Rotator cuff tear With longer-standing pain, the shoulder is favored and gradually loss of motion and weakness may develop, which, due to pain and guarding, are often unrecognized by the patient and only brought to attention during examination. Primary shoulder problems may cause pain over the deltoid muscle intensified by abduction against resistance - the impingement sign. This signifies pain arising from the rotator cuff, but cannot distinguish between inflammation, strain, or tear. Patients may report that they are unable to reach upwards to brush their hair or to lift a food can from an overhead shelf. It has been suggested that no
Rectus sheath transversalis fascia, in contrast to the upper layers, where part of the internal oblique also runs beneath the rectus. Because of the thinner layers below, this region is more susceptible to herniation. Since the tendons of the internal oblique and transversus abdominis only reach as high as the costal margin, it follows that above this level the sheath of the rectus is deficient behind, the muscle resting directly on the cartilages of the ribs, and being covered only by the tendons of the external obliques. Rectus sheath The rectus sheath, also called the rectus fascia, is formed by the aponeuroses