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Supraspinatus Tendon Tears

Supraspinatus Tendonu Yırtığı | Rotator Kaf Yırtığı Nedir?

Supraspinatus Tendon Tears are one of the most common causes of shoulder pain and dysfunction. This condition occurs when the supraspinatus tendon, a key component of the rotator cuff, becomes partially or completely torn due to injury, overuse, or degeneration. Individuals experiencing a supraspinatus tear often report shoulder weakness, limited range of motion, and persistent discomfort, especially when lifting the arm.


Early diagnosis and appropriate treatment are essential to prevent further complications. Understanding the symptoms, causes, and treatment options can help patients manage their condition effectively and improve their quality of life.


What is the Supraspinatus Tendon?

The supraspinatus tendon is one of the four rotator cuff tendons in the shoulder. It originates from the scapula (shoulder blade) and attaches to the front and outer part of the humeral head (upper arm bone).

The four rotator cuff tendons are:

  1. Supraspinatus

  2. Infraspinatus

  3. Teres Minor

  4. Subscapularis


These tendons provide stability to the shoulder joint, allowing a wide range of motion while keeping the joint securely in place. The primary function of the rotator cuff tendons is to balance forces around the shoulder joint and maintain its stability.


What is a Supraspinatus Tendon Tear?

supraspinatus tendon tear refers to the tearing of the supraspinatus tendon, one of the four tendons that make up the rotator cuff. Among these tendons, the supraspinatus tendon is the most commonly torn tendon.


Rotator cuff tears can affect a single tendon or multiple tendons, including the supraspinatus, infraspinatus, teres minor, and subscapularis.


While supraspinatus tendon tears are the most frequent, the subscapularis tendon is the second most commonly affected tendon.


Supraspinatus tendon tears are classified into two main types:

  • Partial Tear (Incomplete Tear)

  • Full-Thickness Tear (Complete Tear)


These tears can occur due to acute injuriesdegenerative changes, or repetitive stress over time.


How Does a Supraspinatus Tendon Tear Occur?

Supraspinatus tendon tears often occur due to different mechanisms in younger and older individuals:

  • In Younger Patients: Usually result from traumatic events such as falls, sudden pulling, or hanging injuries, often linked to sports-related incidents.

  • In Older Patients: Tears commonly result from degeneration of the tendon over time due to natural wear and tear.


Common Causes of Supraspinatus Tendon Tears:

  • Overuse and Strain:


    The supraspinatus tendon plays a crucial role in overhead arm movements. Repetitive actions, such as painting, organizing high shelves, or swimming, can lead to tendon wear and eventually cause a tear. Athletes involved in activities like volleyball or swimming are particularly at risk.

  • Aging and Degeneration:


    As we age, the body's tissues weaken and lose elasticity. In individuals over 40 years old, supraspinatus tendon degeneration becomes more common. With age, reduced blood supply to the tendon impairs its ability to heal, increasing the risk of tearing.

  • Acute Injuries:


    Sudden trauma, such as falling onto an outstretched arm, a direct blow to the shoulder, or abruptly dropping a heavy object held overhead, can result in a tear. Such injuries are commonly seen in sports accidentsfalls, or car crashes.

  • Other Shoulder Problems:


    Pre-existing shoulder conditions, such as tendinosis of the supraspinatus tendon, bone spurs on the acromion, or shoulder instability, can place excessive pressure on the tendon, increasing the risk of a tear.

  • Genetic Factors:


    Some individuals may have a genetic predisposition to rotator cuff tears. A family history of shoulder problems can increase the likelihood of experiencing similar issues.


What is a Partial Supraspinatus Tendon Tear?

partial supraspinatus tendon tear occurs when only a portion of the tendon is torn, rather than a complete rupture.

  • Partial Tear Definition: The tendon is damaged but not fully severed.

  • Diagnosis: The depth and extent of the tear can be determined through MRI imaging.

In partial tears, some fibers remain intact, which may allow the shoulder to retain partial function despite pain and weakness.


What are the Symptoms of Supraspinatus Tendon Tears?

  • Pain:The most common symptom is shoulder pain, often felt at the front and side of the shoulder. Pain can sometimes radiate down to the middle of the arm or even the elbow. Activities such as reaching overhead or lifting objectscan exacerbate the pain. Nighttime shoulder pain is also a frequent complaint.

  • Weakness:Shoulder weakness, especially during overhead movements, is another significant symptom following pain.

  • Reduced Range of Motion:Patients often experience difficulty in raising or rotating their arm fully.

  • Clicking or Popping Sensation:Some individuals may feel or hear clicking or popping sounds during shoulder movements.


How are Supraspinatus Tendon Tears Diagnosed?

Ro
  • Clinical Examination:


    The diagnosis begins with a physical examination to assess shoulder strength, range of motion, and specific clinical tests (e.g., Jobe’s Test or Empty Can Test).

  • MRI (Magnetic Resonance Imaging):


    MRI is the gold standard for diagnosing supraspinatus tendon tears. It provides detailed images to:

    • Confirm the presence of a tear

    • Determine whether it is a partial or full-thickness tear

    • Assess if other tendons or shoulder structures are affected

MRI also helps evaluate the extent of degeneration and associated injuries in the shoulder joint.


MRI Imaging of Supraspinatus Tendon Tears

Tam Kat Supraspinatus Tendon Yırtığı MR Görüntüsü
Full-thickness supraspinatus tear MRI view

Parsiyel Supraspinatus Tendon Yırtığı MR Görüntüsü
Partial supraspinatus tear MRI view


How are Supraspinatus Tendon Tears Treated?


1. Treatment of Full-Thickness Supraspinatus Tendon Tears

If a supraspinatus tendon tear is full-thickness, the only treatment option is surgery.

  • full-thickness tear cannot heal on its own without surgical intervention.

  • Delaying surgery can complicate future repairs, as the torn tendon retracts like an elastic band, making reattachment more difficult.


Surgical Technique:

  • The tear is repaired using shoulder arthroscopy, a minimally invasive surgical procedure.

  • Tiny incisions are made around the shoulder joint.

  • camera (arthroscope) is inserted to visualize the tear.

  • Special anchors (suture anchors) are used to secure the tendon back to the bone.

📹 Watch an Arthroscopic Supraspinatus Tendon Repair by Dr. Utku Erdem Özer:Click Here to Watch the Surgery


📚 Learn More About Supraspinatus Tendon Repair Surgery:Click Here for Detailed Information

Reverse Shoulder Replacement in Advanced Cases:

In elderly patients with:

  • Significant tendon retraction

  • Fatty degeneration of the muscle

  • Poor tendon tissue quality

The success rate of arthroscopic repair decreases. In such cases, a Reverse Shoulder Replacement is performed.

📚 Learn More About Reverse Shoulder Replacement:Click Here for Detailed Information


2. How are Partial Supraspinatus Tendon Tears Treated?

Treatment for partial supraspinatus tendon tears typically begins with non-surgical methods. Surgery is only considered if symptoms persist despite conservative treatment for approximately 3 months.


Non-Surgical Treatment Options:

  • Ultrasound-Guided Injections: PRP (Platelet-Rich Plasma), PRGF (Plasma Rich in Growth Factors), or stem cell injections.

  • Physical Therapy and Exercise: Focused on strengthening the supraspinatus tendon and improving shoulder stability.


Is Surgery Necessary for Partial Supraspinatus Tendon Tears?

  • Surgery is not the first choice for partial tears.

  • Conservative treatments should be tried for at least 3 months.

  • If pain, weakness, or loss of function persists despite non-surgical interventions, surgical repair may be considered.


How is Supraspinatus Tendon Repair Surgery Performed?

  • The surgery is performed arthroscopically through 3-4 small incisions (about 1 cm each) around the shoulder joint.

  • camera (arthroscope) is inserted to visualize the tear's size and location.

  • Suture anchors are placed into the bone, and sutures attached to the anchors are passed through the torn tendon.

  • The tendon is then pulled back to its original position on the bone and secured with knots.

  • Depending on the size and complexity of the tear, 4-6 anchors may be used.


How Long Does Supraspinatus Tendon Repair Surgery Take?

  • The duration of the surgery depends on the size of the tear and whether there are additional injuries in the shoulder.

  • On average, arthroscopic supraspinatus tendon repair surgery takes 1 to 2 hours.


What is the Rehabilitation Process After Supraspinatus Tendon Repair Surgery?

Rehabilitation Plan:

  • First 6 Weeks:

    • The arm is kept in a sling (the first 3 weeks with a pillow for support).

    • Pendulum exercises and table-slide exercises are gradually introduced.

  • After the Sling is Removed:

    • Physical therapy focuses on restoring shoulder mobility and gradually improving strength.

  • Long-Term Goal:

    • Full recovery of shoulder function and strength.

    • Avoiding re-injury through proper exercises and postural awareness.


For more information and expert evaluation, you can visit utkuerdemozer.com and confidently take the right steps for your health.

Kiss. Dr. Utku Erdem Özer Contact

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