About six months ago, I was diagnosed with a partial tear of the supraspinatus tendon.
An MRI examination and consultations (Lovran and Matulji) led to the recommendation of arthroscopy. I have decided to undergo the procedure in about 2-3 months, but I am interested in whether, in your expert opinion, it is better to wait passively or actively (engage in exercises with you).
I occasionally experience significant pain. I am 73 years old.
When deciding on the treatment of partial tears of the rotator cuff of the shoulder (in this case, the supraspinatus), several questions are important. How large is the tear, is it traumatic or degenerative, what is the age of the patient, and what are the demands the patient places on their shoulder (how physically active are they)?
In this regard, we typically aim to surgically repair most traumatic partial tears up to the age of 30 or 40 because the alternative is living with significant physical limitations, and we expect further damage to the shoulder. Unfortunately, rotator cuff tendons hardly or never heal on their own. After this age, especially concerning degenerative tears (which occur gradually as a result of use with poor regeneration), we assess what is best in the specific case.
Degenerative changes in tendons make them fragile, and the surgeon may have difficulty reducing or completely covering the tear. The postoperative recovery is long (at least 6 months) and requires complete dedication from the patient. Due to the condition of the tendons, even when ideally “sutured,” their healing is not guaranteed. Therefore, it is extremely important to undergo appropriate therapy before surgery to reduce pain and establish the best possible shoulder function in the current state. If the condition after therapy is satisfactory for the patient, then the surgeon will have an additional criterion to question the need for surgery. If the condition after therapy does not meet the patient’s requirements, then excellent preparation for surgical intervention has been made, and the prognosis for its outcome is better.
