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Full-thickness tears may also involve complete detachment of the tendon(s) from the humeral head and may result in significantly impaired shoulder motion and function. Shoulder pain is variable and may not be proportional to the size of the tear. Tears are also sometimes classified based on the trauma that caused the injury:
When the arm is raised, the subacromial space (gap between the anterior edge of the acromion and the head of the humerus) narrows; the supraspinatus muscle tendon passes through this space. [6] Anything that causes further narrowing has the tendency to impinge the tendon and cause an inflammatory response, resulting in impingement syndrome.
The infraspinatus and teres minor fuse near their musculotendinous junctions, while the supraspinatus and subscapularis tendons join as a sheath that surrounds the biceps tendon at the entrance of the bicipital groove. [3] The supraspinatus is most commonly involved in a rotator cuff tear.
One study has indicated that arthroscopic surgery for full-thickness supraspinatus tears is effective for improving shoulder functionality. [9] A comparative effectiveness review of nonoperative and operative treatments for rotator cuff tears was performed at the University of Alberta Evidence-based Practice Center in 2010.
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle. [1]
The rotator cuff can cause pain in many different ways including tendonitis, bursitis, calcific tendonitis, partial thickness tears, full thickness tears or mechanical impingement. [5] Tendinitis, bursitis, and impingement syndrome can be treated with tendon repair and the Mumford procedure or acromioplasty. [citation needed]