. However, it is worth noting a common misconception about full thickness tears. Acromioclavicular joint degenerative changes, which means nothing to me. 3. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. There are several video examples to accompany the written explanation. If they do cause pain, then it is important to check with the PT that the technique and level of resistance is appropriate for your condition. I'm sorry I can't give you specific advice about your situation, if you are unsure of which advice from your two doctors is correct a third opinion may help you make sense of it. I did this as instructed, but, to little improvement. I had surgery in Mar 2012 for decompression,near full thickness bursa tear and a near full thickness supraspinatus tear with degeneration and general multi-directional laxity of the shoulder capsule.I know the work I have preformed and physical activities over the past 20yrs haven't helped but it was an acute injury that ended it.Since surgery I have been to a physiotherapist but after a few sessions I was experiencing a spot of pain (hot spot) which the physio dismissed as surgery related pain.To make a long story short, gym didn't go well to which I was told by my physio that I was overdoing it (I followed the program to the letter) anyway a second opinion found I have got a high grade partial tear and possible partial full thickness tear and bursa thickening and bunching on adduction. there is minimal AC arthrosis. I have lost about 45+% of my ROM in my right arm. A full-thickness tear is when the wear in the tendon goes all the way through the tendon. There may also be insurance implications etc. The tear may be a partial or full thickness tear. I'll go check out some of your Lenses. 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. Mild AC arthropathy. Purpose: The objective of this study is to report on the complete arthroscopic repair of full-thickness tears of the supraspinatus.Type of Study: Prospective cohort study. I wish you a speedy and full recovery. All material on this website is protected by copyright. I have pain all the time, it hurts to put a shirt on, can't lay on it, reaching out to my side it hurts to turn my pillow. 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. It plays a critical role in movements involving the shoulder joint, particularly arm elevation. I saw doctor initially who said physiotherapy will help it. It's a supraspinatus tendon tear with 50% thickness and no labral tear. There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. Some days later, I was called back to the VA so they could tell me what they found. It is good that you have discussed the recovery with your surgeon already. I am angry, confused and cannot get any pain relief. Infraspinatus tendon is somewhat hetrogeneous in its deep attachment with what appears to be intra-substance tears down to enthesopathic change at footprint. A tendon is similar to a rope and you can compare the suprasinatus tendon to an inch wide . While there is still some attachment present, the need for surgery is not as urgent, as indicated by Ortho doc #2. Any thoughts? I have experienced some soreness and very limited ROM of my affected L shoulder/arm. I plan on asking the surgeon these questions, but wanted your expert opinion. Questions: 1. I could write another article regarding shoulder surgery for rotator cuff tears (perhaps another day!). and seemed to be doing ok with Cortisone shots. There is no question that the word 'small' can be misleading regarding the amount of pain and discomfort that a supraspinatus tendon tear can cause. When Is Surgery Necessary . Make sure you understand their explanation of what problems are occurring around you shoulder and what treatment options are available to you. Unfortunately I can't give you specific advice over the internet. What I think is more common, is two doctors not taking the time to explain something in normal everyday language and ensuring their patients have understood whatever it is they are trying to say (so lots of people feel like they are being told different things)! 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). Dr Mike, Please help me understand what options I might have in my case of job relater incident. So my tear went from a near full thickness tear to a full thickness tear. 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. Keep in touch to let us know how you go. 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. Must also have to bring the arm back with my other arm if I am lying and have the arm overheadwhich now longer will lie flat on the floor if it is overhead.It has been recommende to do ART then PRP and possibly prolotherapy. Good luck! You mentioned rotator cuff and tendonosis like they were different things. Modify Sport Techniques . the defect measures approximately 1cm anterior to posterior and medial to lateral. Good luck! Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant. Pain is really consistent and moderate with moments of severe. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. 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). Many will report ongoing symptoms despite several months of medication and limited use of the arm. Went down a water slide on a mat head first arms supporting my body. 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). It also allows a quick comparison between the affected shoulder and the healthy shoulder. The Physician is online now Related Medical Questions 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. An orthopedic surgeon will be able to provide you with all the information you need regarding surgery, however, regarding exercises to return to badminton it might be wise to see a physical therapist (also known as physiotherapist) who specialises in sports injuries and rehabilitation. In the mean time, I received another steroid injection treatment. Hi there. Decided to see ortho who ordered an MRi last week. Some general information that may be useful to know is that some people who have similar pathology to that which you have described end up having surgery while other do not. 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. Pain can also be brought on by laying on the side. 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