OpenHealth Q&A

It appears that your recent ultrasound findings indicate a moderate partial tear of the subscapularis muscle, along with signs of tendinosis in the surrounding rotator cuff tendons. You’re experiencing some discomfort and weakness related to your activities, and you're understandably concerned about how to proceed with your treatment.

Understanding Your Diagnosis:

1. Partial Tear: A moderate partial tear means that some fibers of the muscle are damaged but that the tendon is still partially intact. This can lead to pain and functional limitation, especially during lifting or strenuous activities.
2. Tendinosis: The presence of tendinosis indicates degenerative changes due to overuse rather than acute injury. This often contributes to pain or weakness but doesn’t involve a complete rupture.

Prioritized Next Steps:

1. Physical Therapy (PT): Start with a structured physical therapy program focused on:

   • Strengthening: Gradually strengthen the shoulder muscles, especially those around the rotator cuff like the subscapularis.
   • Flexibility: Improve the range of motion to relieve tightness and enhance functionality.
   • Activity Modification: Discuss adjustments with your therapist to manage your lifting and sports activities without exacerbating the tear.

2. Pain Management: Utilize over-the-counter anti-inflammatory medications (like ibuprofen or naproxen) if needed to reduce pain and swelling, as advised by a healthcare professional.

3. Activity Modification: Avoid activities that provoke pain, especially heavy lifting and competitive sports. Gradually reintroduce these activities as your shoulder strengthens and your pain diminishes.

4. Reassessment Timeline: After several weeks of therapy (typically 6-12 weeks), reassess your symptoms and shoulder function. At this point, you can decide whether you feel improvement with conservative management or if surgical options need to be explored.

5. Monitoring Symptoms: Keep track of your shoulder pain, strength, and function. If your symptoms worsen, or if you experience increased pain, instability, or weakness, it’s essential to revisit your healthcare provider for further evaluation.

Considerations for Surgery:

While surgery may be an option depending on how you respond to therapy, it’s often reserved for cases where conservative management fails, or if there is significant functional limitation. You mentioned you're prepared for surgery; however, giving physical therapy a try first is the recommended approach in most cases, particularly for partial tears.

Encouragement:

Healing from shoulder injuries can take time, and results vary from person to person. Stay positive and committed to your therapy program, and you may find significant improvement. Remember to communicate openly with your therapist for guidance tailored to your condition and recovery expectations.

If you have further questions or updates, feel free to ask!