The supraspinatus tendon is a component of the rotator cuff, a group of four muscles and their tendons that surround the shoulder joint. This tendon connects the supraspinatus muscle, located on the top of the shoulder blade, to the upper arm bone (humerus). Its primary role involves stabilizing the shoulder and initiating the lifting motion of the arm, particularly in the first 0 to 15 degrees of abduction.
What a Full Thickness Supraspinatus Tear Means
A full thickness supraspinatus tear indicates that the tendon has completely separated from its attachment point on the bone or features a complete rupture through the tendon itself. This differs from a partial tear, where only some fibers are damaged, but the tendon remains connected. Such a complete disruption often creates a hole in the tendon, signifying a significant injury.
The supraspinatus tendon is frequently affected in rotator cuff injuries, making it the most commonly torn tendon within this group. This type of tear can result from acute trauma, like a fall or sudden heavy lifting, or develop gradually from chronic wear and tear. Given the complete separation of tendon fibers, full thickness tears typically do not heal on their own due to poor blood supply within the tendon.
Signs and Impact of the Injury
A full thickness supraspinatus tear often presents with several noticeable symptoms that can significantly affect daily life. Individuals commonly experience intense pain, particularly when attempting to lift or rotate the arm, and this discomfort can worsen at night, especially if lying on the affected side. The pain might also radiate down the arm, indicating the extent of the injury’s impact.
Beyond pain, a significant weakness in the affected arm is a common indicator, making routine activities challenging. Tasks such as reaching overhead, dressing, or even carrying light objects can become difficult or impossible. This weakness is a direct result of the tendon’s inability to effectively transmit force from the muscle to the bone.
Limited range of motion in the shoulder is another symptom, as the complete tear restricts the smooth movement of the joint. Some individuals may also report a grinding or crackling sensation, known as crepitus, when moving their shoulder. If left unaddressed, a full thickness tear can lead to further muscle atrophy and a progressive decline in shoulder function, increasing the complexity of future treatment.
Approaches to Treatment
Addressing a full thickness supraspinatus tear typically involves considering both non-surgical and surgical strategies. Non-surgical options, such as pain management through medication, physical therapy, and activity modification, are generally less effective for complete tears. These approaches might be considered for older individuals with lower functional demands, those with significant underlying health conditions, or when surgery poses a higher risk.
Physical therapy in a non-surgical context focuses on maintaining range of motion and strengthening surrounding muscles to compensate, rather than repairing the tear. For active individuals seeking to restore full shoulder function, surgical intervention is often recommended. The primary goal of surgery is to reattach the torn tendon to the bone.
Surgical repair aims to alleviate pain and improve arm strength and range of motion. The underlying principle involves securing the tendon back to its anatomical insertion point. This reattachment provides a foundation for the tendon to heal and for the shoulder to regain mechanical integrity.
Path to Recovery and Future Function
Recovery following treatment for a full thickness supraspinatus tear, particularly after surgical repair, is a gradual process that demands patience and consistent effort. A structured rehabilitation program, guided by a physical therapist, is fundamental to regaining strength, flexibility, and range of motion. This program typically progresses through various phases, starting with protecting the repair and gradually introducing exercises to restore mobility and build muscle strength.
The recovery timeline varies significantly, often spanning several months. Initial phases involve immobilization to allow healing, followed by passive and active range of motion exercises. Strengthening exercises are introduced progressively, focusing on the rotator cuff and surrounding shoulder musculature.
Significant improvements in pain and function are common, though complete restoration of pre-injury strength is not always guaranteed. Prognosis factors include patient age, tear size, chronicity, and adherence to rehabilitation. Consistent physical therapy and post-operative guideline adherence are crucial for optimizing long-term functional outcomes.
Approaches to Treatment
Non-surgical options like pain management, physical therapy, and activity modification are generally less effective for complete tears. These approaches may be considered for older individuals, those with lower functional demands, or when surgery poses a higher risk.
Physical therapy in a non-surgical context focuses on maintaining range of motion and strengthening surrounding muscles to compensate. For active individuals, surgical intervention is often recommended to restore full shoulder function. The primary goal of surgery is to reattach the torn tendon to the bone.
Surgical repair aims to alleviate pain and improve arm strength and range of motion. The underlying principle involves securing the tendon back to its anatomical insertion point, providing a foundation for healing. Delaying surgery can complicate future repairs, as the torn tendon may retract.
Path to Recovery and Future Function
Recovery following treatment for a full thickness supraspinatus tear, especially after surgical repair, is a gradual process requiring patience and consistent effort. A structured rehabilitation program, guided by a physical therapist, is fundamental to regaining strength, flexibility, and range of motion. This program progresses through phases, starting with protecting the repair and gradually introducing exercises to restore mobility and build muscle strength.
The recovery timeline varies significantly, often spanning several months. Small tears may take around four months, larger tears six months or more, and severe tears six to twelve months. Initially, the arm is often immobilized in a sling for several weeks, with passive range of motion exercises beginning under therapist guidance.
Active movement typically starts after six to eight weeks, followed by strengthening exercises around eight to twelve weeks post-surgery. Significant improvements in pain and function are common, though complete restoration of pre-injury strength is not always guaranteed. Most patients achieve functional range of motion and adequate strength within four to six months.
Prognosis factors include patient age, tear size, chronicity, and adherence to rehabilitation. Older age, larger tear size, and poor muscle quality can negatively affect tendon healing. Consistent physical therapy and post-operative guideline adherence are crucial for optimizing long-term functional outcomes and reducing re-tear risk.