I don't lay on the side of the hurt arm as I don't think it will be good for it. 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.). If you do opt for surgery. Methods: Patients ranged in age from twenty-nine to seventy-nine years. Acromioclavicular joint degenerative changes, which means nothing to me. An easy way to understand what I mean is to think about eating a steak. The close proximity of the supraspinatus tendon to the acromion-clavicular arch is a common contributing factor in supraspinatus tears, particularly when the tendon becomes impinged between these bone structures with activities that require arm elevation. There are other things your physical therapist may be able to help you with to give you some relief in the short term. 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]. This review will include studies which examined the effectiveness of non-surgical and/or surgical treatment. 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 outcomes to be included will be range of motion, muscle strength, rotator cuff integrity, pain scores, shoulder function, patient satisfaction, and quality of life. The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus. 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 ]. Time passed. I have often seen these cases improve substantially after further surgery to repair these rotator cuff tears + post surgery rehabilitation therapies. 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? Don't even think you won't need help, because you'll need help with even the most basic daily tasks. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. Critical appraisal instruments are available from the Joanna Briggs Institute Reviewers Manual.26 All studies, regardless of their methodological quality, will undergo data extraction and synthesis. On the other hand, if your surgeon thought your tendon would be able to endure pregnancy and nursing your baby without the need for strong medications or the need for surgery, then this may influence your decision on timing for surgery etc. Also now taking Tylenol 500 with5 hydrocodone. Sounds like no guarantee of 100% return to normal, and I'm about 95% now, not to mention a lengthy recovery. The pain is mostly in neck and shoulder blade and collar. Most of the time, it is accompanied by another rotator cuff muscle tear. Thanks for stopping by and sharing your interesting story. The orthopedic said that after 6 weeks of PT if there is pain then we looka possible surgery, is there something else that I should do or look at? Read about knee pain, especially from a torn meniscus. If pregnant or nursing, consult with a qualified provider on an individual basis. There also is mild tendinosis of the infraspinatus at the footprint. I'm sorry to hear of your shoulder trouble. Your shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). Adhesive capsulitis will usually last at least 5 or 6 months (often considerably longer). Thank you for the info posted on this page. What I can say is that for anyone looking to return to unrestricted badminton following a partial thickness supraspinatus tendon tear and shoulder labrum tear (particularly a SLAP lesion) will not be quick or easy. Here are a few notes/tips before you begin: Below is a demonstration of this exercise. The bursa allows the rotator cuff tendons to glide freely when you move your 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. Think about all the times you lift your arms above shoulder height in a given day and try to rearrange your home accordingly. I did this as instructed, but, to little improvement. I am sorry I can't offer you specific advice over the internet about whether you should or should not have surgery. On the other hand, you will also need to ask about the likelihood of decent recovery without surgery. I will surf again! that can be just as difficult to resolve as any structural injury. I suspect you have a bit of work to do over the next 6 months or so to help your shoulder recover. Deciding to have surgery is never an easy decision and you may require some time to recover, but if your shoulder joint issues such as supraspinatus tear are having a significant negative impact on your life, surgery and the associated downtime and physiotherapy may very well be worth it. Good luck! The supraspinatus is part of the rotator cuff of the shoulder. The most common symptoms of a rotator cuff tear include: Tears that happen suddenly, such as from a fall, usually cause intense pain. Joanna Briggs Institute reviewers manual: 2017 edition [Internet]. Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. The longer these tears are left untreated, the more chance the tendon tear will enlarge and retract which results in more difficult surgery to repair this damage. This article discusses shoulder impingement, rotator cuff rehabilitation exercises, and surgical considerations relating to rotator cuff tears and the supraspinatus tendon in particular. It sounds like you have several concerning symptoms there. The rotator cuff is a group of four muscles and their associated tendons that originate from locations on the scapula and insert onto the humeral head. there is a small full thickness insertional tear identified relating to the posterior supraspinatus. In the beginning of 2012, I returned to the Orthopedic specialist at the VA, and the medical staff seemed very surprised that my god awful pain and discomfort was still going on. I have experienced some soreness and very limited ROM of my affected L shoulder/arm. I received my first steroid injection treatment during the summer of 2011 and went through a lengthy 6 moth physical therapy treatment. Hopefully your physio can set you up with an exercise program to strengthen your rotator cuff and improve the biomechanics at your shoulder joint. This can be one of the most frustrating things for people who have whiplash associated disorders. It is difficult to know whether your husband will need surgery based on this information alone. Tears that develop slowly due to overuse may also cause pain and arm weakness. 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. shoulder weakness. What I think is more common, is two doctors not taking the time to explain something in normal everyday language and ensuring their patients have understood whatever it is they are trying to say (so lots of people feel like they are being told different things)! If I need surgery,what is the recovry time.. 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. 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. Being referrfed to a shoulder specialist Tuesday. It sounds like you are not following your surgeons instructions! Her MRI shows a full thickness tear of supraspinatus tendon and a tear of the majority of the infraspinatus tendon (with a few lower infraspinatus fibers still attached). I wrote a previous commentsaw my orthopedic surgeon this week. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily. Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. Thanks for stopping by, you have raised some very good questions. I think these are promising approaches for the types of pathology you described. thank you for your considiration and helle from Turkey:-). Either way, I wish you all the best with it (and a safe deployment and return). (Left)Overhead view of the four tendons that form the rotator cuff. I think it would be wise to listed to the advice from your doctor on this one! No black and white answer for this one I'm afraid. Here is a link to a recent academic journal article on the topic that should be free to access. 4. The best treatment option for alleviation of pain and restored shoulder function in the elderly is still debated.8 Studies have shown satisfactory healing and promising clinical outcomes following surgical repair. 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. 2023 Melbourne Arm Clinic. Patients 80 years and over have an even higher occurrence rate of 80%. 7. However, there are a variety of factors that will need to be considered. If the ball is popping out of the joint (dislocating), then that is a major concern (but this usually doesn't occur without trauma)! The postoperative recovery period following a surgical rotator cuff repair will take months and involve a specific program of range of motion and strengthening exercises that your surgeon will prescribe, often in conjunction with a physical therapist who will teach you exercises and monitor your progression. One thing that you may find encouraging is that often artists don't lift (elevate) their shoulders much when they create art (paint etc.). Good luck with it. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. There is some spurring at the glenoid articular surface. It is plausible to sustain one or the other (or both) from a fall. Subacromial decompression surgery is the most common option to open up the subacromial space and is combined with a rotator cuff repair if the supraspinatus tendon is torn. Rotator cuff tendon surgery and postoperative therapy. Treatment of rotator cuff tears in older individuals: a systematic review. A few months ago it seemed to hurt more and I had problems lifting my arm out or above my head. It is also worth noting that sometimes you can do everything right (good surgery, follow instructions etc.) A funnel plot will be generated to assess publication bias if there are 10 or more studies included in a meta-analysis. muscle atrophy of supraspinatus, infraspinatus, and subscapularis muscles, 3.) 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.). The surgeon may (or may not) want to try arthroscopic surgery to repair any damage or structural problems they can identify on an MRI. Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant. 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. 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. Rotator cuff tendon augmentation grafts are a promising area of research. However, your doctor may also suggest surgery if you are very active and/or use your arms for overhead work or sports. Athletes are especially vulnerable to overuse tears, particularly tennis players and baseball pitchers. There is supraspinatus muscular atrophy. 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. However, there are certainly injuries and structures other than rotator cuff tears that can cause some of the symptoms Tim described above. Thanks for the update and let us know how you go. ), but not so good with the finer movements (better performed by the muscles in the forearm and hand). Time progressed, pain continued and my ROM slowly worsened. 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 acromion joins with the collar bone and attaches to the upper arm (humerus also not shown in this image). AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. Wish me luck!!! The reverse shoulder surgery is extremely involved so I am getting a second opinion. Here is some general information that may be useful. The prevalence of full-thickness rotator cuff tears may occur in up to 22% of all patients over 65. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. Because of the return of the recent pain, a another MRI was ordered and the Radiologist wrote: "1. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. 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. Since then, my pain has gotten to the point where its starting to take effect of my day to day life. Just be aware that even in the best cases, the recovery time following surgery requires months (not weeks) so if you go ahead with the surgery don't be discouraged if you still have some pain in the first weeks after the surgery. There is synovial fluid at the glenohumeral articulation. Your doctor may also advise a trial of physical therapy to see if that can bring relief to his symptoms. I sleep fine as it does not hurt to lay on my back. The rotator cuff exercises should not cause pain while the exercise is being performed. Poorly defined large full-thickness tear of the supraspinatus and infraspinatus tendon measuring at least 2 cm in anteroposterior dimension. If pain is being caused, then there may be a problem with technique or a lower intensity may be required. Remaining tendons of the rotator cuff are normal in signal and morphology. You should not feel pain in the shoulder during the movement. Hi, I have had a partial supraspintus tear for 3 years now, and am wondering if it's too late to anything about it? McMaster University, 2015 (developed by Evidence Prime, Inc.). The soft tissues in their neck that were affected by the initial trauma may actually have healed, but they may still be feeling discomfort. 14. I took a not so graceful fall on a sidewalk about 9 weeks ago and landed on my shoulder. Good luck with your next round of surgery or therapies! What I really want right now is to regain enough to get through normal everyday activities and not feel limited trying to lift an object and also not drop things so frequently. The goal of any treatment is to reduce pain and restore function. Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull. Pain can also be brought on by laying on the side. Your shoulder joints consist of three different bones the clavicle, humerus, and scapula and the head of the humerus and the glenoid cavity or fossa of the scapula combine to create the ball and socket joint that allows your arm to move at a wide range of angles. Edwards P, Ebert J, Joss B, Bhabra G, Ackland T, Wang A. Construction work and other high-risk physical jobs can also increase the likelihood of experiencing this type of injury. Im a bodybuilder for years but I'm getting old. The difficulty with overhead racket sports (like badminton, squash or tennis) is that high level functioning of the rotator cuff muscles are required to stabilise the shoulder joint in what is naturally unstable positions (overhead, and with high speed movement).
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