intrasubstance supraspinatus tendon tear

[MrPhysio+]

Hello Maria,
If you see a sports physio or shoulder specialist physio there is little chance any tear would be aggravated. Some interesting facts: on scanning 100% of 80 year olds, 80% of 70 year olds and 50% of 60 year olds have tears in the supraspinatus tendon whether or not they have symptoms. Also, up to 50% of ultrasound scans give incorrect results ie false positive, false negative or innaccurate estimate of tear size. It is quite possible to have a supraspinatus tear without symptoms, which means that even if a tear is confirmed there may be other reasons for the symptoms. Sometimes a tear can settle, but the muscles supporting the shoulder can be affected by the previous pain or swelling, creating a problem of shoulder joint stability and / or alignment that may be giving you the current problems, or at least contributing. A sub acromial bone spur can form to create problems and the supraspinatus tendon may become partially calcified due to ongoing trauma or initial trauma.

All the above is written to show that shoulders are complex and the symptoms can be caused by many factors. Scans alone are insufficient to base treatment decisions upon. Proper diagnosis requires scans, physical assessment, history taking, possible cause and integrating response to treatment. Sometimes a diagnosis requires visualisation of the area via arthroscopy which may then proceed to repair. There are treatments that can be tried before surgery that can be effective in stopping the need for surgery. MRI is better than ultrasound for scanning. 3D CT scans are wonderful to visualise the bony structural alignments eg bone spurs.
Once again, I hope this information helps.
Cheers,
MrPhysio+

[theshoulderguy]

Maria, in the hands of someone who knows what they are doing and who has a good grasp on shoulder diagnosis and rehabilitation you will most likely have a successful outcome.

The cuff is effectively intact (intrasubstance only) but degenerative. The bursa is, it seems irritated and reactive.

It is highly likely that your rotator cuff and scapula muscles are dysfunctional but with a graduated physiotherapy program including massage, heat, trigger point therapy, mobilisation, postural correction, scapula stability and rotator cuff activation (loading) drills over an approximate 90 day period you should see some positive results if the diagnosis and therapy are accurate.

However, as has been previously stated shoulder pain is complex and the root cause can be different to the presenting problem and unrelated to the presence of a cuff tear so a thorough assessment is essential.

What we know about cuff tendons is they have a tendency to propagate and become larger tears over time. Likewise as previously stated they become more prevalent as we get older, whether we get symptoms or not is another thing (explanation) all together.

Best thing... get in early, get educated, become more aware of how to engage the right muscles to improve the performance of your shoulder NOW because there are no guarantees. You're only young and have hopefully a healthy biology so you should do well.

Good Luck!

Luke

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[M.C.1968]

Thankyou Luke, you have adressed my concerns and again given me great advice. thanks