Thanks for stopping by and leaving a comment. On the other hand, there is nothing speedy about recovery after surgery but at least there usually is recovery (albeit slow). 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. If the injection does give you pain relief, it may allow you a couple of months without pain to do exercises that can strengthen your rotator cuff and improve the biomechanics at your shoulder in an effort to reduce irritation of the bursa and Supraspinatus tendon. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). @Reallmadhatter: Good question. Most people who do have surgery experience acute pain during the first few days (although the acute pain medications usually help with this). Overall function increased by 47.67% from pre-op to post-op3. 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! Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). Not too sure if this article is still active but I'll ask anyways. They may be perfectly justified in their opinion, but if their opinion is based on one or two other specific cases that they know of (or perhaps their own bad experience), it would be a shame to miss out on receiving some potential benefit because a well meaning friend or family is not as well informed on the topic as they may think. Does the fact that it mentions there is some retraction mean the tendon is completely torn or is it possible it is only partly torn. Miller RM, Popchak A, Vyas D, Tashman S, Irrgang JJ, Musahl V, et al. Several factors contribute to degenerative, or chronic, rotator cuff tears. Good luck! In about 80 to 85% of patients, nonsurgical treatment relieves pain and improves function in the shoulder. A Guide to Supraspinatus Tendon Tears (Rotator Cuff Injury) When the most effective non-surgical interventions (such as physical therapy) have not been able to provide sufficient relief of symptoms, then arthroscopic shoulder surgery is often considered. Arthroscopic repair of full-thickness tears of the supraspinatus: does Lots of people express feeling useless, frustrated, and angry at times. Good luck! The main action of the supraspinatus muscle is to abduct the shoulder joint (lift your arm out sideways and upwards). Subcortical reactive changes superiorly and laterally at the humeral head are present. 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. While it is true that rotator cuff tears are more common among middle aged and older people, they can indeed occur among younger people too; particularly when they are performing heavy work or have some kind of trauma event (contact sport, car accident, gym accident etc.). However, trauma (such as sporting injuries or motor vehicle accidents) can cause tears amongst people of any age. I have a referral to a specialist and hopefully I will have some answers soon. From the description of your MRI report it sounds like your shoulder must have been quite painful and inflamed at the time (perhaps it still is)! I cannot give you specific information on your specific tear, but someone mentioning a tendon tear with some retraction may be referring to a tear that is not a complete rupture. Once the full thickness of the tendon is torn, we classify the tears based upon the shape and the number of tendons involved. Good luck with it. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. There are other things your physical therapist may be able to help you with to give you some relief in the short term. I am disappointed not to have been referred to a surgeon, but I have to admit the exercises have already helped me sleep better. The likeliness of these issues increases with age and is more common in the dominant hand; in addition, if you experience a degenerative tear in one shoulder, youre at a greater risk for a tear in the other shoulder. )amount of fluid in acromioclavicular joint and last but not least 5.) It may be helpful to think of the rotator cuff as a group of muscles and each muscle is connected to the bone via a tendon. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. 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. Massive irreparable rotator cuff tear and associated deltoid tear. If you fall down on your outstretched arm or lift something too heavy with a jerking motion, you can tear your rotator cuff. I've started having a smoothie everyday of red vege's (beetroot) and fruit (all the berries) with a slice of ginger and the big one for inflammation turmeric! It is plausible to sustain one or the other (or both) from a fall. However, it is worth noting a common misconception about full thickness tears. Heterogeneity will be assessed statistically using the standard chi-squared and I-squared tests. Large rotator cuff tear with poor quality tissue Fig. Also not sure how long I should wait. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. @DrMikeM: wheather arthoscopy surgry ll help for my injury sir ?what type of surgery needed for dis type of injuries sir.ortho doc told Do exercise for 2 weeks aftr tat if it not improved ll do arthoscopic surgery sir Due to a fall and resulting shoulder pain my doctor prescribed to have an MRI, the findings were; moderate tendinitis in the supraspinatus. Think about all the times you lift your arms above shoulder height in a given day and try to rearrange your home accordingly. I'll go check out some of your Lenses. And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. X-rays are often not very useful in diagnosing shoulder injuries. Good luck! Some people need surgery to reattach a torn rotator cuff. @anonymous: Hi Hans, Thanks for stopping by and sharing your story. Small to moderate glenohumeral joint effusion. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. I was told that there were a few other muscles around the supraspinatus that were torn and I also had some bone spurs that could also be causing some irritation. So in other words, tendinosis is the condition and one of the rotator cuff tendons is probably the structure that was affected. Some days later, I was called back to the VA so they could tell me what they found. 2. Good luck! Cai YZ, Zhang C, Lin XJ. 22. All Rights Reserved. There is supraspinatus muscular atrophy. To be as specific as I can, It feels like someone shoved a knife right into the top of my shoulder blade and right down inside my shoulder. It will also get you back to your normal routine quicker. Rotator cuff integrity, measured by direct magnetic resonance arthrography or conventional MRI. Dry needling in a multimodal rehabilitation protocol following rotator This can be one of the most frustrating things for people who have whiplash associated disorders. She did an MRI and said it was tendonosis, and suggested PT. Arthroscopic shoulder surgery may be required, or even rotator cuff tear procedures may be advised depending on the extent of the injury or damage to your supraspinatus muscle and surrounding bones, tendons, and muscles. there is minimal AC arthrosis. An important thing to consider (as you have correctly mentioned) is that a reverse shoulder replacement is probably unlikely to restore normal shoulder function and resolve the pain if substantial soft tissue problems are still present in the tendons around the shoulder. 3. Popping noises can occur for a variety of reasons, the most common of which are completely normal. 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. 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. 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). 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). Time progressed, pain continued and my ROM slowly worsened. 5. What little I have done has given me improvement. I then went to see another orthopaedic surgeon who said I have whiplash. I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. I all of a sudden lost all my strength in my right arm and dropped the box. Lazarides AL, Alentorn-Geli E, Choi JH, Stuart JJ, Lo IK, Garrigues GE, et al. An analysis of the text words contained in the title and abstract, and of the index terms used to describe the articles will then be conducted. However, worse yet would be delaying in such a way that you miss out on falling pregnant or delivering a healthy baby. I am sorry I can't give you specific advice but here is some general information that may be useful to you. If the pain has been present for only a couple of months (or less) and there were minimal risk of worsening the condition with delay, then often a trial of conservative management (e.g. You are also right that many people often don't understand that you are not 'putting on an act'. my MRI result come out that supraspinant tendom has partial tear. The bursa allows the rotator cuff tendons to glide freely when you move your arm. Pain is really consistent and moderate with moments of severe. Please enable scripts and reload this page. The rotator cuff contributes to both stability and movement of the glenohumeral joint and is vital to the functioning of the upper limb.1 It consists of the supraspinatus, subscapularis, teres minor and infraspinatus muscles. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. Let us know how you go! There are at least three important factors that contribute to supraspinatus tendon tears. I am sorry, I can't give you specific advice over the internet about whether you will need surgery or not. Where required, authors of papers will be contacted to request for missing or additional data. 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. This website also contains material copyrighted by third parties. is PT a good options. Management of rotator cuff tears can broadly be divided into surgical and non-surgical treatment.8 Surgical treatments include arthroscopic repairs, open repairs, mini open repairs, tendon reconstruction and reverse shoulder arthroplasty.11-15 Non-surgical treatments consist of physiotherapy or injection. As I said been dealing with this for about nine months and in that time have run the gamut of treatment. (Right) A full-thickness tear in the supraspinatus tendon. ROM decreased. there is a small full thickness insertional tear identified relating to the posterior supraspinatus. Factors like smoking, hypercholesterolemia, weight and BMI, height, bone spurs, and other genetic factors increase the chances as well. JBI Database of Systematic Reviews and Implementation Reports, Get new journal Tables of Contents sent right to your email inbox, https://reviewersmanual.joannabriggs.org/, Management of full thickness rotator cuff tears in the elderly: a systematic review protocol, Articles in Google Scholar by Michael Nganga, Other articles in this journal by Michael Nganga, Privacy Policy (Updated December 15, 2022). Most tears are the result of a wearing down of the tendon that occurs slowly over time. Hopefully your doctor can give you specific advice in this regard. Thanks to my hubby for finding this site. The outcomes to be included will be range of motion, muscle strength, rotator cuff integrity, pain scores, shoulder function, patient satisfaction, and quality of life. 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. 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. 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. This review will include studies which examined the effectiveness of non-surgical and/or surgical treatment. I don't lay on the side of the hurt arm as I don't think it will be good for it. Infraspinatus tendon is somewhat hetrogeneous in its deep attachment with what appears to be intra-substance tears down to enthesopathic change at footprint. and still end up with an unexpected problem. Good luck! Rest, pain relievers and physical therapy can help. Medicine and physiotherapy often. Is the arthroscopic modified tension band suture technique suitable for all full-thickness rotator cuff tears? Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. Jung HJ, Sim GB, Bae KH, Kekatpure AL, Chun JM, Jeon IH. prospective, randomised trial in 103 patients with a mean four-year follow-up. bone spurs and/or rotator cuff tears. 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. People who do repetitive lifting or overhead activities are also at risk for rotator cuff tears. 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. Good luck! 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). Rotator cuff tendon augmentation grafts are a promising area of research. 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). I am wondering if I can recover without a surgery option. Mild AC arthropathy. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. Because of the risk of infection and and nerve damage. Elbow Surgeons & Treatment Melbourne Arm Clinic, Shoulder Instability: A Surgery Treatment Guide, PRP Injection Recovery Time: What to Know. A few months passed, and I was called into the orthopedic surgen, who was a shoulder specialist, for a "pre surgery consultation". 2023 Melbourne Arm Clinic. I hope I have not waited to long for having this checked, and the only option will be surgery. Gialanella B, Bertolinelli M. Corticosteroids injection in rotator cuff tears in elderly patient: pain outcome prediction. Repair of Rotator Cuff Tears - UW Orthopaedics and Sports Medicine I have always found the anatomy of the shoulder to be very interesting. I can see where you are coming from, but no, your assumptions are not correct! 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. In many cases, torn tendons begin by fraying. The Summary of Findings will present the following information where appropriate: absolute risks for treatment and control, estimates of relative risk, and a ranking of the quality of the evidence based on study limitations (risk of bias), indirectness, inconsistency, imprecision and publication bias. Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. I am sorry I can't provide you specific advice over the internet. @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. Information on this topic is also available as an OrthoInfo Basics PDF Handout. Remaining tendons of the rotator cuff are normal in signal and morphology. (Left)Overhead view of the four tendons that form the rotator cuff. The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. 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. The upregulation of these genes in the full-thickness group was consistent with enhanced synovial inflammation, greater vascular ingrowth, and the loss of collagen organization in both . @anonymous: Dude, I just did nearly the exact same thing. The anterior band of the supraspinatus (most common tear location) is an agonist to external rotation. Particularly about what many people are likely to experience during the often long road to recovery. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. I have not returned back. Information on this topic is also available as an, from the American Academy of Orthopaedic Surgeons, Nonsteroidal anti-inflammatory drugs (NSAIDs), Rotator Cuff Injuries - Clinical Practice Guideline (CPG) | American Academy of Orthopaedic Surgeons (aaos.org), When only a small part of the tendon is detached from the bone, it is referred to as a, When a tendon is completely detached from the bone, it is referred to as a, Pain at rest and at night, particularly if lying on the affected shoulder, Pain when lifting and lowering your arm or with specific movements, Weakness when lifting or rotating your arm, Crepitus, or a crackling sensation, when moving your shoulder in certain positions. @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. You may be trying to access this site from a secured browser on the server. But not result in a normal shoulder. In most rotator cuff tears, the tendon is torn away from the bone. Jacquot A, Dezaly C, Goetzmann T, Roche O, Sirveaux F, Mole D. Is rotator cuff repair appropriate in patients older than 60 years of age? The popping may or may not be related to your shoulder pain (difficult for me to say without an examination etc.) This kind of tear does not heal on its own. The majority of these tears occur amongst people over the age of 40. old I was in good physical shape as a letter carrier(28 yrs) but have been mostly sedentary recovering from the first surgery. 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. Lol. I have a feeling this is going to be a long recovery! Many people will recover after receiving treatment from a physiotherapist (or physical therapist in USA). There is some spurring at the glenoid articular surface. Questions: 1. You have a large tear (more than 3 cm) and the quality of the surrounding tissue is good, You have significant weakness and loss of function in your shoulder, Your tear was caused by a recent, acute injury. This will help you figure out what you are deciding between. 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). Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. 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. 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. The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus. 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. 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). 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. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. When the supraspinatus tendon is torn but not completely ruptured, usually a period of conservative management with a physical therapy program will be trialed rather than rushing into surgery. its been three months with some pt but no noticeable improvement. Partial thickness tears of the supraspinatus muscle are an incomplete disruption of muscle fibers; note that these can progress to a complete or full thickness tear of the supraspinatus muscle, and larger tears pose a higher risk of progression to full tears, even if they are asymptomatic. I have been seeing an orthopedic doctor for the past 18 months. If youre going to have surgery to repair a full or partial thickness tear, you should keep in mind that youre going to have some significant recovery time where you wont be able to use the affected arm as usual. Here is some general information that may be useful. 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 is not possible for me to give you any specific advice over the internet etc., but here are some general thoughts. 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. Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). I guarantee you will not be the last person to read this page wondering about a difference in doctor opinion or trying to figure out whether they have a supraspinatus tendon tear or adhesive capsulitis (or surgery versus no surgery). (Right) A full-thickness tear in the supraspinatus tendon. You may have pain when you lie on the painful side at night. pain that increases with shoulder use. can be damaged without a dislocation occurring at all, particularly when carry heavy items up ladders or performing repetitious activities. 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 was very optimistic about the P.T. The initial keywords include rotator cuff tear, full-thickness tear, elderly, conservative treatment and surgery: This review is to contribute to the completion of the Master of Clinical Science degree at The University of Adelaide, Adelaide, South Australia, for MN.
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