Article

The etiology of rotator cuff tendinopathy is multi-factorial, and has been
attributed to both extrinsic and intrinsic mechanisms. Extrinsic factors that
encroach upon the subacromial space and contribute to bursal side compression of
the rotator cuff tendons include anatomical variants of the acromion, alterations
in scapular or humeral kinematics, postural abnormalities, rotator cuff and
scapular muscle performance deficits, and decreased extensibility of pectoralis
minor or posterior shoulder. A unique extrinsic mechanism, internal impingement,
is attributed to compression of the posterior articular surface of the tendons
between the humeral head and glenoid and is not related to subacromial space
narrowing. Intrinsic factors that contribute to rotator cuff tendon degradation
with tensile/shear overload include alterations in biology, mechanical
properties, morphology, and vascularity. The varied nature of these mechanisms
indicates that rotator cuff tendinopathy is not a homogenous entity, and thus may
require different treatment interventions. Treatment aimed at addressing
mechanistic factors appears to be beneficial for patients with rotator cuff
tendinopathy, however, not for all patients. Classification of rotator cuff
tendinopathy into subgroups based on underlying mechanism may improve treatment
outcomes.
CI - 2010 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS