Question - Rotator Cuff Tear (subscapularis)

by beebs
(NY)

I'm 35 yrs old. Pretty good physical condition. I took a hard fall and felt pain immediately in my dominant right arm. Dr. originally diagnosed impingement and MRI confirmed. Treated with therapy and cortisone. Did not respond so after one year did arthroscopic surgery. Found impingement and cleaned that up(supraspinatus?). Also found supscapularis tear that was in the Dr.'s words "hanging by a thread". No retraction of tendon. He fixed it with some sort of anchor that will eventually disappear. This was Oct. 2007.

I went back to work in 14 weeks after lots of therapy.I continue with stretching and everything else from PT. I'm no better now than I was in Feb.

I do push-ups on my knees and believe it or not-dips. Regular push-ups and my shoulder feels like it will literally pop.

Question is, should this eventually get any better? I have found lots of rotator cuff info. but think that most of it pertains to supraspinatus tears. I know subscapularis tears are rare. Any idea how this rates with serious tears of the other tendons.

I can't itch my back,throw a ball,or lift much of anything "underhanded". Lots of pain if I sleep on that shoulder.

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Question - Rotator Cuff Tear (subscapularis)

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Jul 10, 2008
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How is your motion? NEW
by: Bart - SII

You are right, subscapularis tears are not as common as supraspinatus tears - this has to do with the position of the tendon on the humerus - the subscapularis is farther towards the front of the humerus and is usually less likely to get caught on the acromion and become injured.

The first thing that jumps to my mind with your condition is your range of motion, specifically your ability to rotate and to reach your arm out to your side horizontally. Depending on the repair, you could have developed some tightness in the subscap which will limit your rotation, especially external rotation, and your horizontal abduction.

During your therapy, did your clinician do much along the lines of joint mobilizations - that is where you lie on your back, they take your arm and apply pressure directly on the shoulder to glide the humeral head within the joint - this stretches the joint capsule and allows for normal sliding and gliding of the humeral head within the socket.

After any type of shoulder surgery the normal sliding and gliding of the humerus is almost always restricted - because of immobilization, disuse, and weakness. Joint mobilizations will help to correct this and restore normal joint motion to the shoulder. Without it, your range is restricted and you end up having pain, pinching, and feelings like it needs to pop.

If you didn't have any treatments like what I described, that would be the first thing I would explore - talk to your therapist or physician about whether or not your motion is normal and if you can restore accessory joint motions.

The other key to recovering from rotator cuff tear surgery is to make sure that your scapular stabilizers - the muscles that move and control your shoulder blade - are very strong and working properly.

Hope this helps - comment back with other questions.

Jul 27, 2008
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subscapularis NEW
by: Anonymous

Sorry for the delay. My issue is with internal rotation. Many stories about supraspinatous tendon. Is this easier/harder to come back from? Long term affects. 8 months Stil pretty sore/weak.

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