At the end of your muscle, a strong tissue called the tendon connects the muscle to the bone. One of the injuries that can occur in the tendon is tendon rupture (Supraspinatus). In this article, we first talked about shoulder tendon rupture. Then, the causes, symptoms, diagnosis, treatment of shoulder tendon rupture, recovery, and complications.
How Does a Shoulder Tendon Rupture Happen?
Supraspinatus tear (shoulder tendon rupture) is one of the most common injuries to the shoulder tendon. Inflammation of the shoulder tendon often occurs in older athletes who, after a period of immobility, re-practice and play sports such as team handball, soccer, American football, tennis, badminton, cricket, table tennis, and sports. You must Resume throwing and skiing. This complication is very common in young people whose sport is wrestling and weightlifting or throwing and racket sports. The shoulder joint is surrounded by a tendon cuff consisting of a quadriceps tendon. The supraspinatus, submandibular, and small round muscles are attached to the posterior part of the upper humerus. The last two cases rotate the arm outward while the scapular muscle, which extends to the anterior upper part of the humerus, rotates inward. The tendon is the muscle that forms the tendon cuff and strengthens the shoulder joint capsule from back to top and front. As the shoulder joint moves away, the supraspinatus muscle tendon slides into the space covered by the acromion and the occipital ligament. If a severe external rotation accompanies the away motion, the tendon may slide toward and collide with the ligament instead of the previous position. For tendon function, the muscles under your spine are small, round under the scapula, and when we remove the humerus head, it fixes them in the scapular cavity. In 75% of cases, shoulder pain originates from the tendon cuff and usually the supraspinatus muscle tendon. The supraspinatus muscle and the deltoid raise the humerus as it moves away. A complete rupture of your tendon and supraspinatus muscle will force the athlete to hold the shoulder joint down because of suspense in their hands due to gravity.
Of course, the governor muscle will be replaced later. The weakest point of the supraspinatus muscle is the part that participates in forming the tendon cuff. This section is about one centimetre from the tendon junction to the humerus, and most ruptures occur at this point. These tears can be complete or partial. In the vulnerable part, a capillary network is exposed to destructive changes and differentiates blood flow. This condition often occurs even in athletes aged 30 to 35 years. If your hand is at a distance of 80-120 degrees from your body, it does a static job. Compressed blood vessels indicate that blood flow and tissue oxygen supply are reduced, and the risk of injury increases.
Causes of a Supraspinatus Tear
The causes of shoulder tendon rupture are:
- A force that rotates the arm in the opposite direction inward resistance or prevents the arm from rotating outward (as in the case of team handball, American football, or wrestling).
- Falling straight onto the shoulder or arm outstretched.
- Lifting or throwing a heavy object can also cause the shoulder tendon to rupture.
Signs, symptoms and diagnosis of a Supraspinatus Tear
- Severe pain occurs when an injury occurs, which becomes more pronounced with movement and effort. Pain and symptoms of shoulder tendonitis may worsen within 24 hours and then spread to the upper arm. If the athlete falls on his shoulder or picks up or throws a heavy object, the diagnosis of a supraspinatus tendon rupture will be more certain.
- External rotation of the arm or movement of the hand up and down will be accompanied by pain and other signs and symptoms of shoulder tendon rupture. In case of incomplete rupture of the chord, the arm can be raised in the outward direction and at an angle of 60-80 degrees without pain or with little pain; if the arm rises to an angle of 80-120 degrees, the shoulder pain increases and then subsides (see image below). We perform the following test when we suspect a complete rupture of the shoulder tendon. The arm is held at an angle of more than 120 degrees to the body, but we will suddenly see the hand fall when it comes down. This is an important cause in the diagnosis of shoulder tendon rupture.
- Arm muscle movements will be incomplete due to pain and weakness on the injured side.
- There will be local tenderness in the tendon or its junction.
- Shoulder arthroscopy with or without radiography can confirm the diagnosis of a ruptured shoulder tendon.
Treatment Supraspinatus Tear
The patient should perform the following procedures to treat a shoulder tendon rupture:
- Cool the shoulder at the scene.
- Slow down.
- If the symptoms of a shoulder tendon rupture do not go away, consult a doctor for treatment to get the best treatment for him.
The physician’s actions include:
- Perform surgery if the shoulder tendon strain and shoulder tendon rupture have occurred completely in the patient or young athlete.
- – If the shoulder tendon rupture is not complete, prescribe rest and immobilize the arm for a short time with a bandage.
- Prescribe mobility exercises and other rehabilitation exercises to accelerate the shoulder tendon rupture healing process.
Non-operative treatment for tendon ruptures, including knee and shoulder tendon ruptures, is more commonly prescribed for patients who can successfully resume all activities in the pre-injury period. Because injury defects are usually aesthetically pleasing, most patients can quickly return to their activities without surgery. Primary treatment includes using medication and ice to relieve pain, active and gentle stretching exercises, strengthening exercises, and adjusting activities to avoid activities that provoke pain (causing pain to recur). This treatment program for shoulder tendonitis can often be done independently, although some patients will benefit from physiotherapy. Special exercises can restore physical movement and strengthen the shoulder and effectively treat labrum rupture of the shoulder.
Treatment with Surgery
Rupture of the supraspinatus tendon of the shoulder can cause permanent disability by disrupting organ function. If the shoulder tendon ruptures and other treatments do not work, an orthopedic surgeon or doctor on the shoulder exercise team may recommend surgery. Rupture of the biceps tendon rarely requires surgical treatment. However, some patients, such as athletes and simple workers, who need to fully recover from their physical strength, may need surgery.
Recovery and Rehabilitation
After the operation, the shoulder may be bandaged and temporarily immobilized. The doctor will soon ask the patient to start exercise therapy. Flexibility exercises improve shoulder range of motion. Shoulder strengthening exercises are also gradually added to the patient’s rehabilitation program. After removing the bandage, you can resume physical exercises such as running. Of course, weight lifting and throwing exercises should not be done for 8 to 12 weeks. This period will vary depending on the severity of the complication. The patient must follow the doctor’s treatment plan. Although the treatment program is a slow process, the patient’s commitment to physiotherapy is the most important factor in restarting all the activities he enjoys. Successful surgery can correct muscle deformity and return arm strength and function to an almost normal.