Rotator cuff injury

Rotator cuff injury is a common cause of shoulder pain, especially in older and active people. Tears can be symptomatic or asymptomatic.

The cause of a rotator cuff tear can be traumatic or attritional.

Treatment is typically based on degree of dysfunction, pain, quality of tendons and muscles of the rotator cuff, location of the tear, and patient goals and activity level.

In patients with lower functional demands, rehabilitation therapy, including range of motion and cuff and scapular strengthening exercises, is critical to return patients to better function. A subacromial corticosteroid injection can alleviate pain but should not be performed repeatedly.

If higher activity level is desired or the tear is acute in a younger, active patient, surgical intervention has a better functional result than nonoperative treatment.

The spectrum of rotator cuff pathology is one of the most common groups of conditions affecting the adult shoulder. Tears can occur with trauma (such as with shoulder dislocation in patients >40 years of age) or, more commonly, be attritional (such as with repetitive overhead activity or chronic degeneration from normal usage). Shoulder impingement, subacromial bursitis, rotator cuff syndrome, and rotator cuff tendonitis can all be a continuum of the same pathologic process.