A 60-Year-Old Recreational Athlete with a Rotator Cuff Tear and Repair

  • W. Ben Kibler


Rotator cuff function is a key component of maximal shoulder function, enabling concavity/compression, applied strength, and range of motion. Many senior athletes desire to continue active participation in overhead activities or activities that require shoulder motion. This case illustrates the evaluation of a senior athlete with rotator cuff-related symptoms and the initial treatment and demonstrates the range of possible methods of treatment to optimize function.

The patient demonstrated a common natural history of gradual increase in limiting symptoms, with chronic episodic pain and disability, interspersed with periods of good function. There were adaptations in use of the arms that allowed non symptomatic function. However, acute exacerbations of symptoms and consequent dysfunction, secondary to imposed trauma, which probably relate to increase in tear size, can be expected in a percentage of patients and require further evaluation and treatment. Rehabilitation of the local and distant physiological and biomechanical alterations in strength and flexibility found on clinical exam can be expected to improve functional capability and reduce symptoms in many patients. However, some patients may not improve after rehabilitation or may show some improvements in strength and flexibility without improvement in function. Surgical treatment should be considered early in the disease process to avoid the possibility of further tear progression and known poorer functional outcomes.


Rotator cuff injury Arthroscopy Senior athlete 


  1. 1.
    Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the “scapula summit”. Br J Sports Med. 2013;47:877–85.CrossRefGoogle Scholar
  2. 2.
    Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elb Surg. 2009;18:138–60.CrossRefGoogle Scholar
  3. 3.
    Sciascia A, Karolich D. A comprehensive approach for non-operative treatment of the rotator cuff. Curr Phys Med Rehabil Rep. 2013;1(1):29–37.CrossRefGoogle Scholar
  4. 4.
    Ellenbecker TS, Cools A. Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review. Br J Sports Med. 2010;44:319–27.CrossRefGoogle Scholar
  5. 5.
    McMullen J, Uhl TL. A kinetic chain approach for shoulder rehabilitation. J Athl Train. 2000;35(3):329–37.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Sciascia A, Cromwell R. Kinetic chain rehabilitation: a theoretical framework. Rehabil Res Pract. 2012;2012:1–9.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • W. Ben Kibler
    • 1
  1. 1.Shoulder Center of Kentucky, Lexington ClinicLexingtonUSA

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