Rotator cuff tear may have significance include os acromiale and acromial spurs. Environmental factors implicated include increasing age, shoulder overuse, smoking, and any medical condition that affects circulation or impairs the inflammatory and healing response, such as diabetes mellitus. Intrinsic factors refer to injury mechanisms that occur within the rotator cuff itself. The principal is a degenerative-microtrauma model, which supposes that age-related tendon damage compounded by chronic microtrauma results in partial tendon tears that then develop into full rotator cuff tears. As a result of repetitive microtrauma in the setting of a degenerative rotator cuff tendon, inflammatory mediators alter the local environment, and
Mucous sheaths of the tendons around the ankle Mucous sheaths of the tendons around the ankle The mucous sheaths of the tendons around the ankle protect tendons in the ankle. All the tendons crossing the ankle-joint are enclosed for part of their length in mucous sheaths which have an almost uniform length of about 8 cm. each. On the front of the ankle the sheath for the Tibialis anterior extends from the upper margin of the transverse crural ligament to the interval between the diverging limbs of the cruciate ligament; those for the Extensor digitorum longus and Extensor hallucis longus reach upward to just above the level of