Naples Orthopedic Surgeon - Dr. Robert J. Zehr » supraspinatus tendon

Rotator cuff injury is two years old, too late for surgery?

admin — Mon, 29 Aug 2011 11:00:46 +0000

I injured my rotator cuff about two years ago. At that time, I didn’t have insurance to pay for the surgery. Now with a new job, I want to get this taken care of. But I’m wondering if I waited too long. Do the results depend on the timing of the surgery?

Most rotator cuff tears affect the supraspinatus tendon. If the force of the injury is enough, the tear can extend posteriorly (backwards) to include the supraspinatus tendon. Less often, the subscapularis tendon is injured. If the force is great enough, the tear extends anteriorly. The long head of the biceps can be damaged. This causes a condition called biceps tendon disorder.

Early surgical repair is advised for tears that extend through half (or more) of the tendon. With no delays in treatment, there is less muscle atrophy, less fatty infiltration of the tendon/muscle unit, and less scarring in the area. After three to six months from the time of the injury, pain and loss of motion are signs that surgery is still needed. More than six months after the injury, the surgeon will want to re-evaluate the shoulder and see if the tear can be repaired. Sometimes severe tears cannot be repaired. Instead, shoulder rehab is needed to regain as much motion and function as possible.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Can you have a torn rotator cuff and not know it?

admin — Thu, 21 Jul 2011 11:48:50 +0000

Is it really possible to have a torn rotator cuff and not know it? My aunt tells me she was diagnosed with this type of injury. But they aren’t going to treat it because it doesn’t hurt. Does that seem reasonable to you?

Rotator cuff injuries can be difficult to diagnose. It is indeed true that many older adults with degenerative soft tissue changes have no symptoms. They are said to be asymptomatic. Studies show that it is possible to have a full-thickness tear of the rotator cuff without any symptoms. Finding a clinical test that can accurately diagnose a rotator cuff tear has been a challenge. There are four different tendons that form the rotator cuff. There’s a different clinical test for each one. But sometimes it’s impossible to separate out the supraspinatus from the infraspinatus (two of the commonly involved tendons). The surgeon may have to rely upon ultrasound or other more advanced imaging to make an accurate diagnosis. Many prefer arthroscopic exam because the repair can be done at the same time. Ultrasound does have the advantage of being able to compare one side to the other without invasive surgery.

I injured my rotator cuff two years ago. I couldn’t afford to have surgery at that time, but now I can. Did I wait too long?

admin — Tue, 10 May 2011 16:15:50 +0000

Outcomes of surgery for a rotator cuff tear depend on a wide range of factors. Patient age, duration of symptoms, and time from injury to surgery can make a difference. Even more important is the type and severity of injury.Most rotator cuff tears affect the supraspinatus tendon. If the force of the injury is enough, the tear can extend posteriorly (backwards) to include the supraspinatus tendon. Less often, the subscapularis tendon is injured. If the force is great enough, the tear extends anteriorly. The long head of the biceps can be damaged. This causes a condition called biceps tendon disorder.Early surgical repair is advised for tears that extend through half (or more) of the tendon. With no delays in treatment, there is less muscle atrophy, less fatty infiltration of the tendon/muscle unit, and less scarring in the area.After three to six months from the time of the injury, pain and loss of motion are signs that surgery is still needed. More than six months after the injury, the surgeon will want to re-evaluate the shoulder and see if the tear can be repaired. Sometimes severe tears cannot be repaired. Instead, shoulder rehab is needed to regain as much motion and function as possible.

Shoulder Impingement May Be Causing Swimmer's Pain

admin — Fri, 21 Aug 2009 12:44:38 +0000

I am on my high-school swim team. I have been swimming competitively since I was eight years old. Last season, I started to get shoulder pain doing freestyle. The pain is the worst when my hand goes into the water. Is there any kind of stretching or exercise program I can do for this?

You may be describing a problem called shoulder impingement. Impingement of a tendon causes pain for swimmers at the point of hand entry into the water. In this position, the arm is rotated inward with the hand turned palm and thumb down. The supraspinatus tendon of the shoulder rotator cuff may be getting pushed up against a ligament that crosses the tendon just above it.

Before starting any kind of exercise program, it is important to find out exactly what is causing your symptoms. There are a variety of specific tests that can be done by an orthopedic doctor. Early identification of the problem can help prevent small problems from getting worse. Treatment may involve anti-inflammatory medication, physical therapy, or surgery.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com

Does Shoulder Injury Require X-ray or MRI?

admin — Thu, 20 Aug 2009 14:25:46 +0000

I started a weight-lifting program at home two weeks ago. When I increased to 20 pounds for shoulder movements, I felt a pop in my left shoulder. There was a twinge of pain at the time, and the next day I had extreme shoulder pain. I went to see the doctor, and she said I tore the supraspinatus tendon. There were no X-rays or other tests done. Shouldn’t I have X-rays or MRI?

X-rays have limited value in a case like this. Your doctor might have ordered an X-ray if she thought you could have fractured a bone. MRI (magnetic resonance imaging) is a useful test to identify damaged shoulder tendons. However, it is not always necessary to perform these studies. MRIs are very expensive, and most tendon tears can be accurately identified with a careful physical examination and history. An MRI is probably not necessary unless the doctor is considering surgery. If you do not get better after a program of physical therapy, the doctor may reconsider ordering an MRI. Getting a second opinion from another doctor may confirm the diagnosis at a lesser cost.