Rotator cuff tear oxidative stress induces tenocyte apoptosis causing further rotator cuff tendon degeneration. A neural theory also exists that suggests neural overstimulation leads to the recruitment of inflammatory cells and may also contribute to tendon degeneration. Tears of the rotator cuff tendon are described as partial or full thickness, and full thickness with complete detachment of the tendons from bone. Shoulder pain is variable and may not be proportional to the size of the tear. Neer promoted the concept of three stages of rotator cuff disease. Stage I, according to Neer, occurred in those younger than 25 years and involved edema and
Glenohumeral ligaments capsule is strengthened in front by two bands derived from the tendons of the Pectoralis major and Teres major respectively. During abduction of the arm the middle and inferior ligaments become taut while the superior ligament relaxes. The radius of curvature of the head of the humerus is greater superiorly than inferiorly, which further stretches these ligaments so that they keep the articular surfaces of the joint in their close-packed position. During abduction the greater tubercle of the humerus comes in contact with the upper margin of the glenoid cavity, which limits maximum abduction. By rotating the humerus laterally, this