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Is surgery preferred for SUPRASPINATUS TENDON TEAR?

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A little over a year ago I sustained a tear in my right shoulder as a result of an automated door closing on my arm while I was going in (of a store). The doors were open to begin with and then I started going in and all of a sudden the doors started closing on me. I stuck my arm out against the door while it was closing and right away I felt some discomfort in my shoulder. I had my shoulder checked out by a doctor who recommended an ultra sound. My results are as follows:

The right suprasinatus tendon contains a partial width full thickness tear measuring 4 by 2mm, in the anterior fibers approximately 8mm lateral to the biceps tendon. The infraspinatus contains a subtle hypochoic region measuring 0.5cm within the tendon substance consistent concerning for an intrasubstance tear. The subacromial/subdeltoid burn is thickened to 3mm. The subscapularis and biceps tendon are intact.

Impression: Full thickness partial width tear involving suprapinatus. Overlying bursal thickening.

What are your impressions of these findings? I am really into going to the gym, keeping fit and lifting weights. Would you recommend surgery or can I continue lifting weights with this? I have done physio for 3 months already including icing it and doing band exercises. I feel my right side is a bit sore compared to my left side but I am able to do bicep curls and chest press without too much pain. I just didn't want to make it worse over time.

Please let me know what you think of this. How big is this tear exactly (so I can think of it besides numbers). I was thinking of shoulder surgery but it may take up to a few years to get it done free publicly in Canada. I am curious of the meaning of full thickness partial width tear. Please fill me in.



Category: Orthopedic Surgeon

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Category: Spine Surgeon
Dr. Mukesh Tiwari is online now

Expert:  Dr. Mukesh Tiwari replied 4 Days.

Thank you for your query at DoctorSpring.com.
I have read your query with diligence.
After the injury, you had a partial width full thickness tear of your supraspinatus tendon. A tendon is similar to a rope and you can compare the suprasinatus tendon to an inch wide rope. So partial width full thickness tear means that only a portion of the wide tendon was cut and this part was cut was though and through. In case of the said rope, it would be like a quarter or half inch cut such that the rope is left weakened and gaping but still continuous. I hope you could understand this. The exact size of your tear can be determined only from the ultrasound image by the sonologist performing it unless it has been mentioned in the report
Tendon tears usually take a long time to heal. This would explain the soreness.
If you are having problem with your routine work, presence of persistence pain then you should go for surgery. Generally, surgery done within a month of injury has good results. In your case it has already been a year. In chronic cases results may not be as good as in acute cases. You can discuss the option of surgery with your surgeon who would have examined and known the details of your case.
Since you still have some soreness persisting, weight lifting may not be a good idea as of now. You should give the tendon more time to heal.
Hope this was helpful to you.
Feel free to ask queries.
Thank you.

Dr. Mukesh Tiwari
Category: Spine Surgeon
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
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