In case any physician or clinician tries to tell you that a large tear in the (supraspinatus portion of the) rotator cuff in the shoulder cannot be healed, other than selling you expensive steroid injections, or alternatively refers you to a specialist for a future surgery, mostly years later after having been on a lengthy wait list. Then my experience maybe helps to clear this up.
FIRST, explanation of what all these medical terms mean. [ https://physioworks.com.au/injuries-conditions-1/rotator-cuff-tears ]. The supraspinatus is one of the posterior muscles surrounding the shoulder, specifically the rotator cuff (source of many injuries), the others are trapezius and the largest the deltoid. Important to know is that these are some of the muscles needed to lift or rotate the upper arm.
Unfortunately, when an injury occurs, usually very painful, the first treatment seems to always be prescribing pain medications including most often steroid injections into any of the upper arm muscles. More than not, nilly/willy anywhere. Resulting in either subduing pain, not longer than 4 months, or what is worse, resulting in no pain reduction. Does that sound familiar ?
Plus, injections should always be given ‘guided’ (using a monitor) and by a specialist to know where the needle goes in. Remember, once an injection received, this treatment may go on forever, mostly not resulting in any repair of a tear in the muscle’s tendon. The opposite may more likely be the case.
Surgery ? Not the answer either. Why ? Firstly, surgery cannot be done for elderly patients because their tissue is thinner. Ergo, the tear will probably get worse. Secondly, even if the surgery is using good healthy tissue, no guaranty that pain is resolved and all is well.
Here is my case. January 2016 received an injury in my right arm. Throughout 2016 pain went into my right shoulder. October 2016 ultrasound shows sub deltoid bursa inflammation [Bursa m/l is padding between muscles and bone.], but no focal tears. November 2016 first corticosteroid injection into sub deltoid by GP (no ‘guidance’). After that, I was pain free for 3.5 months. March 2017 the second corticosteroid injection (both were using Triamcinolone acetonide) into my deltoid. No pain reduction whatsoever. Done by same GP in office unguided.
April 2017 several physio therapist sessions, with pretty severe moving of my right arm and shoulder. Needless to say the pain I suffered. June 2017 third and last steroid injection, done guided in hospital, using Depo Medrol. Again, pain was worse after that.
Referred to physiatrist specialists. End June 2017 request for MRI of shoulder.
December 2017 results of MRI id’d : Large tear involving supraspinatus portion of rotator cuff. The doctor who had requested this MRI told me, and I quote:
“There is nothing we can do about this, except continue steroid injections. Surgery is out of the question” [mind you, I never considered surgery] . More steroid injections, thanks, but no thanks.
Instead, I started healing myself since October 2017. My program:
Five times a week working in the local YM/YWCA swimming pool, aqua fit program or swim, then warm pool, weights, carefully moving my right arm and shoulder, to strengthen the surrounding muscles.
What helps is heat. When tissue is still inflamed, ice. I bought myself equipment such as ice pack, and a little ultrasound machine, for that torn upper arm and shoulder. Cannot say, that that helped a lot. Neither did Voltaren gel.
When moving or rotating my right arm, very carefully done. After not being able to lift my right arm, I can do it now, best when heated (under hot shower or in steam room). I am doing better now. Best yet, I save money by helping myself. [At this point I need to mention, be careful, follow your own instincts and programs.]
Checking the NET, there are umpteen sites on “healing rotator cuff tears”, most of them try to sell something. Found a fairly good one :
[ http://www.aidmyrotatorcuff.com/rotator-cuff/stretching-and-exercise-for-a-rotator-cuff-tear.php ]. Also my good book bought ten years ago gives lots of insights.
NOTE. I have not yet had a follow up ultrasound to actually see if that tear is smaller or fluids are still retained. Not likely at my age (80 years) I would get anything done anymore. Nor, do I make the premise that any of such injury can be completely healed.