I'm sorry I can't give you specific advice about whether you will need surgery or not over the internet. Your shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). Also, don't be afraid to ask doctors / surgeons lots of questions. I think it would be wise to listed to the advice from your doctor on this one! And overall her last resort for surgical intervention is a reverse total shoulder arthroplasty. Generally, if an injury is going to heal on it's own, it gets better over time, unless it is re-injured. Of course, if you feel you cannot have an open and honest discussion about the pros and cons of surgery in your particular case with your surgeon, dont be afraid to seek a second independent opinion from another specialist. Sorry for the delay in response. 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. You can partially or fully tear your supraspinatus muscle, and remember that these sorts of tears can be symptomatic (meaning they cause supraspinatus pain and inhibit your range of motion and ability to perform everyday tasks) or asymptomatic, meaning the tear is present but it not currently causing you pain or otherwise causing problems in your life. The first relates to the potential risk of a poorer outcome due to the delay; this may occur due to further damage being caused in structures that are difficult or impossible to repair etc. @will-nelson-790693: Hi Will, Thanks for stopping by and sharing your experience. I received today my results of a CT Scan from my right shoulder, which I had an accident like 5 months ago. This is partly because rehabilitation following surgery will depend on the surgical technique used. All rights reserved. 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]. We excluded patients with isolated tears of the subscapularis tendon, those with a previous shoulder surgery, and those who had any type of injection . Some things to consider when you are discussing your options with a surgeon is the length of recovery time following surgery (likely to be months), consider time to return to work (also consider whether it it possible for you to return to light duties at work). Sorry we are unable to give specific advice over the internet, but I hope this general information is helpful! Hope that helps! The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. I agree that shoulder pain for years, that has not resolved is definitely a good indicator that seeing a doctor is a good idea! Thanks for stopping by and sharing. Rotator cuff integrity, measured by direct magnetic resonance arthrography or conventional MRI. I also can't give you specific advice about your situation over the internet etc. Interpretation: There is a focally retracted full thickness 1.2 x 1.2 cm tear of the supraspinatus tendon at its anterior attachment site on the humerus. If your doctor does end up recommending surgery, make sure you have a good chat about what to expect after the specific surgery they are planning. 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). These tendons have poor blood supply and will not heal themselves. 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. Pain continued and got worse. some loss of motion in your shoulder. Also now taking Tylenol 500 with5 hydrocodone. @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. This includes small (01 cm) and medium (13 cm) tears. there is minimal AC arthrosis. It is not possible for me to give you any specific advice over the internet etc., but here are some general thoughts. Gloria Freeman from Alabama USA on January 21, 2013: Hi lot of good info and tips here. Good luck with your next round of surgery or therapies! Your question regarding using a graft of some sort to help repair a rotator cuff tendon is an interesting one. RCTs in older patients are predominantly attributed to degenerative tears. Small to moderate glenohumeral joint effusion. Small area of subacromial bursitis present. I appreciate your thoughts on this matter. 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! This exercise can be good for pain relief, and may also help increase the range of motion in the shoulder joint. working a full time job nd being a mother of three I could never fit it in my schedule but was also told by a family member that PT would not help. Good luck with it. I here is incidental note made that the teres minor muscle is prominently atrophic. I have a referral to a specialist and hopefully I will have some answers soon. Physiotherapy, including stretching and strengthening exercises, electrotherapy, ultrasound, moist heat and laser therapy. (Right) A full-thickness tear in the supraspinatus tendon. I do not want a metal shoulder. 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 ]. Dr Mike, Please help me understand what options I might have or questions to ask the surgeon about my full thickness rotator cuff tear. Hey DrMikeM doin some research and came across your sight and thought I'd add my two cents. The glenoid labrum and bicipital tendon appear unremarkable in position and morphology. From the information you have provided it is difficult to say whether surgery will be needed. The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. left supraspinatus tendon tear,so what the process of curing? I just had an MRI I have a tiny, focal intratendon tear of the supraspinatus fibers at the humeral insertion measuring 2mm with minor impingement changes are noted in the greater tuberosity of the humerus. There is fluid distending the long head of the biceps tendon sheath, representing tenosynovitis. Shoulder muscles are very good for stabilizing the ball and socket joint and making large movements (to help lift things, throw objects etc. What does all that mean in simple layman terms? Good luck! Partial thickness tearing is where only a portion of the tendon is torn and part of the tendon is still attached to the humeral head. Elderly patients; full thickness rotator cuff tear; non-surgical and surgical treatment. Also if I don eventually need surgery will it hurt to wait until I absolutely need it. My arm is very weak. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). twice, second time relief only lasted 5 minutes) finally local doc ordered M.R.I. I have not returned back. 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 wondering if I can recover without a surgery option. A significant amount of these occur in the supraspinatus muscle, although other areas of the rotator cuff may be involved. Thanks to my hubby for finding this site. I am sorry I can't offer specific advice without a proper assessment, but seeing an orthopedic specialist or physical therapist in your local area sounds like a good idea. 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. The main action of the supraspinatus muscle is to abduct the shoulder joint (lift your arm out sideways and upwards). This illustration of the shoulder highlights the major components of the joint. However, in some cases, the better option may be to consider surgery sooner rather than later (e.g. Depending on the severity of your shoulder tear and other injuries, your age, general health, and lifestyle, it might be possible to alleviate the pain and minimize the issues resulting from a supraspinatus year through a combination of non-invasive tactics like medication and physiotherapy. Please try again soon. Physical therapy exercises for supraspinatus tendon tears usually have one of three purposes: Below is a pendulum exercise demonstration. I can reach behind my back ok. shoulder stiffness. 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. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. A partial or complete rotator cuff tear makes it difficult to raise and move your arm. Original injury was 4 years ago in a MVA and I've been experiencing pain when sleeping on injured side, intermittent loss of sensation for the entire arm resulting in dropping things, loss of muscular endurance and increased pain for repetitive activities ranging from ribcage level and upward, loss of muscular strength and increased pain for lifting objects at the present moment equivalent in weight to a litre of milk or heavier, and an overall sense of lack of spacial awareness for the injured arm as if my arm is not "connected" to my body. She did an MRI and said it was tendonosis, and suggested PT. Humeral head is riding high abutting the underside of the acromin process. In most patients the supraspinatus tendon is the most vulnerable and 90% of rotator cuff tears involve this tendon. 2. HubPages is a registered trademark of The Arena Platform, Inc. Other product and company names shown may be trademarks of their respective owners. I mention this, as this will often influence treatment decisions. I'm quite apprehensive and nervous about the surgery but more so about the recovery. 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. [1] Quite often, the tear occurs in the tendon or as an avulsion from the greater tuberosity. Modify Sport Techniques . Either way, this kind of ongoing shoulder pain is not good. It is also worth mentioning that not all PTs are created equal. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. They do reveal most substantial soft tissue injuries, but they are only as useful as the person interpreting them is skilled. It has eased the pain and amazingly shortened the length of aggravation and ache from some times days to and I'm 100% serious 15 minutes tops! Your doctor will test your range of motion by having you move your arm in different directions. Cold therapy cold therapy cold therapy!! 6 months ago a different ortho diagnosed the problem as frozen shoulder and gave me a cortizone shot followed by physio therapy for few weeks. Geary MB, Elfar JC. My MRI impression reads: suggestive of a full thickness, obliquely oriented tear through the supraspinatus insertion. A full-thickness tear is when the wear in the tendon goes all the way through the tendon. 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 found it very helpful as I am sure all your other subscribers found it to be too. Yes, the surgery will be over very quickly, but it is the rest of the recovery that takes time and effort (and a fair bit of frustration being careful to keep within the movement restrictions). 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. Injection therapy, including corticosteroids, hyaluronic acid and platelet-rich plasma. 1. The search strategy will aim to find both published and unpublished studies. Article Google Scholar Ratte-Larouche M, Szekeres M, Sadi J, Faber KJ. 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? perhaps if delay is likely to lead to a complete rupture that could be prevented with early surgery). The supraspinatus is one of the four muscles that make up the rotator cuff group of muscles. I suspect you have a bit of work to do over the next 6 months or so to help your shoulder recover. I am 67 years old and am an artist and my left arm which is the one in question is my dominate arm. Waiting until after the delivery of your baby to re-attach the tendon may increase the chance of a poorer outcome (not to mention the difficulty nursing a newborn with only one functional arm). I just found out this week that I have Bursitis, and a tear in my Supraspinatus. I have a feeling this is going to be a long recovery! I am really hoping to find some outside advice. Good luck! I had a fall at my workplace and was suffering neck and shoulder pain. Those words exactly. 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. It has been associated with older age and osteoarthritis, but often seems to occur when there is extra fluid in the gleno-humeral (ball and socket) joint. 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. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. However, I would also want to be honest with the surgeon in letting them know that an orthopedic surgeon had previously been consulted and that a second opinion was being sought. Three kids will no doubt also be keeping you busy and missing out sleep because of your shoulder pain doesn't sound like much fun. Surgery may also involve orthopedic alteration of biomechanical factors around the shoulder joint in order to prevent further ongoing damage to the supraspinatus tendon. An initial review of the literature from PubMed, CINAHL, Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews and Implementation Reports and PROSPERO confirmed that a review as extensive as this has not been or is not currently being done. Tears that develop slowly due to overuse may also cause pain and arm weakness. The tendons may tear from their attachment either after an injury such as a fall or from long-term wear and tear. I am worried I will not improve my ROM this time. It is certainly worth discussing a more conservative approach, such as seeing a physical therapist that specializes in shoulders, with your orthopedic surgeon; particularly if you feel you have noticed improvements previously. Supraspinatus is the most commonly injured rotator cuff tendon. It can reduce (relocate back into the socket) long before someone makes it to a hospital (or an onboard medic!) The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. If a condition stays the same or become worse, then its usually a good idea to get it checked out again, or even a second opinion if you are not happy. @anonymous: Thanks for keeping us up to date. A rotator cuff tear can get larger over time. I saw doctor initially who said physiotherapy will help it. Because of the risk of infection and and nerve damage. 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. However, to date, I am not aware of any rigorous large-scale clinical trials that have demonstrated effectiveness (or otherwise) in humans. Generally speaking, MRIs definitely help the surgeon to make a diagnosis and give them an idea of whether surgery will help. I can say though that PT's are trained to help people with painful ROM. I appreciate your thoughts on this matter. Your orthopaedic surgeon will discuss with you the best procedure to meet your individual health needs. Rotator cuff injuries are common, especially as you get older. 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. Full thickness tear of the anterior insertional fibers of the supraspinatus tendon with a 1cm retraction and no evidence of supraspinatus muscular atrophy. In your opinion, do I have any other option other than surgery? List of pain and limited mobility for about a week. Shoulder dislocation, shoulder instability, and shoulder subluxation can all coexist or happen as the result of a partial or full thickness shoulder supraspinatus tear, particularly when these tears occur as a result of trauma to the shoulder joint or acute injury. If you are seeing a physio for this condition, they should be able to provide you some good information about the post-surgery protocols that surgeons in your local area will be likely to prescribe. You may have shoulder pain and arm weakness. Additional surgical techniques not found in the previous systematic review have been added to this review. I went to one orthopedic doctor and he immediately said surgery is my only option. 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). Hopefully your orthopedic surgeon conducted a physical examination to help determine the relative contribution of the partial thickness supraspinatus tendon tear versus whiplash. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant. I'll go check out some of your lenses now. When one or more of the rotator cuff tendons is torn, the tendon becomes partially or completely detached from the head of the humerus. P.S. Small tear involving the supraspinatus tendon only Fig. @anonymous: mike but not dr. mike. Generally speaking, for shoulder pain related to rotator cuff injuries following trauma, often the first strategy is to see whether the pain and other symptoms improve with non-surgical management approaches. Construction work and other high-risk physical jobs can also increase the likelihood of experiencing this type of injury. Drugs, supplements, and natural remedies may have dangerous side effects. 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). Unless the shoulder is actually dislocated at the time of the x-ray, or there is a noticeable bone abnormality (chipped or broken bone, bone spur that is visible on x-ray etc. Sorry for the delay, I have been away. ; 2. A rotator cuff tear can result from an injury such as a fall or heavy lifting, or from normal wear-and-tear and repetitive activities over many years. I am intrigued by the patient's symptoms and active shoulder range of motion versus her imaging. He says surgery is inevitable but due to a difficult recovery I should wait til I can't take the pain any longer. This sounds like quite a pain (literally). I experienced a fall on August 31, 2012. I'm 43 and have been suffering from shoulder issues for over a year. My doctor has told me I need to have arthroscopic revision rotator cuff repair. I'm sorry I can't provide you with specific advice, rather I only provide some general information. Good luck! Advice welcomed. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. Thanks for stopping by and leaving a comment. 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. Anyways, my appointment for surgery on my right shoulder is in 2 weeks.. Arthroscopic.. it use to ache and ache at night but recently its not so bad. Your message has been successfully sent to your colleague. Of the eight studies included in the review, seven focused on surgical treatment and one compared the efficacy of sodium hyaluronate against corticosteroid injection. Either way, don't be afraid to ask your surgeon lots of questions (likelihood of success in your case, what will happen after surgery, recovery time-frames etc.). First, sorry for the delay in response. 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. Time passed. Although I probably wouldn't be forthcoming with the name of the first surgeon or advice given unless the surgeon actually asked about this directly. I was referred to a surgeon who stated that they could not repair the rotator cuff due to the size of the tear from a surgical standpoint. 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). After 4 months of therapy and 3 injections I am unable to lift my right arm. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. The prevalence of full-thickness rotator cuff tears may occur in up to 22% of all patients over 65. Sometimes in cases like this your surgeon may want to try an injection. In many cases, surgery is required. I maybe take a few Advil a week with no loss of function at all. If they were consistent with each other it would seem remarkably unlikely that both reports were wrong. What does he mean by my tendon is failing? I am disappointed not to have been referred to a surgeon, but I have to admit the exercises have already helped me sleep better. 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. Sometimes, it is difficult to tell from people recalling what happened whether a shoulder has been dislocated. 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. 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. ), but not so good with the finer movements (better performed by the muscles in the forearm and hand). In some cases, surgery to repair the tendon is also required. @anonymous: Hi Kazikp, I am sorry I cannot give you advice over the internet but here is some general information you may find useful. muscle atrophy of supraspinatus, infraspinatus, and subscapularis muscles, 3.) It is also worth mentioning that when surgeons send patients for PT and don't hear from them for a while, they may well have just assumed everything went well and there is no more problem (or they have so many patients that they haven't given it much thought). The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. @anonymous: Dude, I just did nearly the exact same thing. The individual shape of the bone structures (particularly the acromion) and soft tissues around the tendon will contribute to whether the tendon is able to move freely or become impinged between structures with arm elevation. There is some spurring at the glenoid articular surface. It was a small rotator cuff tear. Due to the nature of what we were doing, I was unable to immediately seek medical attention, so after regaining some composure, I managed to carry on with my duty, but not without immense pain. Otherwise you will have signficantly reduced function (plus ongiong pain) in that shoulder. Either way, I wish you all the best with it (and a safe deployment and return). Superior subluxation of the humeral head. )amount of fluid in acromioclavicular joint and last but not least 5.) 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. Seek immediate help if you are experiencing a medical emergency. The supraspinatus tendon runs from the muscle body through quite a narrow gap under the acromion. This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do. 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. Keyword Highlighting sorry for the double posting, first time user. The challenge lies in identifying patients with the greatest chance for a successful repair and optimizing timing such that the tear does not progress to a point of irreparability.8. 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. The tendon that seems to be most commonly affected is the supraspinatus, although it could also easily be either infraspinatus, long head of biceps, subscapularis or teres minor tendons. Exercise rehabilitation in the non-operative management of rotator cuff tears: a review of the literature. Your arm is kept in your shoulder socket by the rotator cuff. On the other hand, if surgery is inevitable or at least the most likely outcome, then the treating doctor / surgeon(s) may recommend early surgery. An updated systematic review is now needed to identify the best treatment approach for full thickness rotator cuff tears in the elderly. Gumina S, Carbone S, Campagna V, Candela V, Sacchetti FM, Giannicola G. The impact of aging on rotator cuff tear size. Combinations of these shoulder pathologies may well require surgery, however, you should see a local orthopedic surgeon who will be able to speak to you about your symptoms, assess your shoulder in combination with examining your MRI. The comparators of interest will be non-surgical interventions against non-surgical interventions, non-surgical interventions against surgical interventions, and surgical interventions against surgical interventions. I don't want to experience what you've gone through, but I'm currently deployed and am not getting treated. The most sensitive finding in full-thickness tears is thought to be the presence of fluid signal intensity in the location of the rotator cuff on fat-saturated T2-weighted or intermediate-weighted images 5. 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). The tendon will usually retract if a full rupture has occurred. It is plausible to sustain one or the other (or both) from a fall. Lots of people express feeling useless, frustrated, and angry at times. When getting a second opinion from another surgeon. 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. 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.
Espys 2022 Nominations,
Homes For Sale By Owner Hamburg, Ny,
Articles F
