Rotator cuff tear rotator cuff tear. Generally, the incidence of rotator cuff tears or injuries increases by age while corticosteroid injection for pain relief increases the risk of tendon tear and delays tendon healing. The shoulder is a complex mechanism involving bones, ligaments, joints, muscles, and tendons. The two main causes are injury (acute) and degeneration (chronic and cumulative), and the mechanisms involved can be either extrinsic or intrinsic or, probably most commonly, a combination of both. The cuff is responsible for stabilizing the glenohumeral joint, abducting, externally rotating, and internally rotating the humerus. When shoulder trauma occurs, these functions can be compromised.
Rotator cuff tear single physical examination test distinguishes reliably between bursitis, partial-thickness, and full-thickness tears. On the contrary, a combination of tests seems to provide the most accurate diagnosis. For impingement, these tests include the Hawkins-Kennedy impingement sign in which the examiner medially rotates the patient's flexed arm, forcing the supraspinatus tendon against the coracoacromial ligament and so producing pain if the test is positive a positive painful arc sign, and weakness in external rotation with the arm at the side. For the diagnosis of full-thickness rotator cuff tear, the best combination appears to include once more the painful arc and weakness in