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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
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Experience:  Over 20 yrs of Family Practice
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I have been doing bench press for many years. Then I got an

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I have been doing bench press for many years. Then I got an injury in my right shoulder trying to lift only 45 pounds on each side plus the bar. I felt that something was torn with an excruciating pain. I got an MRI and states the following:
1. Complex tendinopathy of the supraspinatus and inraspinatus tendons with a possible rim-rent of the supraspinatus as wekll as diffuse tendinopathy of both tendons. An interstitial tear of the anterior fibers of the infraspinatus is suggested. There is a small amount of bone marrow edema adjacent to subchondral cyst affecting the conjoined tendon.
2. Degenerative changes of the AC joint are present.
3. Fluid or synovitis is seen in the subdeltoid subacromial bursa and in the subacromial bursa.

Can you explain in plain eanglish?

53 year old male
Hi--first off when did you injure your shoulder and it gave you absolutely no problems before that? When was the MRI done?
Customer: replied 3 years ago.

My injury happened about 5 weeks ago. Prior to the injury I had no problems with my shoulders. The MRI was conducted on 04/09/2013.


Additional information showed by the MRI:


History: rotator cuff tear


Rotator Cuff: There is high signal in the supraspinatus and infraspinatus tendons with focal high signal identified in the anterior supraspinatus which could represent a rim-rent. An oblique interstitial tear is also identified in the anterior infraspinatus.


Glenohumeral Joint: NEGATIVE. The bicep tendons are normal. The biceps labral anchor is intact. The labrum is unremarkable. The humeral head cartilage is normal. There is no hill-Sachs deformity.


Caracoacromial Arch: There is moderate degenerative change of the AC joint with akeel spur on the undersurface of the distal clavicle. There is high signal identified deep to the coracoid close to the expected position of the rotator interval which could represent synovitis. A small amount of fluid is seen in the subcoracoid bursa.


Soft Tissues: NEGATIVE. The spinoglenoid notch and quadrilateral space have a normal appearance.

OK--and we can continue after this if you need more information. Tendonopathy is a term for a chronic tendonitis--inflammation and thickening of a tendon. The supra- and infraspinatus muscles and tendons are part of the rotator cuff. A subchondral cyst is a cyst inside the bone--in this case your humerus. The AC joint is the gap between the acromion of the shoulder blade and the breast bone--degenerative changes means arthritis in that joint. There's a touch of bursitis in the shoulder. Finally you have a partial tear of both the supra- and infraspinatus tendons. The reason I asked about the timing is that a lot of this represents old conditions--present before your injury--except for the bursitis and the tears. At this point I don't see anything here that might require surgery.
Customer: replied 3 years ago.

I assume that the partial tear of both the supra- and infraspinatus tendons would heal with therapy. How long does it take to heal and would I be able to do moderate weight lifting (bench press) after both tendons have been healed? What about the subchondral cyst? Do I have to worry about this cyst? Now I remember that about 30 years ago I hurt my both shoulders playing softball. After that episode I noticed I couldn't pitch a ball because my shoulder was going to hurt. What type of excercise should I do to strengthen the four main tendons that support the shoulder?

Yes they would heal with therapy but that would take at least three months and then you could return to the bench pressing and weight lifting slowly. Nothing to worry about with the cyst--that's been there for quite some time. As for strengthening exercises for the shoulder I'd rather you not try any of that on your own--get the physical therapy with a very qualified trainer and follow his instructions.
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