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 tear extension, or vertical abduction, it is less likely to suffer from a tear of the tendon. Those suspected of having a rotator cuff tear may have operative or non-operative treatment. No evidence of benefit is seen from early rather than delayed surgery, and many with partial tears and some with complete tears will respond to nonoperative management. Consequently, many recommend initial, nonsurgical management. However, early surgical treatment may be considered in significant (>1 cm-1.5 cm) acute tears or in young patients with full-thickness tears who have a significant risk for the development of irreparable rotator cuff changes. A review in