Purpose: A review was conducted to synthesise the available research literature on the pathogenesis of rotator cuff tendinopathy.
Relevance: Musculoskeletal disorders of the shoulder are extremely common, with reports of prevalence ranging from 1 in 3 people experiencing shoulder pain at some stage of their lives to approximately half the population experiencing at least one episode of shoulder pain annually. Pathology of the soft tissues of the shoulder including the musculotendinous rotator cuff and subacromial bursa are a principle cause of pain and suffering.
Conclusions: The pathoaetiology of rotator cuff failure is multifactorial and results from a combination of intrinsic, extrinsic and environmental factors. The specialised morphology of the rotator cuff together the effects of stress shielding may contribute to the development of rotator cuff tendinopathy. Profound changes within the subacromial bursa are strongly related to the pathology and resulting symptoms. A considerable body of research is necessary to more fully understand the aetiology, pathohistology of rotator cuff tendinopathy and its relationship with bursal pathology. Once this knowledge exists more effective management will become available.