Supraspinatus tear - medial information

A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle. The supraspinatus is part of the rotator cuff of the shoulder.
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1. PREPARED BY MARTIN SHAJI PHARM D 🔈 SUPRASPINATUS TEAR- medical information .

2. Introduction A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle. The supraspinatus is part of the rotator cuff of the shoulder. The rotator cuff consists of Supraspinatus, Infraspinatus , Subscapularis and Teres minor. Most of the time it is accompanied with another rotator cuff muscle tear. This tear can occur in 2 ways . Due To A Trauma Or Due Repeated Micro-trauma

3. The supraspinatus tear can be partial or full thickness tear. A partial tear means that the soft tissue (the muscle fibers) will not be completely disrupted. A complete tear on the other hand means that all the muscle fibers are disrupted. It is common that disrupted tendons begin by fraying and when the damage progresses the partial tear evolves into a complete tear. Most of the time the tear occurs in the tendon or as an avulsion from the greater tuberosity. The supraspinatus muscle is responsible for the abduction of the upper limb.

4. There are several factors that contribute to degenerative or chronic tears . • Repetitive stress • Lack of blood supply • Bone spurs (bone overgrowth)

5. RISK FACTORS • Older than 40 years old have a greater risk • Body Mass Index • Height • Repetitive Lifting

6. • Overhead Activities and other people who do overhead work have a greater risk : • Tennis Players • Baseball Pitchers • Painters • Carpenters • Plumbers • Traumatic Injury e.g. a fall, more common cause in younger individuals

7. So we can conclude that rotator cuff tears are associated with older patients, a history of trauma and affected the dominant arm. Patients have also a reduced forward elevation, external rotation and abduction. The most common risk factors for a tear consist of a history of trauma, dominant arm and age.

8. Some of the Symptoms of a Supraspinatus Rupture are : • Excruciating pain in shoulders • Severe pain in the shoulder with rotation of the arms • Severe pain in the shoulders when moving the arms sideways

9. A clinical diagnosis of your shoulder will include questions about how long you have had the pain for, whether there are certain movements that make the pain worse, and whether you have had similar problems in the past. It can be difficult to diagnose a supraspinatus tear because there are many other conditions with similar symptoms, including other types of shoulder tear in the rotator cuff, SLAP tear, or inflammatory conditions such as arthritis. Diagnosis

10. In addition to an examination, the GP may recommend: X-rays – to exclude conditions such as sclerosis Ultrasound – to quickly view the tendons in your shoulder and compare them to your other shoulder MRI – to show the tendon and detect any tears or inflammation.

11. TREATMENT FOR SUPRASPINATUS RUPTURE Supraspinatus Ruptures can be treated both surgically as well as conservatively. In cases if the rupture is pretty small, then conservative management with physical therapy is the best route to go. Physical therapy is also used for individuals with extremely large tears which cannot be repaired via surgery. Conservative option is best for people who want to prolong or even if possible avoid surgical procedure due to the prolonged recovery phase postprocedure .

12. If conservative treatments fail to provide adequate relief of symptoms, then surgery is the route to go but the success of the surgery depends on the extent of the tear and the condition of the muscles. The surgical procedure is done using arthroscopic technique in which an arthroscope which is an instrument with a miniature camera attached to it is inserted in the shoulder via small incisions and the internal structures are observed to look for damage and once identified the damage is repaired. Postsurgery , the tendon will take up to four months to completely heal.

13. To increase range of motion one can use stretching exercises of the ruptured muscle (not too soon in recovery since premature stretching might aggravate the injury), passive- and active range of motion exercises such as pendulum exercises and symptom limited active-assisted range of motion exercises. To increase control and strength the patient will also be prescribed strengthening exercises for the rotator cuff specifically the functions of the supraspinatus muscle (abduction and exorotation ) and external rotation

14. medication may include pain-relief and anti-inflammatory drugs to reduce swelling in the shoulder physical therapy involves advice on exercises to carry out which restore flexibility and strength to your shoulder. This is a common form of treatment, both for minor shoulder injuries and for patients recovering from shoulder surgery . steroid injections are sometimes recommended to provide short-term pain relief if medication hasn’t worked

15. surgery may be considered if the tendon has been badly torn and unlikely to heal on its own. Surgery might involve reattaching the tendon to the born, or transferring a nearby tendon to replace the damaged one. In extreme cases, surgery might involve replacing the shoulder joint.