Age dependent increase in the incidence of rotator cuff disease has been long established and accepted by the medical community. There are a common set of rotator cuff injuries and disease that we see with patients of different ages.
The spectrum of disease typically starts in patients 25 and younger when changes in the tendon are inflammed due to edema and hemorrhage resulting from injury or repetitive activities. An example of a typical patient suffering from this condition would be a young pitcher with shoulder pain after a period of high pitch count. Between the ages of 25 to 40, the changes in the tendon are more in line with irreversible tendon fibrosis. In both of these groups, the treatment for the injury tends to be very conservative. Surgical intervention is limited to a subgroup of patients that don’t respond to conservative treatments like physical therapy.
In the over 40 population, sports medicine specialists see an increase in the incidences of rotator cuff tears. In fact, the incidence of asymptomatic tears can be as high as 20 to 23% in patients older than 50. Unlike the injuries of younger populations, these symptomatic tears usually require surgical intervention. Studies have identified that those aged 65 or older often experience poor healing after rotator cuff repairs.