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
Rotator cuff a rotator cuff tear can include rest, ice, physical therapy, and/or surgery. A published review of 14 trials involving 829 patients found that there is insufficient evidence to demonstrate whether surgery is any better than non-surgical options. A review of manual therapy and exercise treatments found inconclusive evidence as to whether these treatments were any better than placebo, however ""High quality evidence from one trial suggested that manual therapy and exercise improved function only slightly more than placebo at 22 weeks, was little or no different to placebo in terms of other patient-important outcomes (e.g. overall pain), and was associated