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Key Features

  • Shoulder injuries are often a consequence of repetitive overuse and tissue failure

  • Rotator cuff tendonitis and bursitis are the most commonly observed rotator cuff injuries in youth sports

  • Rotator cuff tears in children and adolescents are exceedingly rare

  • These overuse injuries typically occur in sports requiring repetitive overhead motions

    • Muscle imbalances and injury can cause the position of the humeral head to be abnormal, which may cause entrapment of the supraspinatus tendon under the acromial arch

    • Patients with nontraumatic shoulder instability due to ligamentous and capsular laxity (also known as multidirectional instability) are prone to overuse rotator cuff injury

Clinical Findings

  • Injury can be acute or chronic

  • Pain is described as diffuse or anterior and lateral

  • Overhead activities exacerbate the pain


  • Diagnostic workup includes plain radiographs and an outlet view to look for anatomic variability


  • Rehabilitation of this injury is geared toward reduction of inflammation, improved flexibility, and core stabilization and strengthening of the scapular stabilizers and rotator cuff muscles

  • A biomechanics evaluation can assist athletes in the recovery process by building sport-specific skills and eliminating substitution patterns

  • Surgery is rarely indicated

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