Where is supraspinatus tendon

I'm sorry I can't give you specific advice on your case over the internet. In general terms of the types of MRI findings you have described, a combination of these types of pathology could require surgery; particularly if symptoms persisted after trying non-surgical interventions. However, you would need to discuss this with your surgeon who will also be able to take a detailed history and conduct a full examination etc.

I mention this, as this will often influence treatment decisions. Just got my MRI report back on right shoulder and wanted to know if you could shed some light on it. A-C joint is moderately to severely degenerative. Osteophytes and inferior capsular swelling indents the superior margin of the mytendinous junction of supraspinatus. There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval.

Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. 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.

It is possible this tear may communicate with the bursal surface anteriorly. Infraspinatus tendon is somewhat hetrogeneous in its deep attachment with what appears to be intra-substance tears down to enthesopathic change at footprint. It sounds as though you know a little bit about your shoulder situation already, so I won't re-state details about the anatomy that is affected. I also can't give you specific advice about your situation over the internet etc. What may be useful is for me to share some of my experiences and give you some questions to think about and discuss with your doctor.

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.

It sounds like you may have already discussed the likelihood of success with your surgeon, if not, this would be a very wise thing to do.

Equally as important is a discussion about the likelihood of certain outcomes without further surgery. This will help you figure out what you are deciding between. Sometimes the success rate of a second surgery is not as high as the success rate of the first surgery 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.

You may still be able to return to most or all of the things you enjoy At 55 years of age you still have a lot of living still to do, so don't be afraid to talk openly with your doctor about the success rates for all of the options available to you, and the likely recovery times involved.

I had rotator cuff surgery in May for a Small 2mm tear In the supraspinatus tendon. After 4 months of therapy and 3 injections I am unable to lift my right arm. Above my shoulder or behind my back without pain.

I had an arthogram-MRI which showed a 4 mm near full thickness u-shaped tear involving the supraspinatus tendon anteriorly near but not actually at the numeral attachment. This tear leaves only a very thin layer of intact cuff at the site, no impingement, labrum is intact. There is longitudinal split in the subscapularis tendon which extends from the humeral attachment to the musculotendinous junction.

My doctor has told me I need to have arthroscopic revision rotator cuff repair. I am 55 yrs. I am really concerned about success rates for revision surgery. I am worried I will not improve my ROM this time.

Especially since my injury has gotten worse instead of better. I am close to retirement and I am afraid I will not be able to do the things I once enjoyed, outdoor activities. Any advice would be greatly appreciated. This sounds like a difficult situation. It is good that you have discussed the recovery with your surgeon already.

From time to time tendons do rupture from a variety of causes, in your case it sounds like the surgeons description of rope fraying is a good one. When he says your tendon is failing, I think what he is trying to convey is that once some strands of a rope start to break, then there is more load on the remaining strands which may cause more strands to break and then more load on remaining individual strands, more strands tear This level of degradation is not particularly common for someone so young, but does happen from time to time and may well lead to a complete rupture.

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. However, I think the most important thing you mentioned was falling pregnant.

I would make sure your surgeon knows you are planning on falling pregnant within the next 12 months. Having the surgery sooner rather than later may help you to recover as much as possible by the time you fall pregnant.

If your tendon were to completely rupture while you were pregnant, this may be very problematic. Your surgeon and the anesthetist will not want to perform elective orthopedic surgery while you are pregnant to re-attach the tendon.

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. Additionally, you do not want to be dependent on strong medications to reduce pain while you are pregnant. 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.

Children are such a blessing and that time nursing your newborn is such a special and important time. Having pain and sub-optimal shoulder functioning while you are nursing would not be ideal. However, worse yet would be delaying in such a way that you miss out on falling pregnant or delivering a healthy baby. So I think it would be wise to discuss the timing of surgery with your surgeon in the context of wanting to fall pregnant.

Thanks for the update and let us know how you go. If you have any follow up questions just post them here and I'll get back to them as soon as I'm able. I wrote a previous comment He says that my tendon is failing. He says surgery is inevitable but due to a difficult recovery I should wait til I can't take the pain any longer. To recap I have had debridement and subacromial decompression, am 34 years old and now have arthritis, bursitis, tendinitis and impingement.

He says the tendon is fraying like a rope He kind of scared me regarding the recovery for this. Also not sure how long I should wait. He prescribed Vicodin and arthrotec for pain Any thoughts? What does he mean by my tendon is failing? It sounds like you are on the right track with your surgeon and physical therapist. I think these are promising approaches for the types of pathology you described. Your physical therapist should be able to help you improve the strength and functioning of your rotator cuff muscles.

This may not give immediate relief, but hopefully will show some benefit within 6 weeks. If not then, your surgeon will be able to give the likely benefits, risks and recovery time following surgery.

There are other things your physical therapist may be able to help you with to give you some relief in the short term. Recovery after surgery can be quite drawn out, often requiring 6 months or more before functioning becomes similar to before the injury. However, if no benefit has been observed after 6 weeks of PT, then discussion your options with your surgeon sounds like a good plan. Let us know how you go. There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described.

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. The recovery time after surgery is substantial and may vary depending on the surgeon, and specific structures repaired. However, some people will never experience the same level of recovery without the surgery. So while surgery always carries some risks which your surgeon will be able to explain , for some people this is the only option to experience a good outcome.

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. DrMikeM: Hi Dr. Here I am 5 days post op. This surgery is no joke!! For anyone contemplating surgery, buy a recliner to sleep in after surgery. It will be your Godsend. Don't even think you won't need help, because you'll need help with even the most basic daily tasks.

The pain is manageable if you stay on top of it with pain medication. Cold therapy cold therapy cold therapy!! I have a feeling this is going to be a long recovery! DrMikeM: wheather arthoscopy surgry ll help for my injury sir?

Due to a fall and resulting shoulder pain my doctor prescribed to have an MRI, the findings were; moderate tendinitis in the supraspinatus. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. There also is mild tendinosis of the infraspinatus at the footprint. Small to moderate glenohumeral joint effusion. Have been directed to work with a physical therapist and so far have not seen mprovement after two weeks but staying hopefull.

The incident happened on Sept 25 and it is now Nov Any suggestions and generally how long is the recovery period?

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? Thank you. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. 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.

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. 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.

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.

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.

They will be able to help you return to sport. Thanks for stopping by and sharing your interesting story. I'm sorry I can't provide you with specific advice, rather I only provide some general information. You may find it interesting to note that a prior subacriomial decompression is not necessarily an indication that future surgery to address other injuries or further biomechanical problems will not be successful. There are also non-surgical treatment options that orthopedic surgeons may consider for degenerative acromioclavicular changes, supraspinatus tendinopathy and subacromial bursitis.

Exercise is important for many reasons not the least of which are physical and mental health benefits. So don't give up on your ambition to participate in exercise. It may take a while to overcome your shoulder pain, and you may even need to modify the types of activities you do, but working hard to be able to return to exercise is definitely a worthwhile goal.

Sorry I can't give you specific advice over the internet, but it sounds like your shoulder specialist will be able to give you good personalized advice on Tues. Some general information you may find useful is that generally not a lot of people seem to have a full recovery following a SLAP lesion without surgery. I'm sure it is no surprise to you, but when someone is experiencing worsening pain with conventional conservative management like physical therapy this is also not a good sign for a speedy recovery without surgery.

On the other hand, there is nothing speedy about recovery after surgery This is just general information of course. There are many sub-types of SLAP tears and varying severity. Your shoulder specialist will be able to provide you with specific advice regarding your chance of recovery without surgery, as well as what to expect if you do decide to go down the surgery path. I had subacromial decompression February a year after a motor vehicle injury I am currently a 34 year old female. I started adding exercise back in to my life a couple of months ago and what had been intermittent pain has once again become fairly continual.

I returned to the orthopedic surgeon at which point he did an x-ray which looked good and sent for a mri Monday. Results are as follows Small area of subacromial bursitis present. I left out a bunch of other things that are normal. Any thoughts on treatment for this considering previous surgery?

Follow up not til next Wednesday. Pain is really consistent and moderate with moments of severe. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy.

SLAP type tear of the superior labrum. Moderately large joint effusion. Had mild discomfort in shoulder for a few weeks in August. Went down a water slide on a mat head first arms supporting my body. Severe pain after. Went to an orthopedic surgeon who said I had frozen shoulder and injected the capsule with cortisone and told me to return in 3 months. Sought 2 nd opinion 3weeks later due to the server pain. Couldn't even lay down. Did MRI of neck 1st which showed degenerative disc disease in c and c7-t1.

Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. Now I have these results stated above. Have been taking mg Motrin tid. Also now taking Tylenol with5 hydrocodone.

Being referrfed to a shoulder specialist Tuesday. Is surgery my only option? It sounds like you have several concerning symptoms there. I am sorry I am unable to provide any specific advice over the internet without conducting a physical examination etc. However, it sounds as though you must be under the care of a medical team in order to have received MRI results, which is a good thing.

In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. I am aware than many clinicians who administer prolotherapy advocate for its benefits though.

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.

Thanks to my hubby for finding this site. 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.

It's been very frustrating dealing with the chronic pain and reduction of normal activities in an attempt to adapt to my "new normal". In physio just weeks after the onset of injury, I was unable to lift a 1lb weight with the injured arm bent near armpit while lying on my back.

In the interim, physio, chiro, massage, taping were part of my pain management and ROM for all pain sites relating to MVA.

I completed 6 treatments of prolotherapy approximately 9 months ago prior to this latest diagnosis. It did manage to decrease my overall pain but I still feel like I'm suffering unnecessarily.

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. 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. DrMikeM: Well, I'm 3 months post injury and still in a tremendous amount of discomfort and pain.

I've met with 2 orthopedic surgeons and both have indicated surgery is my best option for recovery. That being said, I am scheduled for surgery on 6 Nov. I'm quite apprehensive and nervous about the surgery but more so about the recovery. It seems to be a long recovery period with a great deal of physical therapy following.

I do so appreciate the advice and direction you have given to myself and others through this posting. Wish me luck!!! Thanks again Dr. Without seeing the scan or conducting a physical examination, I can only offer some general comments in response.

There are a few interesting things worth noting here. The words 'very large, nearly complete 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.

Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon without surgery. If the nearly complete tear were to become a complete tear, this would require surgery ideally quite quickly to re-attach the tendon otherwise the functioning of the supraspinatus muscle it elevates the upper arm would be lost. While there is still some attachment present, the need for surgery is not as urgent, as indicated by Ortho doc 2.

It is interesting that you are not experiencing a lot of discomfort with a very large tear, but this sometimes happens and can lead to difficulty in diagnosing the exact structural damage that is causing the condition. This is a good example of why MRI's can be very valuable in cases like this.

If in doubt, don't be afraid to ask Ortho doc 2 about any questions or concerns you might have. The rehabilitation after surgery is likely to take time. Now, my Ortho doc 2 who recommended i do the MRI also reccomends a surgery to fix the tear.

He did say that it can be done in the next few months and no urgent intervention required. However it does bother me when i open the car door and my current range of left arm is restricted when i left up straight. 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.

Most people with ongoing pain will usually try the conservative interventions before considering surgery. However, in some cases it is clear that surgery is likely to be the best option. That is some interesting advice you have received. 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.

As I think you already suspect, an MRI is likely to have greater diagnostic accuracy for ruling out or in the involvement of other structures in your shoulder, such as the long head of Biceps Brachi. 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. My pain is mostly in the bicep area and I do not have trouble lifting the arm but bringing it back down and also bringing the lower arm down when the upper arm is at 90 degrees.

Must also have to bring the arm back with my other arm if I am lying and have the arm overhead When you thow something, for example a Javelin, you use the powerful chest muscles to propel it forwards. After you have release the Javelin your arm must decelerate. As a result, huge forces go through the supraspinatus and other rotator cuff muscles. But few people bother to train these muscles. A heavy fall onto the shoulder can also result in injuring this muscle. Injury can occur to the tendon as it inserts into the top of the shoulder on the humerus.

Read more on treatment and rehabilitation of rotator cuff tears. Shoulder injuries are either acute sudden onset , or chronic gradual onset caused by overuse. Here we explain the common and less common causes of shoulder…. Rotator cuff strain diagnosis involves a number of specific tests. Other shoulder injuries have similar symptoms so it is important to get an accurate diagnosis.

This rotator cuff strain rehabilitation program is based around four stages. The acute stage, immediately after injury, recovery stage, functional stage and returning to full…. This is accomplished by placing the arm behind the back, thus medially rotating the humerus. How big is the supraspinatus tendon? The mean superior to inferior tendon thickness at the rotator interval was Does supraspinatus initiate shoulder abduction?

Supraspinatus is recruited prior to movement of the humerus into abduction but not earlier than many other shoulder muscles, including infraspinatus, deltoid and axioscapular muscles.

The common statement that supraspinatus initiates abduction is therefore, misleading. How do you stretch the infraspinatus? Hold a stick behind your back with one hand and grasp the other end of the stick with your other hand. Pull the stick horizontally, causing the shoulder to passively stretch. Feel the pull generated with this movement. Hold for half a minute and then relax for half a minute. Why is Scaption important? Physios often use scaption as both an assessment and rehab point. It is particularly important for assessing the function of the shoulder blade.

Gentle pressure is used initially across the supraspinatus tendon until the area becomes numb, known as the analgesic effect.

At this point the depth of pressure is gradually increased without inducing pain. The length and frequency of treatment will depend on the stage of injury. Transverse friction massage should only be carried out by a trained professional such as a physical therapist as success relies on a good knowledge of anatomy and structural organisation of the tissue so that they can be applied to the exact site of the supraspinatus tendonitis lesions, in the correct direction and at the right depth for the appropriate duration and frequency.

Anyone suffering from painful arc syndrome should see a physical therapist. They will fully assess your shoulder and identify anything which may be contributing to your shoulder problem.

Physical therapy for supraspinatus tendonitis will tailored to what was found on examination and may include:. It is really important to avoid activities which bring on your shoulder pain to reduce the stress on the supraspinatus tendon and give it time to heal. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear.

If your painful arc syndrome is linked to sport, seek expert advice on how to improve your technique to reduce the strain through the rotator cuff to prevent further irritation and supraspinatus tendon damage. Painkillers and anti-inflammatories tablets or gels can help reduce pain and inflammation with painful arc syndrome.

Massaging a wet ice-cube over the tender area for 10 minutes can help reduce localised pain and inflammation. An injection of steroid and local anaesthetic can help to reduce pain and inflammation and aid healing with supraspinatus tendonitis. Steroid injections do temporarily weaken the tendon and can temporarily increase shoulder pain so it is important to take things easy for a few days and avoid any heavy lifting. If symptoms of supraspinatus tendonitis have failed to resolve after months of conservative treatment, then shoulder surgery may be recommended.

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.