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Key Features

  • Can be due to trauma or be more degenerative

  • Can be caused by acute injuries related to falls on an outstretched arm or to pulling on the shoulder

  • Can also be related to chronic repetitive injuries with overhead movement and lifting

  • Partial tears are one of the most common reasons for impingement syndrome

  • Full thickness rotator cuff tears are usually more symptomatic and may require surgical treatment

  • The most commonly torn tendon is the supraspinatus

Clinical Findings

  • Difficulty lifting the arm with limited active range of motion

  • Weakness with resisted strength testing suggests full thickness tears

  • Night pain is also a common complaint

  • The affected patient usually also has positive Neer and Hawkins impingement tests usually positive

  • See Table 41–1

Table 41–1.Shoulder examination.

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