supraspinatus tear

[angela1]

The swelling and chest pain is due to the clavical separation. I wonder if you had a fracture that was missed. A bone scan would be able to pick that up. The pain that you describe in your arm and neck are typical of rotator cuff injuries. You will need the tendon repaired if possible - it may be complicated by the clavical displacement.

[sweens]

Although the Supraspinatus is an integral part of the rotator cuff in its role in initiating movement, you can function with a full tear. However most commonly I find a lot of people then suffer secondary symptoms where the surrounding muscles start to give a little too much of themselves and trigger points develop and effective shortening of the muscles occur. The Upper Trapezius fibres and Pectorals tend to be prone to this. After some time pain and shoulder complex dysfunction come into play.

If I was your Physio I'd start by dealing with any trigger points in all the prime suspects (and there are a few!). There are several effective techniques, such as acupunture, TP release, myofascial release. Posture correction is appropriate as is ensuring good Scapula control. Then you can start to look at (cautious) strengthening. If you're into doing weights I'd also be careful in not overloading the muscles you've had released. Loss of form and technique, and early fatigue in the shoulder are good pointers.

Ultimately it could be a stop gap and surgery might be the only answer. Have a look shirtless in the mirror. Does your shoulder roll forward or does it look like the 'ball' of the joint has dropped? They both [I]could[I] be an indication of bad the situation is.

All the best with your future treatment,

Sweens

[ramywhite]

Hello sweens,
"TP release???" Sorry, but I am not familiar with that abbreviation. Could you please explain what it is?
many thanks!

[emad]

Why are we going to use trigger point release therapy inspite of no pain ? He says very little pain meaning no active triggers there . What are we going to release ?

Cheers
Emad

[sweens]

The complainant did say he had no joint pain but did mention aching in the muscles surrounding the shoulder complex as well as some referred pain into the lower arm. This could be caused by inflammation in the joint granted, but it could indicate some active trigger pts not already assessed or found. Personally I would be surprised if there were none as he/she mentioned the injury is now 4-5 months old.

I just think ruling out all objective findings would be the way to go. My comments were based on the importance of a thorough subjective and objective assessment.

Sweens

[emad]

hi sweens ;

I think the issue of Trigger point therapy still needs research to support ,sometimes i see triggers as just sensitive neural areas/spots .Just my view .
As for this current shoulder case , i think practical assessing of this case is important ,because we can NOT assess the passive abduction if it is available or not to conclude the tear hypothesis ,because pain sometimes may be severe around shoulder that the motion could be thought of as paralysis or tear .

Cheers
Emad

[davidjack]

hi its high time u r going for MRI after 8 long months.its ok then, u said x-ray shows clavicle separation. ur symptoms & x-ray corelation shows u hav AC JOINT SEPARATION. just check with ur ortho surgeon to rule out it.
there r diff grades 1,2 ,3. urs may possibly maybe 2 r 3. even if its 2 r 3 dont worry it can be made alright.do reply after MRI result