ABSTRACT: Symptomatic rotator cuff disease usually occurs whenbiological factors combine with dynamic events in the setting of staticstructural problems. At risk are persons with compromised blood supplyto the cuff tissues; a history of repetitive overhead or sudden,acute trauma to the rotator cuff; or abnormalities that disrupt thebalance of forces across the cuff. The key to management lies in understandingrotator cuff anatomy and biomechanics. Patients maypresent with pain and weakness, but tears also may be asymptomatic.A combination of physical examination, shoulder testing, and MRIusually will confirm the diagnosis. Evidence suggests that rotator cuffdisease can progress if the patient does not receive treatment. Rest,corticosteroids, and physical therapy are the basics of conservativecare. (J Musculoskel Med. 2008;25:481-488)
