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Supraspinatus Tear: When Surgery May Be Required

Understand more about the difference between full thickness tears and partial thickness tears

supraspinatus tear

If you’ve experienced a rotator cuff tear, there’s a good chance that it could be a supraspinatus tear. It is the most common tendon to be damaged in the shoulder.

This is what a tear or rupture of the tendon connected to the supraspinatus muscle (which is part of the rotator cuff of the shoulder) is called.

It’s often accompanied by other tears in the muscles that make up the rotator cuff.

Your shoulder joints consist of three different bones – the clavicle, humerus, and scapula – and the head of the humerus and the glenoid cavity or “fossa” of the scapula combine to create the ball and socket joint that allows your arm to move at a wide range of angles.

supraspinatus tendon

The rotator cuff is what keeps the head of the humerus in place, and it is composed of the supraspinatus, infraspinatus, subscapularis, and teres minor tendons.

The supraspinatus tendon is located on the back of your shoulder and helps your arm to move throughout its full range of motion – and helps with power and strength.

What causes supraspinatus tears?

Acute tears of the tendons in your shoulder occur due to sports or similar activities, along with more general wear and tear on the tendon depending on your age or lifestyle.

Old age is also a major factor in supraspinatus tears; in fact, over 50% of people over seventy years old have a supraspinatus tear when they pass.

Rotator cuff tear is the term commonly used by the general public to describe any detachment or tear of the tendons that connect that connect or attach the muscle from your shoulder to the head of the humerus.

A significant amount of these occur in the supraspinatus muscle, although other areas of the rotator cuff may be involved. There are two categories of supraspinatus tears, degenerative and acute.

A supraspinatus tendon tear can be full thickness (meaning that the entire muscle is affected) or partial thickness (or an incomplete tear).

These types of tears can also be symptomatic – meaning that it causes significant pain and impedes your ability to perform basic everyday tasks – or asymptomatic, meaning that the tear doesn’t cause significant pain, but should still be monitored by an orthopaedic surgeon since tears can grow worse over time.

supraspinatus tendon tear

Acute supraspinatus tears and degenerative supraspinatus tears

An acute tear of the supraspinatus muscle can occur alongside injuries like shoulder dislocation, clavicle fractures, or other rotator cuff injuries that can happen as the result of things like a fall on your outstretched arm or attempting to lift something too heavy; plus there are a variety of sports where the athletes are prone to shoulder damage like baseball, basketball, rugby, AFL Football, and tennis.

Construction work and other high-risk physical jobs can also increase the likelihood of experiencing this type of injury.

A degenerative tear is the opposite – instead of a single catastrophic episode or trauma to the shoulder, these tears are the result of damage and wear on the joint slowly over time.

The likeliness of these issues increases with age and is more common in the dominant hand; in addition, if you experience a degenerative tear in one shoulder, you’re at a greater risk for a tear in the other shoulder.

Men over forty are the most likely to have degenerative supraspinatus tears. Factors like smoking, hypercholesterolemia, weight and BMI, height, bone spurs, and other genetic factors increase the chances as well.

People who play baseball, tennis, and similar sports with a lot of overhead or overarm motions as well people in trades like painting, carpentry, plumbing, and other construction work that involves a lot of overhead motion are also more prone to degenerative tears of the supraspinatus and the other tendons that make up your shoulder joint.

What is the difference between full thickness tears and partial thickness tears?

You can partially or fully tear your supraspinatus muscle, and remember that these sorts of tears can be symptomatic (meaning they cause supraspinatus pain and inhibit your range of motion and ability to perform everyday tasks) or asymptomatic, meaning the tear is present but it not currently causing you pain or otherwise causing problems in your life.

Partial thickness tears of the supraspinatus muscle are an incomplete disruption of muscle fibers; note that these can progress to a complete or full thickness tear of the supraspinatus muscle, and larger tears pose a higher risk of progression to full tears, even if they are asymptomatic.

Any type of tear should be regularly monitored by your orthopaedic surgeon in case of further progression or damage. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon.

Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery.

These tendons have poor blood supply and will not heal themselves. The longer these tears are left untreated, the more chance the tendon tear will enlarge and retract which results in more difficult surgery to repair this damage.

supraspinatus pain

How is a supraspinatus tear test & diagnosed?

Physical examinations, imaging tests like X-rays, magnetic resonance imaging (MRIs), and ultrasound scans are all used to diagnose supraspinatus tears.

Tenderness, loss of function, shoulder weakness, shoulder impingement, and pain when raising or rotating the arm are the main physical signs your orthopaedic surgeon will be looking for in the physical examination, while the imaging tests will show changes in the bones such as shoulder blade shape via X-rays and changes in the movement, shape, thickness of the tendons and other problems like bursitis or arthritis via MRIs and ultrasound testing.

How are supraspinatus tears treated?

Depending on the severity of your tear, your surgeon may recommend starting with a non-surgical treatment like physiotherapy and supraspinatus tear exercises with the goal of restoring the range of movement and the strength of the shoulder, activity modification (changing your lifestyle to avoid the tasks that increase your pain and may exacerbate the tear), pain management with non-steroidal anti-inflammatory medications, analgesics, and cortisone injections.

Of course, all these options should involve regular check-ups with your orthopaedic surgeon in order to make sure the problem isn’t getting worse.

For full thickness tears and more major tears (or if the tear involves more than one tendon) or there is significant damage to the tendon, various surgical procedures may be required.

Arthroscopic shoulder surgery may be required, or even rotator cuff tear procedures may be advised depending on the extent of the injury or damage to your supraspinatus muscle and surrounding bones, tendons, and muscles.

You can live with a damaged rotator cuff for some time, especially the tearing is minimal and you can manage the pain with activity modification. Surgery may be recommended sooner rather than later for younger patients, particularly those who’ve experienced acute trauma.

Full thickness tears will not heal without surgery.

supraspinatus tear test

What is surgery of a supraspinatus tear recovery time like?

If you’re going to have surgery to repair a full or partial thickness tear, you should keep in mind that you’re going to have some significant recovery time where you won’t be able to use the affected arm as usual.

If you have a spouse, partner, family member, or close friend on hand to help you out post-surgery for your supraspinatus muscle tear, you’ll be better off, since you won’t be able to lift things over chest height or even do other simple tasks for around 2 to 6 weeks after your surgery.

Stocking up on prepared foods or meal prepping in advance and freezing things, as well as scheduling services like house cleaning and laundry is also helpful.

You should also move commonly used items to lower shelves or drawers or similar easy-to-access spots, since it’s going to be a while before you regain your previous range of movement.

Think about all the times you lift your arms above shoulder height in a given day and try to rearrange your home accordingly. Your future self will thank you!

What other shoulder issues are related to supraspinatus tears?

Shoulder dislocation, shoulder instability, and shoulder subluxation can all coexist or happen as the result of a partial or full thickness shoulder supraspinatus tear, particularly when these tears occur as a result of trauma to the shoulder joint or acute injury.

If you’ve experienced acute damage or a recent shoulder injury, or are otherwise experiencing pain in your shoulder or rotator cuff area, consult your doctor and an orthopaedic surgeon as soon as possible, particularly if you work in a field, play a sport, or have a hobby that involves lots of overhead lifting and repetitive arm motions.

Are you a candidate for surgery or other treatment for supraspinatus tears?

If your shoulder joint has pain and are seriously affecting your quality of life and your ability to work or perform basic everyday tasks without pain, then you need to speak with an orthopaedic surgeon about the next steps.

The goal of any shoulder joint treatment plan is to reduce pain and restore function as much as possible.

Depending on the severity of your shoulder tear and other injuries, your age, general health, and lifestyle, it might be possible to alleviate the pain and minimize the issues resulting from a supraspinatus year through a combination of non-invasive tactics like medication and physiotherapy.

Deciding to have surgery is never an easy decision and you may require some time to recover, but if your shoulder joint issues such as supraspinatus tear are having a significant negative impact on your life, surgery and the associated downtime and physiotherapy may very well be worth it.

Consult with your orthopaedic surgeon to determine the best solution for your case, your supraspinatus tears, any other associated injuries, and your lifestyle.

9 Comments

  1. Felix Donath

    thank you for the very informative article. Perhaps a little information regards what an operation to repair a total tear of the supraspinatus would be or how the teared tissue can be rejoined would be welcome.

  2. Walter Harlow

    Wow great info injured my R shoulder 3/12/19. Nesting goose attacked me coming in 1o’clock 2o’clock knocking me off my bike. Fell on L shoulder but raising my R arm to fend off the goose evidently tore my supraspinatus muscle according to mri read by my orthopedic surgeon specializing in shoulders. I canceled surgery this morning researching alternatives. Think I hit the jackpot with your info! First question-should I attempt physical therapy with bands & weights? 2nd question can you recommend a PT in the Tidewater Virginia area(23507-23462 zip code)?

  3. Thanks for all this info . I had a fall in march and need to have an operation . But I cannot have it done before October . I am worried that I am leaving it for too long . I have a 10mm incomplete full thickness tear at the anterior edge of the supraspinatus tendon . Is this a big tear ? And what does incomplete full thickness mean ? It sounds contradictory . Thanks Pat. Anastasi

  4. Neha mehta

    Hi this is neha i am suffering from this same wht to do

  5. I was diagnosed with full sickness tear of the supraspinatus in left shoulder . I am 69 almost 70 years of age ; I swim 2 miles each day in open water; my diagnosis was at least five years ago . Was scheduled for surgery but declined thinking that the swimming was improving the situation and was also concerned about the limited percentages of success stories.
    Recently I have experienced increased pain in the affected area and I’m wondering if I should or would be a candidate for surgery again at this point in time , after waiting so long .
    I truly feel that I need some kind of help to relieve the chronic pain .
    SHEILA M Currie

    1. Full thickness tear ( correction)

  6. Kaushang Patel

    My father has a full thickness tear of supraspinatus tendon at the site of attachment and there is approx 14-15 mm proximal retraction due to injury. Is it necessary to have a surgery or it can heal with medicine. Please give suggestion.

  7. Wayne Robert Kelly

    Hi,
    I’m from Melbourne, but currently live in Norway.
    I hurt my shoulder somehow three weeks ago. After a moderately intense morning workout (pushups, chinups) I later felt pain. The pain continued (right, back shoulder blade area) and I suddenly lost strength. Hence I went to the doctor.

    Following an MRI the Doctor/Shoulder specialist has informed me I have a fully torn supraspinatas tendon. He says my shoulder muscle and tendon appear in sufficiently good condition for a good result from surgery. He therefore suggests surgery. I am, however, 50 years old and I am extremely worried about this. I have no pain and excellent movement at the moment. I have started to regain strength again since I noticed pain and loss of strength three weeks ago. I am now back to more than half my general capacity doing exercises such as push ups and chin ups sit ups and running. Yesterday, for example, I managed three sets of 20 pushups and 3 sets of 6 chinups with little trouble.

    My question is – MUST I have the surgery? Can I live without the supraspinatas tendon (I understand a full tear will not heal)? Are there any cases where it has healed? But most importantly can I live without this tendon OR what may happen in the future if I don’t take the surgery.?
    Any feedback absolutely welcome. Thanks enormously in advance.
    Best wishes,

    Wayne Kelly.

  8. Nkululeko

    I was using an spring device to exercise and did some pulls above my head,one hand immobile the other pulling,after two days I could feel pain on my right shoulder and thought maybe it was the effects of the exercise as it had been years since I had not been active that way,I however noticed that it was just the one shoulder and have been in pain since,
    My question is what should I do as it is getting painful even at rest,it’s 3weeeks since the incident and it’s only now that it’s getting this sore

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