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
Annular ligaments of fingers Annular ligaments of fingers In human anatomy, the annular ligaments of the fingers, often referred to as A pulleys, are the annular part of the fibrous sheathes of the fingers. Four or five such annular pulleys, together with three cruciate pulleys, form a fibro-osseous tunnel on the palmar aspect of the hand through which passes the deep and superficial flexor tendons. The annular and cruciate ligaments serve to govern the flexor mechanism of the hand and wrist, providing critical constraints to the flexor tendons to prevent bowstringing upon contraction and excursion of extrinsic flexor musculo-tendinous units. The first annular pulley