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
Shoulder joint the biceps brachii on the anterior side of the arm, and tendons of the rotator cuff; which are fused to all sides of the capsule except the inferior margin. The tendon of the long head of the biceps brachii passes through the bicipital groove on the humerus and inserts on the superior margin of the glenoid cavity to press the head of the humerus against the glenoid cavity. The tendons of the rotator cuff and their respective muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) stabilize and fix the joint. The supraspinatus, infraspinatus and teres minor muscles aid in abduction and