but unfortunately, the results were extremely minor. Very much appreciated. I'm still processing in my head what I heard in a VM left 10hrs ago, because I finally found out the findings from my shoulder MRI/Arthogram completed about 6 weeks ago. These types of pathology are nothing to be sneezed at and have potential to cause quite a lot of pain (which you probably know a thing or two about). Now I have these results stated above. 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! The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. (Right)A full-thickness tear in the supraspinatus tendon. So don't give up on your ambition to participate in exercise. It gets weak and tired pretty quickly, I can't sleep on my side and it aches all the time. However, it is worth noting a common misconception about full thickness tears. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. substantial trauma from a fall), or from repeated microtrauma (e.g due to biomechanics + / - age-associated changes). Some studies suggest that young patients with traumatic tears may be best managed with surgery while many atraumatic rotator cuff tears, which is common in older patients, may be amenable to a non-surgical treatment.4 In addition, compared to younger patients (<50), rotator cuff tears in older patients (>70) are characterized by greater retraction in the frontal plane and greater fatty infiltration.6 A study showed that only 82.5% of rotator cuff tear patients older than 70 who exhibited these features had supraspinatus involvement and underwent arthroscopic rotator cuff repair achieved complete healing, compared to 95% in patients under 50. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. People who do repetitive lifting or overhead activities are also at risk for rotator cuff tears. In most rotator cuff tears, the tendon is torn away from the bone. 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. Highlight selected keywords in the article text. Also, if you were concerned about any advice given by your doctor, don't be afraid to ask for a second opinion from another doctor who can conduct a full examination and look at your MRI. Again, because your case is not straightforward, seeking advice from your surgeon(s) in this regard is certainly wise. Generally speaking, do small tears need surgical repair? I have been diagnosed with a tear of the supraspinatus tendon by exam and u/s. @DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain. 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. Subcortical reactive changes superiorly and laterally at the humeral head are present. @anonymous: Hi Les, I am glad you found this information helpful. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. Decided to see ortho who ordered an MRi last week. Family is important, and I would not encourage people to discard their advice or offend their family and friends, but definitely weigh up advice on its merit. 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.). I don't lay on the side of the hurt arm as I don't think it will be good for it. The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. @anonymous: Hi Donald, I'm sorry to hear about your shoulder trouble and insurance situation. Moderate subacromial/sub deltoid bursitis. I know that since it has been years since seeing a dr about it that I should make an appointment, but what is your opinion of my situation? I experienced a fall on August 31, 2012. Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. Selected studies will be critically appraised by two independent reviewers using standardized critical appraisal instruments from JBI SUMARI. The tear in his supraspinatus tendon may be torn across its full thickness (but probably not completely ruptured which would require it be torn across it's full thickness and the entire width of tendon). Exercise is important for many reasons (not the least of which are physical and mental health benefits). All Rights Reserved. Visited many doctors and was always told it was nothing, the pain got unbearable and I saw yet another dr who was completely caught off guard my the loud pop my shoulder makes. Thanks for sharing this detailed account with everyone. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate. I explained of my ongoing problems since the incident, and once the claim was processed I was sent through a variety of medical departments for a full diagnostic. Above my shoulder or behind my back without pain. Don't be afraid to say how you feel (no doubt you'd do this in a respectful way) about trying a whole bunch of non-surgical options, but not seeing any lasting results (as you have described for us above) and being keen to move forward toward some kind of resolution to the problem. 24. I plan on asking the surgeon these questions, but wanted your expert opinion. Any thoughts? Fluid signal anterior to the proximal humerus as well as within the sucoracoid bursa. The lack of a normal amount of synovial fluid in the joint space could potentially be a sign of adhesive capsulitis (also known as frozen shoulder) among some people. Data is temporarily unavailable. Either way, I wish you all the best with it (and a safe deployment and return). Communication between health professionals (such as PTs and surgeons) may not be as good as it could be. So quite often the best treatment approach is not always immediately clear. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. Some will have more training, experience or ability in helping patients to overcome the biomechanical factors that can cause shoulder impingement and supraspinatus tears. I had subacromial decompression February 2010 a year after a motor vehicle injury (I am currently a 34 year old female). @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. The supraspinatous is one of the 4 muscles that make u. Some minor tears may be treated without surgery. Make sure you ask the orthopedic surgeon about what to expect after the surgery and the likely recovery time. 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. McMaster University, 2015 (developed by Evidence Prime, Inc.). This content is accurate and true to the best of the authors knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. I am sorry I can't provide you specific advice over the internet. Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). Joanna Briggs Institute reviewers manual: 2017 edition [Internet]. to maintaining your privacy and will not share your personal information without Sleeping on my right side became impossible. Good luck with your next round of surgery or therapies! Could this require surgery. Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. Reinold MM, Macrina LC, Wilk KE, Dugas JR, Cain EL, Andrews JR. I don't think there is a clear answer to this one. It's a supraspinatus tendon tear with 50% thickness and no labral tear. This may give you relief, even if you have been getting symptoms for a few years. This surgical method is a simple and effective I'm 43 and have been suffering from shoulder issues for over a year. Most tears are the result of a wearing down of the tendon that occurs slowly over time. We will also discuss surgical interventions for tendon injuries. Had mild discomfort in shoulder for a few weeks in August. It is also very interesting to note that for those people who have persistent whiplash symptoms there is often a change in the way their brain processes sensation from the neck and shoulder region. Good luck with it and I hope you are feeling pain free sooner rather than later. Does the reverse shoulder arthroplasty and deltoid repair be a possible option of treatment? Examination otherwise demonstrates the osseous structures of the shoulder to be otherwise unremarkable in signal and morphology. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. Following the search, all identified citations will be collated and uploaded into bibliographic software or citation management system and duplicates removed. This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. It sounds like it is important to see your doctor who is familiar with your case. Particularly about what many people are likely to experience during the often long road to recovery. If you get a chance drop by again and let us know how you went. This information is provided as an educational service and is not intended to serve as medical advice. Good luck! 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. This is a good example of why MRI's can be very valuable in cases like this. Effects of Rotator Cuff Pathology and Physical Therapy on In Vivo Shoulder Motion and Clinical Outcomes in Patients With a Symptomatic Full-Thickness Rotator Cuff Tear. dull ache in your shoulder and upper arm. 3. modify the keyword list to augment your search. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. 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. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. 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. In my reports say that I have less fluid and possible tear. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. People tend to expect recovery after surgery will take a few weeks. Your doctor should be able to explain your options and potential expected outcomes. It is possible this tear may communicate with the bursal surface anteriorly. This review will consider studies that have measured one or more of the following outcomes: This review will consider randomized controlled trials, pseudo-randomized controlled trials, quasi-experimental studies, case-control studies and cohort studies. Available from. It is good that you have discussed the recovery with your surgeon already. 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, I can't give you specific advice over the internet about whether you will need surgery or not. This will help you figure out what you are deciding between. I have about 3" less range reaching up behind my back, but I think some pre-existing tears and arthritis were fixed. 22. Full thickness tears will not heal without surgery. My question to you is why can they not try to repair the rotator cuff using a graft of somesort. I also can't give you specific advice about your situation over the internet etc. Supraspinatus tear: If you want a chance for a full recovery surgery is your best option. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). Subgroup analyses will be conducted if appropriate based on participant age, type of non-surgical, and type of surgical treatment. The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. Read More Please try again soon. Where required, authors of papers will be contacted to request for missing or additional data. The supraspinatus is part of the rotator cuff of the shoulder. An acute tear of the supraspinatus muscle can occur alongside injuries like shoulder dislocation, clavicle fractures, or other rotator cuff injuries that can happen as the result of things like a fall on your outstretched arm or attempting to lift something too heavy; plus there are a variety of sports where the athletes are prone to shoulder damage like baseball, basketball, rugby, AFL Football, and tennis. I was told that they were now wanting to do surgery to actually go in and see what they might be able to do to repair some of the damage they thought they saw. 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. 3. For this reason, many doctors first recommend management of rotator cuff tears with physical therapy and other nonsurgical treatments. Jackie. 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). 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. I here is incidental note made that the teres minor muscle is prominently atrophic. J Bone Joint Surg (Am Vol). 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. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. Let us know how things turn out for you. 19. Of the eight studies included in the review, seven focused on surgical treatment and one compared the efficacy of sodium hyaluronate against corticosteroid injection. 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). It was sometime in the early months of 2011 that I was sent off to have an MRI done. bested on all of the above. This type of tear can occur with other injuries, such as a broken collarbone, a dislocated shoulder, or a wrist fracture. The pain is mostly in neck and shoulder blade and collar. The reverse shoulder surgery is extremely involved so I am getting a second opinion. Having pain and sub-optimal shoulder functioning while you are nursing would not be ideal. 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. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object. If the tendon has been completely ruptured (no longer attached), then surgery will definitely be required with some level of urgency for the tendon to be successfully reattached. 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). So my tear went from a near full thickness tear to a full thickness tear. that can be just as difficult to resolve as any structural injury. That being said, a surgeon's own experiences, skills and abilities (as well as risk tolerance) may factor into their decision as to whether a surgical repair (and the nature of the repair) is something they will advise. 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. sir i am a shuttle badminton player.. i got injury on my shoulder .. doc told to tke MRI scan.. after taking MRI scan these are the final impressions.. 1.partial tear in the supraspinatus tendon at the level of insertion in the greater tubersity for a length of about 15mm with intact insertion, 2 partial tear in the anterior superior labrum. Many people have seen sporting heroes dislocate a shoulder during a heavy contact, have a medic "pop" it back in, then continue on 15 minutes later. Please enable scripts and reload this page. Nganga, Michael1,2; Lizarondo, Lucylynn2; Krishnan, Jegan1,3; Stephenson, Matthew2, 1The International Musculoskeletal Research Institute Inc., Adelaide, South Australia, 2Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia, 3Department of Orthopaedics, School of Medicine, Flinders University, Adelaide, Australia, Correspondence: Michael Nganga, [emailprotected]. Rotator cuff surgery in patients older than 75 years with large and massive tears. Rotator cuff tendon surgery and postoperative therapy. The effect of neuromuscular electrical stimulation of the infraspinatus on shoulder external rotation force production after rotator cuff repair surgery. Strengthening the rotator cuff is not really like going to the gym and lifting heavy weights. This is what a tear or rupture of the tendon connected to the supraspinatus muscle (which is part of the rotator cuff of the shoulder) is called. Second, I am sorry to hear about your fall and subsequent shoulder pain. If muscles of the rotator cuff are not providing adequate stability throughout the shoulder's range of motion, this can contribute to shoulder impingement and a break down of the supraspinatus tendon. 2019;101(12):1050-60. The classic full thickness rotator cuff tendon tear involves the supraspinatus and then progresses to involve the long head of biceps, followed by the infraspinatus and subscapularis. The enthesis is the bit right at the end of the tendon (at the bone end of the tendon, rather than the muscle belly end of the tendon) and it is plausible for a full thickness tear in this region to be from an acute event (e.g. The acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). Surgery may be recommended sooner rather than later for younger patients, particularly those whove experienced acute trauma.

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