Supraspinatus tendon tear

[jellybean]

Hi,

'Just wondering if anyone out there has either torn their Supraspinatus tendon at the insertion into the humerus (i.e. where it attaches to the bone) or treated this?

I ended up with a small (10mm x 5mm) full thickness tear at the central insertion nearly two years ago as the result of a skiing fall. As a complication, I developed a secondary capsulitis (frozen shoulder) which affected me up until a few months ago (at which point I did my knee!!?@#%* but that?s another story - my ?purple patch? of injuries). I pretty much have full range of movement back in my shoulder now except for internal rotation which I?m told takes longer to return. I thought, apparently wrongly, that once the frozen shoulder resolved I would be pain free. But that?s not the case. It is still constantly sore and really lets me know it if I do anything slightly out of the ?ordinary? (that can be something as simple as carrying a heavyish bag in each hand or lifting a bike off a bike rack).

My questions are: i. is this something I just have to put up with (I seem to remember someone saying at some stage that I?d be better off with a complete tear in the body of the tendon than the small tear at the insertion) or can something be done about it? ii. Is there any way of telling whether the tear?s getting any bigger short of getting another ultrasound or MRI? (The sports physician who last saw it ? 18 months ago - told me at the time that the tear was borderline for surgical repair and that if it got any bigger it would require it).

?Interested to hear thoughts or experiences from others who have experienced or treated this sort of tear.

Thanks!

Cheers,

Jellybean

[kjwilkin]

Hi,

'Just wondering if anyone out there has either torn their Supraspinatus tendon at the insertion into the humerus (i.e. where it attaches to the bone) or treated this?

I ended up with a small (10mm x 5mm) full thickness tear at the central insertion nearly two years ago as the result of a skiing fall. As a complication, I developed a secondary capsulitis (frozen shoulder) which affected me up until a few months ago (at which point I did my knee!!?@#%* but that?s another story - my ?purple patch? of injuries). I pretty much have full range of movement back in my shoulder now except for internal rotation which I?m told takes longer to return. I thought, apparently wrongly, that once the frozen shoulder resolved I would be pain free. But that?s not the case. It is still constantly sore and really lets me know it if I do anything slightly out of the ?ordinary? (that can be something as simple as carrying a heavyish bag in each hand or lifting a bike off a bike rack).

My questions are: i. is this something I just have to put up with (I seem to remember someone saying at some stage that I?d be better off with a complete tear in the body of the tendon than the small tear at the insertion) or can something be done about it? ii. Is there any way of telling whether the tear?s getting any bigger short of getting another ultrasound or MRI? (The sports physician who last saw it ? 18 months ago - told me at the time that the tear was borderline for surgical repair and that if it got any bigger it would require it).

?Interested to hear thoughts or experiences from others who have experienced or treated this sort of tear.

Thanks!

Cheers,

Jellybean

Hi there,

If I was you I'd go back and see a good sports physician. There is no substitute for good professional advice. You only get one body and you need to look after it.

Shoulder injuries are extremely painful. I've currently got an unstable shoulder and am in a lot of pain. Am due to have surgery to stabilise it in early September. So, I can understand how frustrated you must be feeling.

Where are you based ? I know a fantastic shoulder physio and sports physician in Melbourne. My shoulder physio has helped me helps.

Good luck !

[jellybean]

Hi,

Thanks for your post. You are right, both about the need to seek professional advice and ?you only get one body? bit.

?Sorry to hear about your injury, I can definitely empathise with the pain part. The pain in my shoulder kept me awake at night for about 12 months (constant pain and poor sleep are not good partners) and, while I?m not a fan of cortisone, by the time I eventually agreed to have a shot (I tried acupuncture and physio first) I was in so much pain I would have begged for it. Fortunately it gave some relief for about 4 weeks and in that time we made a breakthrough in physio and I started to get some range and function back. The pain I have now is not like that, just an annoyance. I bet you will be glad to have the surgery and get some normality back in your life (once you get through the rehab)!?

I?m based on the northern beaches in Sydney. The sports physician I saw last time re my shoulder (specialises in shoulders) is excellent but is away with the Boomers at present and my shoulder physio (also excellent) moved to NZ a few months ago!! (but I have an alternative). My bigger priority at the moment however (because it is more problematic and affects more of what I do) is to get my knee sorted out. Had surgery 4 months ago (partial menisectomy and chrondroplasty to repair damage to back of patella). ?Thought rehab was going well but as soon as I started pushing it a bit on the bike (and I am doing nothing compared to normal) it started ?blowing up?. Something is clearly not right. Went and saw another sports physician on Friday for a thorough review. He thinks I may still have a meniscal tear (significant swelling, pain on medial joint line and a positive McMurrays in deep flexion)!? Unfortunately it looks like I will be getting back on the medical merry-go-round. I just want a body that functions normally again.

A valuable lesson from the doc visit was something he mentioned as an aside - that my immune system has obviously not been functioning too well. (I am not normally ?injury prone?, ?have had no real injuries for nearly 20 years despite a very active lifestyle and rarely get sick, but in the last two years have had 2 quite serious injuries with complications and prolonged rehab. I?ve also just had a mild case of pneumonia]. It?s something I hadn?t considered (but should have ? it?s so obvious). This corresponds with a period in which I set up my own business and have been working pretty crazy hours. Has been worthwhile professionally and is easy to do because I love the work but I obviously need to get my life back in balance and give myself some time to ?stop and smell the roses? (something I?m not very good at ? I?m always on the go whether it?s work or play). A bit of a wake up call.

Anyway, enough waffle from me. Keep us posted on your shoulder surgery ? keen to hear how it goes and I know it helps to know there?s others out there who have some idea what you?re going through.

Good luck!

Jellybean

[sisterno3]

Hi
Have been going through something similar over the last 12 months. have just gone through the MAAS assessment and had the assessor tell me to pursue a shoulder specialist. Do not seem to have the severity of problems that you describe though.
What i have discovered is that whilst i maintain my fitness level (AerobicsX3 per week, weight program monitored by my physio X 2/week, cycling X 5/week) my shoulder survives OK. It is when i push the performance that it hurts and causes pain. So as a result i modify life activities (work - computer based, house painting etc) to not more than 2 consecutive hours. If i do more than that i WILL get pain and only rest, Ibuprofen and hot packs will resolve it.
as i was hit by a car on my bike my physio and the MAAS assessor tell me that the only reason it is not worse is because i was in "almost peak" physical condition at the time. I am getting the strong impression that unless I wish to pursue surgery (my quality of life is not that severely affected at this point - and shoulder surgery is problematic at best) then the fitness activities i currently do (see above) are going to be a good conservative management process - pro tem

Hope that this helps

[jellybean]

Hi sisterno3,

Thanks for your post.

My experience with my shoulder injury is similar to you in some ways. The supraspinatus tear was on the borderline for surgical repair (I was told by my sports physician that if it got any bigger it would have to be surgically repaired), and possibly would have warranted it if I was still competing but I'm not so we used conservative measures to treat it. I still have a few problems with it - like you mostly when I do anything that involves reaching above my head or lifting anything out in front or above my head. I definitely couldn't last 2 hours! Plenty of physio and rotator cuff exercises, however, have helped make the shoulder stronger and I am glad I took the conservative approach. (I also modify the way I do things to avoid aggravating it).

I also ride and when I had the frozen shoulder I had to stick to the wind trainer and ride sitting up, no hands - I couldn't put any weight on my hands on the bars initially (and the vibration from the road also caused pain my shoulder), and then, at it's worst, I couldn't reach the bars (I thought about modifying my bars and shifting my right hand brake and gear lever over to the left (it can be done) so I could reach the bars and ride on the road, but the continuing vibration problems put an end to that idea).

'Sounds like you have a good rehab program in place. Keep up the good work and take care on the roads (I haven't been hit - touch wood - but have had a few very close shaves).

Cheers,

JB

[bdnik]

I've been researching articles on the internet related to shoulder rotator cuff tears(supraspinatus) and came across this thread. I had a construction accident in 2000 that required surgery on my left shoulder to repair the supraspinatus(not knowing at the time I also tore my right shoulder but not to badly then). The left shoulder injury was a full tear and required 8 anchor pin to reattach the tendon. Over the next year I retore the tendon and went through a second surgery in 2001. This time it required 8 more pins and a special surgurial patch made by Johnson and Johnson that was cultured in a lab. It was supposed to help hold things together and would dissolve in a few months. I still have some discomfort with my left shoulder and am not able to sleep on that side. I am 58 now, and very physically fit. I work out several times a week, but am very limited to how much weight I work out with. Now my right shoulder has the same type of tear(1.5 cm). I have gone through PT for 12 weeks which helped some. I am not able to sleep on either side, but still am not ready to go through surgery knowing the time it takes to recover. I am looking for atlernatives to surgrey. I was just wondering how the people in this thread are doing and how you're helping yourselves. Thanks
Brad

[kjwilkin]

I've been researching articles on the internet related to shoulder rotator cuff tears(supraspinatus) and came across this thread. I had a construction accident in 2000 that required surgery on my left shoulder to repair the supraspinatus(not knowing at the time I also tore my right shoulder but not to badly then). The left shoulder injury was a full tear and required 8 anchor pin to reattach the tendon. Over the next year I retore the tendon and went through a second surgery in 2001. This time it required 8 more pins and a special surgurial patch made by Johnson and Johnson that was cultured in a lab. It was supposed to help hold things together and would dissolve in a few months. I still have some discomfort with my left shoulder and am not able to sleep on that side. I am 58 now, and very physically fit. I work out several times a week, but am very limited to how much weight I work out with. Now my right shoulder has the same type of tear(1.5 cm). I have gone through PT for 12 weeks which helped some. I am not able to sleep on either side, but still am not ready to go through surgery knowing the time it takes to recover. I am looking for atlernatives to surgrey. I was just wondering how the people in this thread are doing and how you're helping yourselves. Thanks
Brad

Hi Brad,

I can appreciate how frustrating shoulder problems are due to currently suffering from shoulder instability. Currently I am at my last teather as to what to do. I do pilates twice a week which has helped in terms of building the muscles around my shoulder. I do it with two different phyios that supervise me.

In Melbourne I have seen John Salmon, an OS that specialises in shoulders. I am due to undergo surgery with him in early March. I am also getting another opinion from Greg Hoy who is meant to be the other really good surgeon for shoulders in Melbourne in mid February. Whereabouts are you based ? It may also be worth going to see a sports physician that may have some other suggestions on non-operative treatments.

Good luck and let us know how you go.

[angieliu]

Hi JB,

Sorry to hear that you are having troubles with both your shoulder and knee. I think that it sounds like you need to take things a little slower. But I'd get it checked out if you are still concerned. When I was looking to find a second opinion in Sydney, the Sydney Shoulder Clinic were really helpful (02 9744 2666). Hope your shoulder and knee gets better soon.

Angie

[jellybean]

Hi Ang,

Thanks for your post. It's a while since I wrote my initial post in this thread and my shoulder has settled down again. I've pretty much decided that it is something that I have to put up with and am just looking after it with rotator cuff exercises and by modifying the way I do everyday things (I try and avoid things I know that aggravate it, e.g., lifting things out in front of me or above my head). Seamus did mention that it would remain "symptomatic" and he should know, apart from the fact that that is his area of professional expertise he also has rotator cuff injuries in both shoulders. (My focus has been on getting my knee right - far more problematic). If I do have more significant problems with my shoulder I will have no hesitation in going back to the people I've mentioned in the shoulder threads. They have all been excellent.

P.S. You're right about the need to slow down, it is one of my New Year's resolutions - but it won't be starting until after February - lol - Jan/Feb are crazy workwise.

Thanks again.

Take care.

JB

P.S. Brad, just saw your post - see my comments above re shoulder rehab exs and modfiying your activities. Make sure you are also seeing a good sports physician who is good with shoulders. Good luck!

[angieliu]

Hey JB,

I think you're right about your shoulder, it's just something you have to put up with. I'm in the same boat. If it plays up a bit, I just have to take it easy and scale things down a bit and when it feels better, I still have to learn to be good to it. As for movements like lifting things in front of me and to the side , I always get this clunking noise and I think that will just stay there so I just avoid it.

As for your knee and slowing down. I never really appreciated how good rest can be until just recently after taking 2 weeks off and not going to the gym because of the christmas/new year period and going travelling and my shoulder has been so nice to me. It's amazing what it can do.. So take it easy!

[jellybean]

Hey Ang,

I think for my shoulder "just putting up with it" unless it really becomes problematic again is the best solution, but that conclusion was reached after two years of seeing people, getting treatment, and rehabbing it as much as possible, etc. It's not the best solution for everyone (seeing good medicos and making decisions based on their advice about your particular injury is). I just need to be careful with the shoulder, especially when I start skiing again (hopefully this winter), it probably wouldn't take much to push it over the edge.

My shoulder clunks and grinds and feels horrible when asked to do things it doesn't like - one reason why freestyle swimming now seems to be out for me (I tried a few weeks ago for a total of 25m and was rewarded with an aching shoulder for about 5 days afterwards). I am now sticking to kick only in the pool.

'Glad your shoulder eased up a bit over the break - a nice reward!

Cheers,

JB