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
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