Supraspinatus Rupture: Causes, Symptoms, Diagnosis, Treatment
Supraspinatus Rupture: This is a painful condition of the shoulder in which there is a tear or rupture of the tendons of the Supraspinatus Muscle. This condition is relatively common and generally extremely painful. This condition is usually developed as a result of a direct blow to the shoulder like when falling on the shoulder or other sporting injuries.
In this article, we will discuss about:
- Causes of Supraspinatus Rupture
- Symptoms of Supraspinatus Rupture
- Treatments options available for Supraspinatus Rupture
How Do We Define Supraspinatus Rupture?
The function of a tendon is to connect muscles to bones and the muscles pull the bones with pulling on to the tendons. When there is any sort of damage to the tendons in trying to move the tendon the muscles pull a part of the tendon away form the bone resulting in fraying and soreness of the point of attachment. Over time, the tendon completely disconnects from the bone and this condition is called a Tendon Rupture. This results in loss of mobility of the joint. Usually, the tendons are quite strong but its attachment to bone is pretty weak and is the first to give way. Tendon Rupture is pretty common in shoulders as it is one of the joints which is very frequently used in everyday life and is prone to this condition. When the tendon rupture takes place in the Supraspinatus Muscle, which is one of the rotator cuff muscles, it is called as Supraspinatus Rupture.
Causes of Supraspinatus Rupture
Studies indicate that there are at least three important factors which may cause a Supraspinatus Rupture. Some factors can be attended to with the help of exercises while other factors need surgery to correct the problem. These three factors are:
Degeneration with Aging: The Supraspinatus Tendon tends to get weak as the individual ages and becomes prone to tears. Most of Supraspinatus Ruptures have been found in people above the age of 40 but individuals involved in the sporting field or are involved in motor vehicle accidents which can cause direct trauma to the shoulders can also develop this condition.
Shoulder Girdle Structure: The individual shape of bony structures play a vital role in determining whether a tendon is able to move freely or gets impinged between structures with frequent elevation of arms.
Shoulder Biomechanics: As stated, the Supraspinatus Muscle is a part of the muscles that constitute the rotator cuff which facilitates stability to the shoulder. In case, the other rotator cuff muscles are not providing enough stability to the joint with range of motion then the Supraspinatus Muscle becomes prone to a rupture.
Apart from the above mentioned factors, Supraspinatus Rupture also occurs with sporting activities which involve powerful throwing like baseball etc. Also, people working in occupations which require heavy lifting overhead are also prone to Supraspinatus Rupture.
Symptoms Of Supraspinatus Rupture
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
Diagnosis of Supraspinatus Rupture
In order to diagnose a Supraspinatus Rupture, the physician will begin with a detailed physical examination of the shoulders and will ask the individual to move the arm in different directions to assess for range of motion. The physician will then look for any palpable tenderness or deformity in the shoulder area. The physician will also check the strength of the arm to look for any sort of muscle weakness.
For A Confirmatory Diagnosis The Treating Physician Will Order The Following Imaging Studies:
- X-rays: Since x-rays are not sensitive enough to show deeper areas of the shoulder it may reveal a normal study.
- MRI Scan/Ultrasound: These studies are more sensitive and the physician will be able to look at the deeper structures of the rotator cuff and confirm the diagnosis of a tendon tear. The scans will also reveal the quality of the muscles and tendons of the shoulders.
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,
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 but the healing process again depends on the following factors:
- The tendon should be of adequate thickness in order to hold the sutures
- The affected individual should limit his motion during the healing phase
- Smoking needs to be absolutely avoided as it impairs healing.
Studies reflect that medium sized Supraspinatus Ruptures heal in about 75% of cases with the recovery period being about six months before the individual can return to normal activities.