intrasubstance supraspinatus tendon tear

[theshoulderguy]

MC1968, you have to be careful when making a diagnosis based on an ultrasound report or examination as it is a very user dependant investigation. In fact a small intra-substance tear could just be an incidental finding or intrasubstance swelling but it is the overall rotator cuff tendinopathy or degeneration that may be contributing to a lack of shoulder performance and painful bursal involvement.

On the other hand the ultrasound may be under reporting the pathology present...all dependent on the user?


Tendons need appropriate mechanical stimulation for optimal health.

However, if you have overloaded or in fact under loaded the tendon at some stage or are doing so right now during daily activity or at gym or sport then your problem is likely to persist. In your age group it is usually related to an overloading incident.

The tendon gets overloaded, struggles to return to normal, the bursa gets involved (contributing to the night pain), injection therapy if successful can reduce the pain significantly if only for a short while indicating that the pain is more likely bursal related. More over the rotator cuff starts to fails in its humeral head control leading to further impingement and bursal irritation etc etc

Controlling the overload and pain is very important and an injection could be repeated in your case to allow a relative pain free window to get the full benefit of what is most important...a specific and graduated shoulder physiotherapy program that gradually increases the activation of your rotator cuff muscles allowing hopefully a normalisation of the surrounding tendon structure and better shoulder performance.

Only thing is you got to get in early and start the rehab asap.

Good Luck!

Luke

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