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Adults over the age of 60 are more susceptible to a rotator cuff tear, with the overall frequency of tears increasing with age. [92] By the age of 50 10% of people with normal shoulders have a rotator cuff tear. [93] In an autopsy study of rotator cuff tears, the incidence of partial tears was 28%, and of complete rupture 30%.
A torn rotator cuff can occur following trauma to the shoulder or it can occur through the "wear and tear" on tendons, most commonly the supraspinatus tendon found under the acromion. Rotator cuff injuries are commonly associated with motions that require repeated overhead motions or forceful pulling motions.
Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear; Drop arm test: a positive test indicates a supraspinatus tear; External Rotation test: a positive test indicates an infraspinatus or teres minor tear
The primary cause of shoulder pain is a rotator cuff tear. [20] The supraspinatus is most commonly involved in a rotator cuff tear, [22] but other parts of the rotator cuff may also be involved. There are different severities of a rotator cuff tear, which range from a partial tear to a full-thickness tear. [23]
In both tests, the patient is placed in a standing or sitting position, and the arms are raised parallel to the ground in the scapular plane. [2] The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1]
In tendinitis of the shoulder, the rotator cuff and/or biceps tendon become inflamed, usually as a result of being pinched by surrounding structures. The injury may vary from mild inflammation to involvement of most of the rotator cuff. When the rotator cuff tendon becomes inflamed and thickened, it may get trapped under the acromion.
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