The most severe forms of rotator cuff injury have two common causes. They are separated into acute and chronic onset injuries.
An "acute" onset is related to an identifiable incident or event. This can be something such as a sports injury or car crash. This is the most common cause of cuff problems in younger people (under 40 years old).
A "chronic" injury comes on more slowly over time and is much more common in people over 40. A chronic injury is often caused through gradual wear and tear or impingement of the cuff tendons.
Tremendous damage can be done to the human body by car crashes, sports injuries and falls. Anything with a significant impact can result in an injury to the rotator cuff. Such events are, thankfully, still quite rare.
If you have suffered just such a misfortune your cuff is likely to be fairly low down in order of priority. You will be much more concerned with stabilising major organs, healing broken bones and being put back together again.
Over time, however, you will realise that your rotator cuff injury symptoms will also require attention. Chances are this was overlooked at the time of the original incident; unless you suffered significant shoulder damage. There are just too many complicating factors in trauma cases for me to cover all possibilities now.
By far, the severest rotator cuff injury is a complete rupture or full thickness tear. This is often complicated by the tendon detaching itself from the Humerus.
The degree of severity is generally considered to be decided upon the size of the tear. This can be further complicated by the number of torn tendons. For example, a full thickness tear of two, or more, rotator cuff tendons, is about as bad as it could ever get.
A fully torn rotator cuff may require surgery but this is not always the best option. Surgical success increases in relation to patient age. The younger you are, the better the overall quality of the affected tendon is likely to be, this improves the chances of healing.
The two major symptoms associated with cuff injuries are pain and weakness. The pain can be severe and the weakness truly debilitating. Pain and weakness can also lead to further problems developing; everything from sleep disorders to depression.
The pain is often centred on the front and outer part of the shoulder, particularly towards the point. Weakness in the shoulder can affect both strength and range of movement.
The most severe cases will always require surgery. In all other cases, exercise is the key. Pain is reduced, strength and mobility restored and all purely through rest and following a straightforward exercise program.
Surgical success varies from 90% in the young with small tears and good quality tendons to a failure rate of 40% in older patients with large tears and poor quality tendons.