Simplified Portal Message for MRI Findings
Your MRI shows a significant tear in your rotator cuff (the main shoulder tendon) along with arthritis and inflammation that will require treatment—I recommend starting with physical therapy and discussing both non-surgical and surgical options with an orthopedic specialist.
What the MRI Found
The Main Problem - Rotator Cuff Damage
- You have a complete tear through part of your supraspinatus tendon (the main tendon on top of your shoulder), though it doesn't extend across the entire width of the tendon 1, 2
- There's also early damage (tendinosis) to two other shoulder tendons: the infraspinatus and subscapularis 2
- Your rotator cuff muscles show mild shrinkage (atrophy), which happens when tendons are torn 1, 3
Additional Findings
- Moderate arthritis where your collarbone meets your shoulder blade (AC joint), with bone spurs that may be pinching the space above your rotator cuff 2
- Mild inflammation in the fluid sac above your shoulder (bursa) and a small amount of fluid in the main shoulder joint 2
- Good news: Your biceps tendon is intact, and there are no bone fractures 2
Recommended Treatment Plan
Start with Conservative Management (3-6 Months)
- Physical therapy is essential and should focus on strengthening your rotator cuff, stabilizing your shoulder blade, and improving range of motion 1, 4
- Modify activities to avoid repetitive overhead movements and heavy lifting that stress the damaged tendon 4
- Pain management with anti-inflammatory medications (NSAIDs) and ice therapy (10-minute sessions through a wet towel) 4
- Consider a cortisone injection into the shoulder space if inflammation is limiting your therapy progress 1, 2
When Surgery Becomes Necessary
- Refer to orthopedic surgery if you don't improve after 3-6 months of structured physical therapy 1, 4
- Surgical repair aims to reattach the torn tendon to bone, which provides better long-term outcomes than leaving it torn 1, 2
- Important: If surgery is performed, your surgeon should NOT routinely remove bone from your acromion (acromioplasty), as studies show this doesn't improve outcomes for your type of shoulder anatomy 2, 4
What to Expect
If Conservative Treatment Works
- Most patients see improvement in pain and function within 3-6 months 1, 4
- You'll need to continue maintenance exercises long-term to prevent worsening 1
If Surgery Is Needed
- Recovery requires wearing a sling for 4-6 weeks followed by several months of rehabilitation 2, 4
- Even with successful tendon healing, some fatty changes in the muscle may persist, though function typically improves significantly 3, 5
- The goal is achieving tendon-to-bone healing, which correlates with better clinical outcomes 1, 2
Critical Points to Remember
- Don't delay starting physical therapy—muscle atrophy worsens with complete rest 4
- Avoid cortisone injections directly into the tendon (as opposed to the space around it), as this can weaken the tendon further 4
- The combination of your tear pattern, mild muscle atrophy, and arthritis means this won't heal on its own without intervention 1, 6