Partial rotator cuff injury in athletes: bursal or articular?

Abstract

A painful shoulder is a very common complaint among athletes, especially in the case of those in sports involving throwing. Partial lesions of the rotator cuff may be very painful and cause significant functional limitation to athletes’ sports practice. The incidence of partial lesions of the cuff is variable (13–37%). It is difficult to make the clinical and radiological diagnosis, and this condition should be borne in mind in the cases of all athletes who present symptoms of rotator cuff syndrome, including in patients who are diagnosed only with tendinopathy.ObjectiveTo evaluate the epidemiological behavior of partial lesions of the rotator cuff in both amateur and professional athletes in different types of sports.MethodsWe evaluated 720 medical files on athletes attended at the shoulder service of the Discipline of Sports Medicine at the Sports Traumatology Center, Federal University of São Paulo. The majority of them were men (65%). Among all the patients, 83 of them were diagnosed with partial lesions of the rotator cuff, by means of ultrasonography or magnetic resonance, or in some cases using both. We applied the binomial test to compare the proportions found.ResultIt was observed that intra-articular lesions predominated (67.6%) and that these occurred more frequently in athletes in sports involving throwing (66%). Bursal lesions occurred in 32.4% of the athletes, predominantly in those who did muscle building (75%).ConclusionIntra-articular lesions are more frequent than bursal lesions and they occur predominantly in athletes in sports involving throwing, while bursal lesions were more prevalent in athletes who did muscle building.

Magnetic resonance imaging of the shoulder

“…Articular-sided tears are more common than bursal-sided tears. A study on athletes showed a similar trend, but noted a higher number of articular-sided tears in athletes who throw repeatedly, while bursal-sided tears were likely in weightlifters [26]. Differences in the composition of these two regions (complex of tendon, joint, and ligament in articular-sided v. tendon bundles in bursal-sided regions) may be a reason why articular-sided regions are more vulnerable to a tensile load [27].…”

Ultrasound-Guided Injection of a Tendon-Compatible Hyaluronic Acid Preparation for the Management of Partial Thickness Rotator Cuff Tear: A Case Report

“…Regarding the etiology of partial tears, bursal-side tears tend to be primarily caused by biomechanical subacromial impingement on a progressively degenerated tendon, while articular side tears result from trauma, repetitive movements, and/or an insidious start associated with degenerative age-related alterations on the tendon. In contrast, intrasubstance tears can result from internal tendon degeneration, namely cellular or extracellular matrix degenerative degradation [ 3 ].…”

Perfil nociceptivo e uso de analgésicos em pacientes submetidos à cirurgia de reparo do manguito rotador: Coorte prospectiva

“… 12 Partial rotator cuff injuries has an incidence of 13% to 37% of world population. 13 However, rotator cuff surgical repair, either open or arthroscopic, is the best conduct in case of persistent pain and evolutive muscle weakness. 14 Peripheral nerve block may provide adequate analgesia in immediate postoperative until 20 hours.…”