Supraspinatus tendon repair (SST repair)

A tear or rupture of the tendon of the supraspinatus muscle is known as a supraspinatus tear. Supraspinatus is generally a part of the rotator cuff of the shoulder and most of the times it is accompanied with another rotator cuff muscle tear which mainly occurs in the case of trauma or repeated micro- trauma. And, then is present as a partial or full thickness tear and mainly the tear occurs in the tendon or as an avulsion from the greater tuberosity. The repair is mainly done for acute tear and degenerative.

In case of acute tear, there is a fall on your arm and it can occur with other shoulder injuries. It generally happens when you lift heavy weight. Degenerative means the wear and tear of the tendon slowly over time and increases with age, more common in the dominant arm.

Symptoms of SST

  • Pain/worsening pain (in cases where tears are progressing): Most common symptom
    • Pain when lifting and lowering your arm or with specific movement
    • Pain at rest
    • Pain at night, predominantly when you lie on the affected shoulder
    • Traumatic tears: Sudden, intense pain often accompanied by a snapping sensation and immediate weakness in the upper arm
    • Located antero-laterally and superiorly
    • Referred to the level of the deltoidinsertion with full-thickness tears
    • Repetitive strain tear: Starts off mild and only when lifting your arm; over time the pain can become more noticeable at rest
    • Aggravated in overhead or forward-flexed position
    • Limited range of motion:
    • Reduced forward elevation, external rotation and abduction
    • Struggle with activities like reaching behind back, combing hair and overhead activities
    • Weakness when rotating or lifting your arm
    • Crepitus
    • Clicking
    • Stiffness
    • Limited range of motion:
    • Reduced forward elevation, external rotation and abduction
    • Struggle with activities like reaching behind back, combing hair and overhead activities
    • Instability

Risks factors of SST

  • > 40 years old
  • Male > Female
  • Smoking
  • Genetics
  • Hypercholesterolemia
  • Body mass index
  • Height
  • Repetitive stress/lifting
  • History of trauma
  • Lack of blood supply
  • Bony spurs
  • Overhead activities and other people who do overhead work:
  • Tennis players
  • Baseball pitchers
  • Painters
  • Carpenters
  • Plumbers
  • Traumatic injury

Causes of SST repair:

It is generally caused due to the rotator cuff tear in the tendon or muscle which leads to impingement syndrome where your tendon gets trapped between bones in your shoulder. Anybody can injure their rotator cuff badly as it happens most often from traumatic or sudden accidents and the overuse or repetitive stress.

Rehabilitation of SST repair

A physical therapy program that helps you in regaining shoulder strength and motion. The program includes:

Immobilization– After surgery, at first, protection of the repair is to be done. You will most likely use a sling and avoid using your arm for the first 4 to 6 weeks. How long you require a sling depends upon the severity of your injury.

Passive exercise– Though your tear has been repaired, but still the muscles around your arm remains weak so once your surgeon decides it is safe for you to move your arm and shoulder. With passive exercise, your therapist supports your arm and moves it in different positions. In most cases, the exercise begins within the first 4 to 6 weeks after surgery.

Active exercise: After 4 to 6 weeks, you will progress to doing active exercises without the help of your therapist. Moving your muscles on your own will gradually increase your strength and improve your arm control. At 8 to 12 weeks, your therapist will start you on a strengthening exercise program.