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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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What exercises do I do to cure a swollen left supraspinatus

Customer Question

what exercises do I do to cure a swollen left supraspinatus
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I would ask you why do you have a left supraspinatus swelling? did you rupture your supraspinatus tendon? is it a complete tear or a partial tear? Do you have a rotator cuff tendon injury? The mechanism of injury is important here in determining what to do for exercise. Dr Frank

Customer: replied 1 year ago.
x ray left shoulder - surfing injury. Findings - there is normal alignment at the glenohumeral joint with preservation of the acromiohumeral interval. The humeral head cortex is smooth. No evidence of an acute fracture or dislocation. Minor degenerative changes affect the clavicular joint. Then I had an ultrasound. Findings - The left biceps tendon is normal in appearance and normally located. The subscapularis tendon exhibits a normal contour without evidence of a tear. The left supraspinatus tendon is swollen and contains a 3 x 6mm hypoechoic defect at the articular surface(approx. 17mm posrerior to the biceps tendon) in keeping with a partial thickness tear. The overlying subdeltoid bursa is thickened. On abduction, there is evidence of bunching of the of the supraspinatus tendon, likely on the basis of swelling.The infraspinatus tendon exhibits a normal contour and echotexture. Normal appearances to the acromioclavicular joint. Regards Richard.
Expert:  Dr. Frank replied 1 year ago.

Hi. So you understand the issue, at least as I see it. You have the SITS muscles. Supraspinatus (which is the largest contributor), infraspinatus, teres minor, and subscapularis. 4 muscles, they all come together off the scapular spine to insert around the humeral head as the "rotator cuff" muscles. The largest component is supraspinatus, and with a hypoechogenic defect in the articular surface (the part rubbing up along the supraspinatus ridge on its way to the humerus) there is a partial thickness tear (fortunately this is not a full thickness tear/completed tear) Over these tendons lie a bursa (a pad containing fluid to provide a slippery surface) which is under the deltoid muscle and that is thickened, in response to the partial tear. Your infraspinatus tendon, one of the four, looks good. So- you have a partial tear, and these come up in men as they age after the age of 60, regardless of trauma. With you, a surfing injury can certainly cause this. you should have some pain and maybe weakness with elevation of your arm above the horizontal. Also abduction, or bringing your arm away from your body above the horizontal is weak. The real issue is surgery vs. non surgical strengthening. You would need to get an orthopedist to order a shoulder MRI and review it to give you an answer. But I can tell you that studies have shown that after the age of 65, it seems that physical therapy is as good as reparative surgery for partial tears of the SITS muscles. So that having been said, I will send you a page on exercises to strengthen your rotator cuff muscles. Get back to me after you review this to ask questions if I can answer them, or if satisfied with this answer please remember to rate my service as that is how I am compensated for this work. Click on the stars. thanks *****

Expert:  Dr. Frank replied 1 year ago.

http://orthoinfo.aaos.org/PDFs/Rehab_Shoulder_5.pdf

Expert:  Dr. Frank replied 1 year ago.

Here is a nice program to rehab your shoulder from a rotator cuff partial tear. Try this and please get back to me if I can help Dr Frank