Full thickness tears: usually categorized by size in centimeters. Symptomatic full thickness rotator cuff tears can be managed surgically. No tendon retraction or muscle belly atrophy. I maybe take a few Advil a week with no loss of function at all. Your doctor should be able to explain your options and potential expected outcomes. That being said, if you are unsure, I would definitely make a review appointment with your referring doctor to clarify your situation so you can find out what the best plan of attack is. ROM hurts so I'm not sure. The CT impression read like this: High-grade partial tear of the supraspinatus tendon at its insertion (rim rent tear). Dr. Burks explains what the injury is and when to . The recovery time after surgery is substantial (and may vary depending on the surgeon, and specific structures repaired). 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). The supraspinatus tendon is the one most likely to become torn. 8% (102/1251) 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. Can a supraspinatus tendon tear heal itself? A complete, full thickness tear means that the tear goes all the way through the tendon. Pitchers, swimmers, and tennis players are common examples. A full-thickness tear might also be described as extending from the anterior leading edge with 1 cm of supraspinatus remaining intact or as involving the midportion with 1 cm of supraspinatus intact anteriorly and 1 cm of infraspinatus intact posteriorly, and so forth. have got bursal thickening as well and mild thickening of. 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. The results showed a "partial tear of the supraspinatus tendon, with large swelling and irritation". I would like to get the tendon fixed, the thought of advancing an existing tear makes me cringe. I have had this problem with my shoulder/arm for about 6 months maybe. there is minimal AC arthrosis. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). A few months passed, and I was called into the orthopedic surgen, who was a shoulder specialist, for a "pre surgery consultation". Remember that you are not aiming for speed; slow, steady, and controlled movement is best. Without seeing the scan or conducting a physical examination, I can only offer some general comments in response. This was caused by contact with another person and (I'm self diagnosing) some prior existing minor tendon tears. A rotator cuff tear (RCT) is a common disorder associated with pain and dysfunction in the shoulder, the prevalence of which increases with age [].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]. When I went in, he told me that after looking at my MRI, he did not think that anything was necessary, and instead wanted me to go back into physical therapy and continue to get steroid injection treatments. Background: Good functional results have been reported for arthroscopic repair of rotator cuff tears, but the rate of tendon-to-bone healing is still unknown. I plan on asking the surgeon these questions, but wanted your expert opinion. The supraspinatus tendon has a tendency to weaken with age and become prone to tendon tears. Since most rotator cuff tendons are about as wide as three of your fingers, a small tear would be one the size of your fingernail or smaller (less than one centimeter of tendon torn) (Figure 7). ; 2. It extends slightly into the proximal subscapularis bursa. I am sorry I can't give you any specific advice over the internet, but here are some thoughts that may be useful to you. (Right) A full-thickness tear in the supraspinatus tendon. I tried to figure out what the onset was, but could never figure it out, it just seemed completely random. Don't be afraid to ask lots of questions about what is likely to happen if you do or don't have surgery. So first off, I should say that I have certainly seen situations where a small supraspinatus tear has been surgically repaired, only for a worsening of symptoms to occur after further pathology (such as other rotator cuff tendon tears) either develop or become easier to detect on imaging (e.g. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. There is some really good information in what you have said. Now, my Ortho doc #2 who recommended i do the MRI also reccomends a surgery to fix the tear. This is a good example of why MRI's can be very valuable in cases like this. The surgeon(s) who ordered the imaging are usually the best person to speak with regarding the pros and cons in any particular case. Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. I'm unable to say whether this has occurred in your case, however, the reason why this springs to mind is that I cannot recall ever seeing a true case of adhesive capsulitis (sometimes called frozen shoulder) that resolved in 6 weeks? 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. This is just general information of course. 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. From a mechanical point of view the muscles and soft tissues around the shoulder do an amazing job to keep the head of the humerus (ball) in the small glenoid fossa (bony component of the socket)! Hi there. For awhile I was able to get my arm somewhat back to normal but wilh slight aching. That was July of 2011. A partial tear may require only a trimming or smoothing procedure called a dbridement. However, not all tears need surgery. I all of a sudden lost all my strength in my right arm and dropped the box. 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. The infraspinatus contains a subtle hypochoic region measuring 0.5cm within the tendon substance consistent concerning for an intrasubstance tear. ), while others do not. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. This likely represents extension of an existing tear. Wish me luck!!! 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). Complete: With a full-thickness or complete tear, the tendon separates completely from the bone. A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle, which is located at the back of the shoulder. Mary Kay. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. You mentioned rotator cuff and tendonosis like they were different things. my ROM did increase a very small amount, but my pain and discomfort never went away. or should you just ask for their opinion with no outside information> Thanks Judy. I am 60 years old and do not want surgery but if it helps to stop it getting worse as I get older I will have to. Interstitial hyperintensity is seen within biceps tendon in the . 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 tear of the subscapularis muscle is less common then the tear of the other rotator cuff muscles, such as the supraspinatus, infraspinatus or suprascapularis. 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). MRI does demonstrate a complete massive tear of my rotator cuff with retraction and severe atrophy. 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. It is important the the surgical repair of the tendon is protected initially to ensure that a re-injury does not occur. A good doc should be able to assess your shoulder and give you some specific advice regarding the best next plan of attack. Dr. Mike great info here thanks. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. Large. Tendinosis means that the tendon has some damage at the cellular level (generally where there has been repeated amounts of small damage (sometimes called microtrauma) that your body has tried to repair), but there is not swelling (inflammation) currently present. When I visit my DR. what are the thing I need to be aware for the diagnostic? 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