Repetitive microtrauma and anatomical variations lead to most of the rotator cuff injuries. Many individuals with full thickness cuff tears are not only asymptomatic, but have minimal functional disability. Surgery results in better function regardless of the patient's age. The great majority is found in patients aged 55-85 years. Younger patients are more likely to have rotator cuff dysfunction due to overuse, subtle instability, and muscle imbalance.
Older patients tend to have chronic shoulder pain and degeneration.
Pain should be characterized according to its duration of onset, location, radiation, timing, and quality. In addition, investigate pain for its relationship to activities and sport. Pain is the most common symptom encountered with rotator cuff injury. Pain usually is located anterolaterally and superiorly, and referred to the level of the deltoid insertion with full thickness tears. Pain is aggravated in activities where the arm must be in an overhead or in a forward-flexed position.