Went down a water slide on a mat head first arms supporting my body. The results are: full thickness cuff tear 2.3 cm AP involving supra spinets and a portion of infra spinets at distal critical zone and enthesis. @anonymous: Hi Hans, Thanks for stopping by and sharing your story. 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. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. 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. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. Good luck! 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. Pain can also be brought on by laying on the side. Surgical repairs can be compromised when post-operative instructions are not followed, so if you have surgery make sure you know exactly what you should and should not do! Productive acromioclavicular joint changes are associated with an anterolaterally down sloping type II acromial configuration. Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). In your opinion, do I have any other option other than surgery? You have asked for information about potential options. Any thoughts? 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). sorry for the double posting, first time user. 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). When you speak to your doctor and discuss your plan for treatment, make sure you discuss any relevant work / sport related activities so you both know what to expect. 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. (MRI), demonstrating a full-thickness supraspinatus tear. This may include things like having a lesser ability to detect hot versus cold on their skin in the neck region, they may also genuinely feel pain to what would usually be non-painful stimulus. @anonymous: Hi Mike, Good luck with your appointment next week, hopefully you will be able to find some relief one way or another after you consult your surgeon. Full thickness tears may involve only part of one tendon (usually the supraspinatus). (See Fig. My arm was nearly frozen for a period of about 10 minutes, but I slowly started regaining some ROM. ,Been dealing with shoulder pain for about nine months now and thought I'd share my experience with you and other readers. 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. Surgical repair can often be . The blue arrows represent a full-thickness tear in the supraspinatus tendon, which is the most common site for rotator cuff tears. It is not possible for me to give you any specific advice over the internet etc., but here are some general thoughts. 8% (102/1251) bested on all of the above. There's a hole or rip in the tendon. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. They will be able to give you information about the likelihood of a conservative approach being helpful in your specific case. there is a small full thickness insertional tear identified relating to the posterior supraspinatus. Any suggestions? The pain is manageable if you stay on top of it with pain medication. These tears can be painful. I left out a bunch of other things that are normal. So my tear went from a near full thickness tear to a full thickness tear. I have experienced some soreness and very limited ROM of my affected L shoulder/arm. 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. The reverse shoulder surgery is extremely involved so I am getting a second opinion. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. 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. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. I am really hoping to find some outside advice. If you are not keen to rush into surgery don't be afraid to ask your orthopedic specialist about conservative treatment options that may be worth trialing, on the other hand, your surgeon may be able to give you a good indication of whether they think surgery is the most promising option. From the information you have provided it is difficult to say whether surgery will be needed. Just found out I have a partial tickness undersurface tear of the supraspinatus tendon. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. 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. Seek immediate help if you are experiencing a medical emergency. Conclusion: Nonoperative treatment is an effective and lasting option for many patients with a chronic, full-thickness rotator cuff tear. I think this is a common dilemma that people face. No visible labral tear. I am sorry I can't provide you specific advice over the internet. is PT a good options. Any advice would be greatly appreciated. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. @Reallmadhatter: Good question. i'm a long distance runner and in good fitness and the shoulder problem does not bother me during running. The goal of acromioplasty is to increase the size of the subacromial space. What does all that mean in simple layman terms? Pain is moderate. ( x-ray, phys ther,corticosteroid inj. Supraspinatus tendon tear symptoms commonly go on for months (or even years) until the underlying problem is resolved (usually through improving the functioning of the rotator cuff, surgery, or both). Surgical repair can often be . Questions: 1. Rehabilitation plays a critical role in both the nonsurgical and surgical treatment of a rotator cuff tear. 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. 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. Judging by the description of atrophy in your rotator cuff muscles, I am guessing it has already been some time since the incident occurred. This sounds like a difficult situation. Those words exactly. If I need surgery,what is the recovry time.. Had periods of pain go from the back of my shoulder down my arm like before. Risk of infection and nerve damage are worthy of consideration for any surgery, particularly one as involved as a reverse shoulder replacement. Mike!! 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. Good luck! 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. So in summary Tim, I would say I feel for you buddy. and seemed to be doing ok with Cortisone shots. only taking out for prescribed exercises (e.g. Medicine and physiotherapy often help in reducing pain but the effect is temporary. I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. The tear may be a partial or full thickness tear. There may also be insurance implications etc. Thanks for stopping by and leaving a comment. while that helped in the short term and improved my left arm motion range, after i stopped the therapy the pain came back and reduced the range. Good luck! I have a second opinion on Monday. In some cases, surgery to repair the tendon is also required. labra are not evaluated 4. pain management and physical therapy) may be the first choice to see if surgery can be avoided. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. Best to have a chat with your doctor. massive cuff tears. Advice welcomed. On the other hand, it is possible that soft tissue structures (ligaments, tendons etc.) The rotator cuff exercises should not cause pain while the exercise is being performed. For anyone contemplating surgery, buy a recliner to sleep in after surgery. Not all the time, but it was intermittent. As another rule of thumb, if you are getting mixed opinions from non-specialist doctors, it is often a good idea to refer you to a specialist (who will have most likely have seen your condition ever other day and have plenty of experience treating it). @DrMikeM: Dr Mike - as you rightly say I must wait to learn the actual facts of my case - and I have an appointment soon so I will learn then I hope. The technicians wont say more and nor will my doctor. If they suggest surgery, ask them about what you can expect after surgery and the likely recovery time (including how long it is likely to be before you can use your arm for normal occupational or day to day activities). Thoughts on surgery? Strengthening the rotator cuff is not really like going to the gym and lifting heavy weights. How do you repair a rotator cuff tear? It sounds like you have several concerning symptoms there. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. I got a recent MRI which showed a full width/ thickness supraspinatus tendon tear. 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. ), a shoulder x-ray may not reveal anything conclusive. As far as general information goes, it is also worthwhile noting that chronic pain and inflammation at a joint can lead to secondary changes (weakening muscles, changes in the way the body processes pain etc.) I have lost about 45+% of my ROM in my right arm. This study was done in order to identify stages of rotator cuff tears that signal the need for surgery. Some quite compelling research has indicated that a substantial proportion of people (particularly young people) who receive this kind of treatment will go on to have further shoulder problems (sometimes instability in the shoulder joint or pain and discomfort from damaged structures). If the nearly complete tear were to become a complete tear, this would require surgery (ideally quite quickly) to re-attach the tendon otherwise the functioning of the supraspinatus muscle (it elevates the upper arm) would be lost. A-C joint is moderately to severely degenerative. 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). It is possible this tear may communicate with the bursal surface anteriorly. If you get a chance, drop by and let us know how you go with your recovery! I just received my MRI report which states : supraspinatus tendon is thickened and immediate in signal, with a small 3mm (transverse) x 3mm (AP) full thickness footplate tear. @anonymous: Thanks for sharing you story Marcia. I don't know what exactly to do, or what my REALISTIC problem could be. Superior subluxation of the humeral head. Thanks for stopping by and sharing. This is just general information of course. 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). Unfortunately, I suspect that a whole bunch of people will read your account and hear bits and pieces that remind them of their own circumstance. )amount of fluid in acromioclavicular joint and last but not least 5.) I had surgery last Thursday for a complete tear of the supraspinatus tendon due to a car accident and was told the tendon was repaired with titanium staples.My concern is of the staples coming out ,I wear a sling whenever outside but have been taking it off when sleeping in my recliner which I've found the best since the accident.If I am just walking around the house I've let it hang down and do not feel pain at the shoulder so figure there is no risk of them pulling out by doing this,am I correct? Information on this topic is also available as an OrthoInfo Basics PDF Handout. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. @brando87: Thanks brando87, that's what I aim for! I sleep fine as it does not hurt to lay on my back. Surgical repairs of complete tendon tears from a traumatic event, like a car accident, can easily fail when surgeons instructions aren't followed. I am 55 and active, so I don't want to hurt my "golden" years, so I am not sure what to think. Thanks! It is worth noting that dislocating a shoulder generally causes soft tissue trauma, like tears in the glenoid labrum (the bit that acts like a big suction cup keeping the ball part of the arm in the shoulder socket), as well as other structures. 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. A recent study from Kim et al 19 used en masse suture bridge techniques for full-thickness supraspinatus tears. He kind of scared me regarding the recovery for this. This surgery is no joke!! Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. Dr. Mike. No black and white answer for this one I'm afraid. 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). Thanks again Dr. The rotator cuff is a group of four muscles that come together as tendons to form a "cuff," or cover, over the head of the humerus (upper arm bone). HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. 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). There also is mild tendinosis of the infraspinatus at the footprint. 1 Supraspinatus Rupture causes microscopic tear, major tear and dislocation from its attachment to humerus and scapula. It plays a critical role in movements involving the shoulder joint, particularly arm elevation. Now, my Ortho doc #2 who recommended i do the MRI also reccomends a surgery to fix the tear. Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant. A rotator cuff tear can extend or get larger over time. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. and still end up with an unexpected problem. but can get back fairly good motion about the shoulder . Taking on certain pain, loss of motion and lengthy recovery scares me given my mostly normal function. Make sure you understand their explanation of what problems are occurring around you shoulder and what treatment options are available to you. 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. I was instructed to ice pack my shoulder and take it easy. For most people, it is usually preferable to lean on a bench or table rather than the seat of a chair. I will surf again! Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. 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. I have also been doing the pendulum exercise as prescribed and figured walking with the sling off would be no more risky to the staples. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. In 9 of the 24 the tear was smaller. It may be present with overhead activities such as lifting or reaching (e.g., serving in tennis, painting a ceiling). Even though surgery repairs the defect in the tendon, the muscles around the arm remain weak, and a strong effort at rehabilitation is necessary for the procedure to succeed. Good luck! Another subtle point of interest is that the first surgeon was not saying that the MRI was wrong (pictures generally don't lie, although sometimes image quality is poor), but that he disagrees with the report prepared by the radiologist. @anonymous: Oh Tonia, I feel for you. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. My best wishes go to all of them. Hi there. I am 72, I just got the mri with same partial tear. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. The majority of these tears occur amongst people over the age of 40. Good luck! There is a small band of hyperintensity on the footprint attachment of the anterior aspect of supraspintus in keeping with tendinopathy -small unretracted intra-substance tear. 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. 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. The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). Children are such a blessing and that time nursing your newborn is such a special and important time. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". I have a referral to a specialist and hopefully I will have some answers soon. With a focus on the surgical treatment of reparable full-thickness rotator cuff tears, this article aims to provide an overview of the current knowledge on the treatment of rotator cuff disorders and to highlight which new aspects are relevant. I am unable to carry any significant weight. 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. 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). Also, don't be afraid to ask doctors / surgeons lots of questions. 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). Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. So while surgery always carries some risks (which your surgeon will be able to explain), for some people this is the only option to experience a good outcome. I was released from the P.T. It's been very frustrating dealing with the chronic pain and reduction of normal activities in an attempt to adapt to my "new normal". She presented initially with active shoulder flexion range of motion (ROM) 0-80 . shoulder or arm weakness. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. I had an arthogram-MRI which showed a 4 mm near full thickness u-shaped tear involving the supraspinatus tendon anteriorly near but not actually at the numeral attachment. From my experience, orthopedic surgeons are not usually eager to perform surgery for something like this unless they think there is a good chance of a favorable outcome. The incident happened on Sept 25 and it is now Nov 10. Heuberer et al 15 used the knotless cinch-bridge technique for supraspinatus tears. I am close to retirement and I am afraid I will not be able to do the things I once enjoyed, outdoor activities. No. In these cases often a multidisciplinary treatment team skilled in treating whiplash can be very useful (this may include health professionals like physiotherapists, psychologists, occupational therapists and doctors). Instantly a wave of incredible pain came over my entire arm, generating from the back of my shoulder all the way down to my hand. There are some biomechanical and physiological attributes associated with the types of tendon injuries you have described that make them difficult to successfully repair. Good luck! My question to you is why can they not try and repair the rotator cuff using a graft of somesort. I'm not really sure how the whole army doctor situation works while you are on deployment, but I think if you have ongoing symptoms then it is worth making sure the appropriate people know. The rotator cuff tendons cover the head of the humerus (upper arm bone), helping you to raise and rotate your arm. 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. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. @ anonymous: Hi Hans, Thanks for stopping by and sharing your story tried to figure what! Full-Thickness rotator cuff supraspinatus tendon, which is the most common site for rotator cuff tears that signal need. Demonstrating a full-thickness supraspinatus tear and landed on my shoulder and take it easy a partial tear! To have problems with my arm and initially was told that i a. 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Like you have Been diagnosed with a partial tear time, but i some...
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