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Rotator Cuff

Rotator Cuff Tears – some facts

  • The cause of rotator cuff can be traumatic such as a fall on an outstretched hand, shoulder dislocation or degenerative / atraumatic with no clear cause for the pain.
  • The rotator cuff especially the supraspinatus, infraspinatus and biceps can become overloaded, as they are susceptible to fatigue due to their small musculoskeletal tendon units, poor blood supply and they are used at a high level during activities of daily living.
  • Articular surface tears are considered degenerative, asymptomatic and a normal part of aging. Bursal surface tears are mostly commonly involved in mechanical compression or impingement. Bursal surface partial thickness tears are less likely to progress to full thickness tears than articular surface tears.
  • The good news, only a small percentage of degenerative rotator cuff tears progress to full thickness tears where surgery may be indicated. These are monitored over time. Traumatic tears have a higher percentage progress to full thickness tears requiring surgery.
  • A tear if acute can take up to 6 weeks to develop and 6 to 12 months to settle. We need to be realistic with expectations and there is a need for a progressive therapeutic program tailored to the individual as recruitment patterns will be different between shoulders and care is needed to respect the healing.
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