Here is the indication as received from my MRI on 11/11/2009
Complete Rupture of the Rotator Cuff
Just posterios to the rotator interval, there is a 1.6 cm wide area of Bursal Surface Tearing and Tendon Degeneration in the distal Supraspinatus tendon involving 75% of the craniocaudal tendon thickness at its greatest depth. Some intratendinous delamination is evident to the infraspinatus tendon. Associated mild subacromial-subdeltoid bursa thickening and peribursal inflammationsuggest some type of external subacromial impingement. Additionally there is tendinopathy and extensive partial thickness tearing in the intra-articular long bicep tendon as it extends to the bicep/labral anchor. Tendinopathy and interstitial, partial thickness, tearing in the upper subscapularis tendon is also evident.
Limited evaluation of the labrum.
There is mild acromioclavicular joint arthritis. Small subacromial osseous ridge at the coracoacromial ligament attachment. No severe glenohumeral arthritis or fractures.
1. High-grade bursal/interstitial partial thickness tear in the supraspinatis tendon with intratendious delamination t the infraspinatus tendon. Given the subacromia/subdeltoid bursa edema and inflammation the finding suggest some degree of external subacromial impingement.
2. Markedly abnormal intra0 articular long bicep tendon with tendinopathy and partial thickness tearing of the subscapularis tendon. This may reflect the hidden lesion.
The recommendation of the Doctor is I have to have surgery. How severe is this in relation to what others have experienced? I'm 33yrs old. I love to golf, workout etc. I'm searching for some advise if you will. Thanks!
Hoopefully you'll get a reply from Sharon (aka SSkylor, resident PT) but all I know is that I saw subscap and bicep tendon in your post and I am feeling your pain. Had repairs done to both tendons (biceps tenodesis) and the subscap is the really icky one since it allows all your interior and exterior moions.
Good luck and hopefully someone can translate for you but it does sound like you will be joining us in surgery and the longggg recovery process.
Chris May I ask how long you have any kind of shoulder pain? Besides golf what else exactly do you do for work and activities like overhead stuff?
The best thing you have going for you is your age. In summary you have all tendons plus the bursa either torn or very inflammed. The most serious would be the supraspinatus tendon
which is 75% torn, this is the muscle that moves the arm out to the side. The next is the subscapularis muscle which has a partial tear, like Gale said moves the arm toward and away from the body. You have tendonopathy of the biceps and degeneration of the infraspinatus.
So this is alot to repair in one shoulder. Most on this site have a SLAP tear which does not appear to be a problem on your MRI and then many have one tendon and the SLAP. You have 4 tendon problems, 3 that will need repairing and a sub acromial decompresion likely to make room for the cuff muscles to avoid future impingment problems. So in comparison to others it is alot. You will most likely be in a sling for 6 weeks , read the site for pre-op preparations. Hopefully you will find a very good surgeon and PT to follow. Ask lots of questions about his post-op protocol. Good Luck, Sharon
First off thank you for the reply. Back in May, I fell out of a tube and a canoe multiple times. Funny I know! That is when I first noticed it. I have an office job so very little lifting is needed.
I considered the shoulder more of a pain in the butt for about 5 months, but I was able to do most everything. About a month ago is when it really started to hurt at night.
I'm right handed and it is my left shoulder. The weird part is an overhead press does not cause me any pain. Bench pressing really doesn't either. Turning the steering wheel hurts, putting my arm into a shirt/jacket hurts and sleeping.
So the facts are tendons won't heal, correct? Can the inflammation subside and other muscles be strengthened to avoid surgery?
I know I'm sounding like a broken record, but after reading the lifestyle change and chance of failure, is there anyone that has opted out of surgery in my position?
Thanks again for being patient. The whole thing is kind of surreal to me.